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Case Report
Isolated back pain as an initial presentation of diffusely metastatic renal cell carcinoma
1 Internal Medicine Residency, Morehouse School of Medicine, Atlanta, GA, USA
2 Cardiovascular disease Fellowship, Morehouse School of Medicine, Atlanta, GA, USA
3 Division of Hematology and Oncology, Morehouse School of Medicine, Atlanta, GA, USA
Address correspondence to:
Iloabueke Chineke
MD, 3232 Verdant Drive SW, Apt 414, Atlanta, GA 30331,
USA
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Article ID: 100059Z10IC2018
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Chineke I, Kagbo-Kue S, Egbuche O, Jain S. Isolated back pain as an initial presentation of diffusely metastatic renal cell carcinoma. J Case Rep Images Oncology 2018;4:100059Z10IC2018.ABSTRACT
Introduction: Renal cell carcinoma classically presents with the triad of flank pain, hematuria, and a palpable abdominal mass. Non-specific back pain has rarely been reported as the initial presenting symptom. Most patients who present with back pain do not require additional imaging or testing, however suspicion of serious underlying pathology, such as malignancy, may be an important reason to obtain further workup for back pain.
Case Report: A 40-year-old male with no significant past medical history presented with generalized back pain and was discovered to have a highly elevated alkaline phosphatase. Computed tomography scan of the abdomen and pelvis showed an upper pole right renal mass with diffuse heterogeneous areas of both lytic and sclerotic lesions in the bones. A core biopsy from the iliac crest revealed metastatic renal cell cancer and positron emission tomography scan was significant for extensive metastasis. The patient was placed on palliative treatment with sunitinib and radiotherapy.
Conclusion: Renal cell carcinoma is uncommon in people less than 50 years and isolated non-specific back pain as an initial presentation of diffusely metastatic renal cell carcinoma with both lytic and sclerotic osseous lesions to the best of our knowledge is a rare phenomenon.
Keywords: Backpain, Carcinoma, Metastatic, Mixed osseous metastases, Renal
SUPPORTING INFORMATION
Author Contributions
Iloabueke Chineke - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Suaka Kagbo-Kue - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Obiora Egbuche - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Sanjay Jain - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Guaranter of SubmissionThe corresponding author is the guarantor of submission.
Source of SupportNone
Consent StatementWritten informed consent was obtained from the patient for publication of this case report.
Data AvailabilityAll relevant data are within the paper and its Supporting Information files.
Conflict of InterestAuthors declare no conflict of interest.
Copyright© 2018 Iloabueke Chineke et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.
