Bibliographic Details
| Title: |
Spontaneous sacral fracture with associated acrometastasis of the hand. |
| Authors: |
Umana, Giuseppe Emmanuele, Scalia, Gianluca, Palmisciano, Paolo, Passanisi, Maurizio, Pompili, Gianluca, Amico, Paolo, Ippolito, Massimo, Sabini, Maria Gabriella, Cicero, Salvatore, Perrotta, Rosario |
| Source: |
Surgical Neurology International; 10/25/2021, Vol. 12, p1-4, 4p |
| Subject Terms: |
SACRAL fractures, SPONTANEOUS fractures, PROGNOSIS, LUMBAR pain, FINGERS, METASTASIS |
| Abstract: |
Background: Acrometastases, secondary tumors affecting oncological patients with systemic metastases, are associated with a poor prognosis. In rare cases, acrometastases may precede establishing the primary tumor diagnosis. Case Description: A 72-year-old female heavy smoker presented with low back pain, and right lower extremity sciatica/radiculopathy. X-rays, CT, MR, and PET-CT scans documented primary lung cancer with multi-organ metastases and accompanying pathological fractures involving the sacrum (S1) and right 4th digit. She underwent a S1 laminectomy and amputation of the distal phalanx of the right fourth finger. The histological examination documented a poorly differentiated pulmonary adenocarcinoma infiltrating bone and soft tissues in the respective locations. The patient was treated with a course of systemic immunotherapy (i.e. pembrolizumab). At 6-month follow-up, the patient is doing well and can stand and walk without pain. Conclusion: Spontaneous sacral fractures may be readily misdiagnosed as osteoporotic and/or traumatic lesions. However, in this case, the additional simultaneous presence of a lytic finger lesion raised the suspicion that these were both metastatic tumors. Such acrometastases, as in this case attributed to a lung primary, may indeed involve the spine. [ABSTRACT FROM AUTHOR] |
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| Database: |
Complementary Index |
