ABSTRACT
A 67-year-old man presented to his general practitioner with intermittent episodes of unilateral sciatica over a 2-month period for which he was referred for an outpatient MRI of his spine. This evidenced a significant lumbar vertebral mass that showed tight canal stenosis and compression of the cauda equina. The patient was sent to the emergency department for management by orthopaedic surgeons. He was mobilising independently, pain free on arrival and without neurological deficit on assessment. Clinically, this patient presented with no red flag symptoms of cauda equina syndrome or reason to suspect malignancy. In these circumstances, National Institute for Health and Care Excellence guidelines do not support radiological investigation of the spine outside of specialist services. However, in this case, investigation helped deliver urgent care for cancer that otherwise may have been delayed. This leads to the question, do the current guidelines meet clinical requirements?
Subject(s)
Adenocarcinoma/diagnosis , Cauda Equina Syndrome/diagnosis , Prostatic Neoplasms/diagnosis , Spinal Neoplasms/complications , Spinal Stenosis/diagnosis , Adenocarcinoma/complications , Adenocarcinoma/secondary , Adenocarcinoma/therapy , Aged , Cauda Equina/diagnostic imaging , Cauda Equina Syndrome/blood , Cauda Equina Syndrome/etiology , Cauda Equina Syndrome/therapy , Chemoradiotherapy/methods , Humans , Image-Guided Biopsy , Kallikreins/blood , Lumbar Vertebrae/diagnostic imaging , Lumbar Vertebrae/pathology , Magnetic Resonance Imaging , Male , Palliative Care/methods , Prostate/diagnostic imaging , Prostate/pathology , Prostate-Specific Antigen/blood , Prostatic Neoplasms/blood , Prostatic Neoplasms/pathology , Prostatic Neoplasms/therapy , Spinal Neoplasms/blood , Spinal Neoplasms/diagnosis , Spinal Neoplasms/secondary , Spinal Stenosis/etiology , Spinal Stenosis/therapy , Ultrasonography, InterventionalABSTRACT
In this review, we report a case of a bone's metastatic breast cancer in Malian patient treated by chemotherapy in whom SRAS-COV-2's diagnosis was made 9days after the onset gastrointestinal symptoms. Patient quickly died before any COVID-19's treatment. According to the poor outcomes of cancer patients with COVID-19, authors emphasize to an intensive attention to such patients in order to find the best therapeutic balance between the two pathologies during this pandemic.