title: Psoas abscess secondary to retroperitoneal distant metastases from squamous cell carcinoma of the cervix with thrombosis of the inferior vena cava and duodenal infiltration treated by Whipple procedure: A case report and review of the literature.
abstract: BACKGROUND
  Psoas abscess is a rare clinical disease of various origins. Most common causes include hematogenous spread of bacteria from a different primary source, spondylodiscitis or perforated intestinal organs. But rarely some abscesses are related to malignant metastatic disease.
  
  
  METHODS
  In this case report we present the case of a patient with known squamous cell carcinoma of the cervix treated with radio-chemotherapy three years prior. She now presented with a psoas abscess and subsequent complete inferior vena cava thrombosis, as well as duodenal and vertebral infiltration. The abscess was drained over a prolonged period of time and later was found to be a complication caused by metastases of the cervical carcinoma. Due to the massive extent of the metastases a Whipple procedure was performed to successfully control the local progress of the metastasis.
  
  
  CONCLUSIONS
  As psoas abscess is an unspecific disease which presents with non-specific symptoms adequate therapy may be delayed due to lack of early diagnostic results. This case report highlights the difficulties of managing a malignant abscess and demonstrates some diagnostic pitfalls that might be encountered. It stresses the necessity of adequate diagnostics to initiate successful therapy. Reports on psoas abscesses that are related to cervix carcinoma are scarce, probably due to the rarity of this event, and are limited to very few case reports. We are the first to report a case in which an extensive and complex abdominal procedure was needed for local control to improve quality of life.
authors: Department of Surgery II, Faculty of Medicine, Clinic for Visceral, Transplantation, Thoracic and Vascular Surgery, OKL, University of Leipzig, Liebig Strasse 20, Leipzig, 04103, Germany.
authors: Matthias
authors: M
authors: Mehdorn
authors: Department of Radiology, University of Leipzig, Liebig Strasse 20, Leipzig, 04103, Germany.
authors: Tim-Ole
authors: TO
authors: Petersen
authors: Department of Surgery II, Faculty of Medicine, Clinic for Visceral, Transplantation, Thoracic and Vascular Surgery, OKL, University of Leipzig, Liebig Strasse 20, Leipzig, 04103, Germany.
authors: Michael
authors: M
authors: Bartels
authors: Department of Surgery II, Faculty of Medicine, Clinic for Visceral, Transplantation, Thoracic and Vascular Surgery, OKL, University of Leipzig, Liebig Strasse 20, Leipzig, 04103, Germany.
authors: Boris
authors: B
authors: Jansen-Winkeln
authors: Department of Surgery II, Faculty of Medicine, Clinic for Visceral, Transplantation, Thoracic and Vascular Surgery, OKL, University of Leipzig, Liebig Strasse 20, Leipzig, 04103, Germany. woubet.kassahun@uniklinik-leipzig.de.
authors: Woubet Tefera
authors: WT
authors: Kassahun
mesh_terms: D002294:Carcinoma, Squamous Cell / Q000000981:diagnostic imaging / Q000556:secondary* / Q000601:surgery; D004322:Drainage; D005260:Female; D006801:Humans; D008875:Middle Aged; D016577:Pancreaticoduodenectomy; D016659:Psoas Abscess / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D012186:Retroperitoneal Neoplasms / Q000000981:diagnostic imaging / Q000556:secondary* / Q000601:surgery; D013927:Thrombosis / Q000209:etiology*; D014057:Tomography, X-Ray Computed; D002583:Uterine Cervical Neoplasms / Q000473:pathology*; D014682:Vena Cava, Inferior
keywords: Malignant psoas abscess; Squamous cell carcinoma of the cervix; Whipple procedure