title: Cervical Spine pain as a presenting complaint in metastatic pancreatic cancer: a case report.
abstract: A 48 year-old female presented to her primary care physician with a two-month history of neck pain with negative cervical spine x-rays. During that office visit, the patient was noted to be tachycardic with EKG revealing ST depressions, which led to hospital admission. Acute coronary syndrome was ruled out, however, persistent neck pain warranted inpatient MRI of the cervical spine, which revealed a cervical spine lesion. Extensive investigation and biopsy ultimately confirmed stage IV pancreatic adenocarcinoma with metastases to the bone, liver, and likely lung. In the literature, the findings of a primary metastatic site being bone is rare with only a few case reports showing vertebral or sternal metastasis as the first clinical manifestation of pancreatic cancer. The uniqueness of this case lies in the only presenting complaint being cervical spine pain in the setting of extensive metastases to the liver, bone, and likely lung.
authors.affiliation: a The Department of Family Medicine , University of South Florida , Tampa , FL , USA.
authors.forename: Emily
authors.initials: E
authors.lastname: Rosenberg
authors.affiliation: a The Department of Family Medicine , University of South Florida , Tampa , FL , USA.
authors.forename: Lindsey
authors.initials: L
authors.lastname: Buchtel
mesh_terms: D000230:Adenocarcinoma / Q000150:complications / Q000175:diagnosis* / Q000556:secondary; D001368:Axis, Cervical Vertebra / Q000000981:diagnostic imaging / Q000473:pathology*; D001859:Bone Neoplasms / Q000175:diagnosis / Q000556:secondary; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000556:secondary; D008175:Lung Neoplasms / Q000175:diagnosis / Q000556:secondary; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D019547:Neck Pain / Q000175:diagnosis* / Q000209:etiology; D010190:Pancreatic Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology; D012272:Ribs / Q000000981:diagnostic imaging; D013125:Spinal Neoplasms / Q000150:complications / Q000175:diagnosis* / Q000556:secondary; D015899:Tomography, Emission-Computed, Single-Photon; D014057:Tomography, X-Ray Computed
keywords: Cervical spine metastasis; bone pain; neck pain; pancreatic adenocarcinoma