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A "cough induced" pelvic fracture as the first sign of a malignant neoplasm.

Sharma N, Sidhu M, Simpson D - Int J Surg Case Rep (2015)

Bottom Line: The patient had been investigated extensively six months before presentation for weight loss, but results were inconclusive.Despite this patient having being investigated extensively for a presumed neoplasm the results of which, at the time were inconclusive, she presented six-months later with lung cancer and gross metastasis to the stomach, liver and bone, not amenable for active treatment.This case highlights the importance of considering sinister causes in patients presenting with non-traumatic pelvic fractures and the need for regular follow up for those patients investigated with unexplained weight-loss with inconclusive results, but with a high index of suspicion for malignancy.

View Article: PubMed Central - PubMed

Affiliation: Specialty registrar CT3, Royal Stoke NHS Trusts, UK. Electronic address: n-sharma@doctors.org.uk.

No MeSH data available.


Related in: MedlinePlus

A computerized tomography of the thorax showing a right hilar mass with lymphadenopathy.
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fig0015: A computerized tomography of the thorax showing a right hilar mass with lymphadenopathy.

Mentions: Plain radiographs demonstrated an undisplaced, fracture of the left ilial wing with suspicion of metastatic deposits around the fracture site (see Fig. 1). Further imaging, with magnetic resonance was obtained and revealed multiple focal abnormalities of the pelvis and femur with vertebral collapse at T7 and L1 (see Fig. 2). CT thorax identified a right hilar lung mass with multiple metastases to the ribs, T9, L1, pelvis and liver (see Fig. 3). This was thought to be a stage 4 metastatic lung cancers. The patient underwent a further OGD, on which an ulcer was identified. Histology revealed a poorly differentiated gastric adenocarcinoma. Serum electrophoresis and urinary Bence-Jones protein were both negative. The fracture was managed conservatively with analgesia, physiotherapy and mobilization.


A "cough induced" pelvic fracture as the first sign of a malignant neoplasm.

Sharma N, Sidhu M, Simpson D - Int J Surg Case Rep (2015)

A computerized tomography of the thorax showing a right hilar mass with lymphadenopathy.
© Copyright Policy - CC BY-NC-ND
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4446674&req=5

fig0015: A computerized tomography of the thorax showing a right hilar mass with lymphadenopathy.
Mentions: Plain radiographs demonstrated an undisplaced, fracture of the left ilial wing with suspicion of metastatic deposits around the fracture site (see Fig. 1). Further imaging, with magnetic resonance was obtained and revealed multiple focal abnormalities of the pelvis and femur with vertebral collapse at T7 and L1 (see Fig. 2). CT thorax identified a right hilar lung mass with multiple metastases to the ribs, T9, L1, pelvis and liver (see Fig. 3). This was thought to be a stage 4 metastatic lung cancers. The patient underwent a further OGD, on which an ulcer was identified. Histology revealed a poorly differentiated gastric adenocarcinoma. Serum electrophoresis and urinary Bence-Jones protein were both negative. The fracture was managed conservatively with analgesia, physiotherapy and mobilization.

Bottom Line: The patient had been investigated extensively six months before presentation for weight loss, but results were inconclusive.Despite this patient having being investigated extensively for a presumed neoplasm the results of which, at the time were inconclusive, she presented six-months later with lung cancer and gross metastasis to the stomach, liver and bone, not amenable for active treatment.This case highlights the importance of considering sinister causes in patients presenting with non-traumatic pelvic fractures and the need for regular follow up for those patients investigated with unexplained weight-loss with inconclusive results, but with a high index of suspicion for malignancy.

View Article: PubMed Central - PubMed

Affiliation: Specialty registrar CT3, Royal Stoke NHS Trusts, UK. Electronic address: n-sharma@doctors.org.uk.

No MeSH data available.


Related in: MedlinePlus