A Young Female With Low Back Pain Caused by Stage IV Lung Cancer

Year 2021, , 26 - 29, 29.01.2021

Firdevs Ulutaş , Mahmut Demirci Ferda Bir , Veli Çobankara , Uğur Karasu

https://doi.org/10.46310/tjim.794913

Abstract

Abstract

Low back pain is one of the most common symptoms, having a broad range of etiologies in differential diagnosis, such as inflammatory and degenerative disorders, malignancy and infections. Herein we present an interesting patient who initially presented with sacroiliitis and was ultimately diagnosed with stage IV lung cancer. She was initially misdiagnosed as axial spondyloarthritis. We aim to emphasize red flags in the differential diagnosis of sacroiliitis. Hypercalcemia and progressive, unbearable low back pain were supportive factors for underlying malignancy in our case.

Keywords

lung cancer, sacroiliitis, hypercalcemia

References

• 1. Shaye Kivity, Shany Guly Gofrit, Fadi Abu Baker, Maama Leibushor, Shahar Tavor, Merav Lidar, Iris Eshed. Association between inflammatory back pain features, acute and structural sacroiliitis on MRI, and the diagnosis of spondyloarthritis. Clin Rheumatol. 2019;38(6):1579-1585.
• 2. Braun J, Sieper J, Bollow M. Imaging of sacroiliitis. Clin Rheumatol. 2000;19:51-7.
• 3. S M Humphrey, R D Inman. Metastatic adenocarcinoma mimicking unilateral sacroiliitis. J Rheumatol. 1995;22(5):970-2.
• 4. Zheng Zhao, Yanyan Wang, Jingyu Jin, Xiaohu Deng, Feng Huang. An analysis of abnormal magnetic resonance imaging of sacroiliac joints in patients misdiagnosed as spondyloarthritis. Zhonghua Nei Ke Za Zhi. 2014;53(9):724-9.
• 5. T Witte, X Baraliakos. Magnetic resonance imaging (MRI) diagnostics in axial spondyloarthritis. Z Rheumatol. 2017;76(7):574-579.
• 6. Janneke de Winter, Manouk de Hooge, Marleen van de Sande, Henriette de Jong, Lonneke van Hoeven, Anıek de Koning. Magnetic Resonance Imaging of the Sacroiliac Joints Indicating Sacroiliitis According to the Assessment of Spondylo Arthritis international Society Definition in Healthy Individuals, Runners, and Women With Postpartum Back Pain. Arthritis Rheumatol. 2018;70(7):1042-1048.
• 7. Arianne P Verhagen, Aron Downie, Nahid Popal, Chris Maher, Bart W Koes. Red flags presented in current low back pain guidelines: a review. Eur Spine J. 2016;25(9):2788-802.
• 8. Nurullah Akkoc, Muhammad A Khan. ASAS classification criteria for axial spondyloarthritis: time to modify. Clinical Rheumatology. 2016;35:1415-1423.
• 9. Xu Li, Zhixin Bie, Zijin Zhang, Yuanming Li, Xueging Hu, Wenbo Liu. Clinical analysis of 64 patients with lung-cancer-associated hypercalcemia. J Cancer Res Ther. 2015;11 Suppl:C275-9.
• 10. Xu Song, Fengmin Wang, Haibo Shen, Jie Li, Tianjun Hu, Zhenhua Yang. Correlation between Plasma D-dimer Count and Features of Non-small Cell Lung Cancer. Zhongguo Fei Ai Za Zhi. 2019(20);22(3):151-156.