title: Lung cancer presenting as a metastasis to the tibial bones: a case report.
abstract: OBJECTIVE
  Bone metastasis below the knee from primary lung cancer is rare. Discussion of such cases in a multidisciplinary team is important to establish the correct treatment approach.
  
  
  METHODS
  We analyzed the diagnostic pathway of a 53-year-old female patient with a 5-month history of pain in the right foot. The patient underwent several radiological examinations for the pain. An initial diagnosis of osteoporotic syndrome was made, followed by a diagnosis of primary sarcoma. Only when the patient continued to have pain were other radiological examinations performed and a biopsy of the right ankle taken. This revealed a metastasis from undifferentiated pulmonary adenocarcinoma. A total-body computed tomography scan did not show any tumor locations apart from the primary lung cancer. The patient underwent chemotherapy and palliative therapies. This case has been reported for its rarity.
authors.affiliation: Oncology Institute of Southern Switzerland, Bellinzona - Switzerland.
authors.forename: Lorena
authors.initials: L
authors.lastname: Gurrieri
authors.forename: Alessandra
authors.initials: A
authors.lastname: Longhi
authors.forename: Antonio
authors.initials: A
authors.lastname: Braghetti
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis* / Q000556:secondary*; D000077192:Adenocarcinoma of Lung; D001859:Bone Neoplasms / Q000150:complications / Q000000981:diagnostic imaging / Q000556:secondary*; D003937:Diagnosis, Differential; D003951:Diagnostic Errors; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000556:secondary; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D010146:Pain / Q000209:etiology*; D013977:Tibia / Q000473:pathology*; D014057:Tomography, X-Ray Computed