Low back pain indicative of psoas muscle metastasis and bronchopulmonary cancer

Abstract

Muscle metastases of bronchopulmonary cancer are rare, notably when they are revealing. They can affect all muscles of the body with a predominance of psoas, diaphragmatic and para-vertebral muscles. We report a case of psoas muscle metastasis revealing bronchopulmonary cancer in a 40-year-old patient with a long history of smoking (30 packs of cigarettes/year) presenting a chronic left low back pain with asthenia and weight loss (15 kg/year). The clinical examination was unremarkable. An abdominal computed tomography scan showing a retroperitoneal mass at the expense of the left psoas muscle, lysing the L2 vertebral and left pedicle with intraspinal extension. A complement by cervico-thoracic computed tomography scan showed a lung mass with hilar and mediastinal lymphadenopathy. A scan-guided biopsy puncture of the psoas muscle mass identified its metastatic origin. The clinical picture is often deceptive leading to diagnostic and therapeutic delay, hence the interest of the imagery as well as histological confirmation is recommended.

Unusual finding of bronchopulmonary carcinoma through a pterygoid muscle metastasis. About a case

“…The sarcolemma represents an effective barrier against tumor cells that could develop more easily in case of muscle trauma. In addition to these biomechanical processes, other muscle growth and regeneration factors could play a key role in slowing down tumor proliferation [ 2 , 6 ].…”

“…Muscular metastasis is mostly derived from lung carcinoma [1] . They can involve any muscles of the body but frequently localized in the psoas, diaphragmatic and paravertebral muscles [2] . We report a case of metastasis mass in the lateral pterygoid muscle from a squamous cell carcinoma of the lung.…”