Background: A case of metastatic carcinoma secondary to urothelial carcinoma presenting as musculoskeletal pain
is reported. A brief review of urothelial and metastatic carcinoma including clinical presentation, diagnostic testing,
treatment and chiropractic considerations is discussed.
Case presentation: This patient presented in November 2014 with progressive neck, thorax and upper extremity
pain. Computed tomography revealed a destructive soft tissue mass in the cervical spine and additional lytic lesion
of the 1st rib. Prompt referral was made for surgical consultation and medical management.
Conclusion: Distant metastasis is rare, but can present as a musculoskeletal complaint. History of carcinoma should
alert the treating chiropractic physician to potential for serious disease processes.
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