title: Lung cancer presenting as heel pain: A case report.
abstract: Bone metastasis as the first symptom of lung cancer is common, particularly in the axial skeleton. The calcaneus is an unusual site of metastatic involvement. Chronic plantar heel pain (CPHP) is one of the most common complaints of the foot requiring medical treatment. The most typical symptom of CPHP is pain under the medial heel during weight-bearing, and this symptom is therefore generally initially diagnosed as CPHP by clinicians. The current case study reports a female patient never-smoker with non-small cell lung cancer accompanied by calcaneal metastasis presenting as heel pain. The patient was initially diagnosed with CPHP without any imaging examinations. As there was no relief from the heel pain six months later, a foot X-ray was performed, which revealed a lesion of the calcaneus. The analysis of a biopsy obtained from the lesion resulted in a diagnosis of adenocarcinoma. The present case indicates that patients suspected to have CPHP should be conventionally examined with radiography of the foot during the initial diagnosis. Similarly, if a patient with lung cancer has symptoms such as CPHP, distant metastasis should be accounted for; despite their rarity, clinicians should maintain a high level of suspicion, since accurate diagnosis and timely treatment is important in management and outcome.
authors.affiliation: Department of Orthopedics, Guanghua Integrative Medicine Hospital, Shanghai 200052, P.R. China.
authors.forename: Hao
authors.initials: H
authors.lastname: Dai
authors.affiliation: Department of Orthopedics and Traumatology, East Hospital, Tongji University School of Medicine, Shanghai 200120, P.R. China.
authors.forename: Minfei
authors.initials: M
authors.lastname: Qiang
authors.affiliation: Department of Orthopedics and Traumatology, East Hospital, Tongji University School of Medicine, Shanghai 200120, P.R. China.
authors.forename: Yanxi
authors.initials: Y
authors.lastname: Chen
authors.affiliation: Department of Orthopedics, Guanghua Integrative Medicine Hospital, Shanghai 200052, P.R. China.
authors.forename: Weitao
authors.initials: W
authors.lastname: Zhai
authors.affiliation: Department of Orthopedics and Traumatology, East Hospital, Tongji University School of Medicine, Shanghai 200120, P.R. China.
authors.forename: Kun
authors.initials: K
authors.lastname: Zhang
keywords: biopsy; bone metastasis; heel pain; lung cancer