Psoas Muscle Infiltration Masquerading Distant Adenocarcinoma
Malignant metastasis to the psoas muscle is rare. We report a case that clinically mimicked psoas abscess that was subsequently proven to be from metastatic disease secondary to adenocarcinoma of the duodenum. A 62-year-old male presented with a seven-month history of right lower quadrant abdominal...
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| Format: | Article |
| Language: | English |
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Wiley
2014-01-01
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| Series: | Case Reports in Gastrointestinal Medicine |
| Online Access: | http://dx.doi.org/10.1155/2014/986453 |
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| author | Kamel A. Gharaibeh Arnaldo Lopez-Ruiz Tauqeer Yousuf |
| author_facet | Kamel A. Gharaibeh Arnaldo Lopez-Ruiz Tauqeer Yousuf |
| author_sort | Kamel A. Gharaibeh |
| collection | DOAJ |
| description | Malignant metastasis to the psoas muscle is rare. We report a case that clinically mimicked psoas abscess that was subsequently proven to be from metastatic disease secondary to adenocarcinoma of the duodenum. A 62-year-old male presented with a seven-month history of right lower quadrant abdominal pain and progressive dysphagia. CT scan of abdomen-pelvis revealed a right psoas infiltration not amenable to surgical drainage. Patient was treated with two courses of oral antibiotics without improvement. Repeated CT scan showed ill-defined low-density area with inflammatory changes involving the right psoas muscle. Using CT guidance, a fine needle aspiration biopsy of the right psoas was performed that reported metastatic undifferentiated adenocarcinoma. Patient underwent upper endoscopy, which showed a duodenal mass that was biopsied which also reported poorly differentiated adenocarcinoma. In this case, unresponsiveness to medical therapy or lack of improvement in imaging studies warrants consideration of differential diagnosis such as malignancy. Iliopsoas metastases have shown to mimic psoas abscess on their clinical presentation and in imaging studies. To facilitate early diagnosis and improve prognosis, patients who embody strong risk factors and symptoms compatible with underlying malignancies who present with psoas imaging concerning for abscess should have further investigations. |
| format | Article |
| id | doaj-art-513eee78183c4775b01afa25a806c2a8 |
| institution | Kabale University |
| issn | 2090-6528 2090-6536 |
| language | English |
| publishDate | 2014-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Gastrointestinal Medicine |
| spelling | doaj-art-513eee78183c4775b01afa25a806c2a82025-02-03T06:08:48ZengWileyCase Reports in Gastrointestinal Medicine2090-65282090-65362014-01-01201410.1155/2014/986453986453Psoas Muscle Infiltration Masquerading Distant AdenocarcinomaKamel A. Gharaibeh0Arnaldo Lopez-Ruiz1Tauqeer Yousuf2Department of Internal Medicine, University of Mississippi Medical Center, 2500 North State Street, Jackson, MS 39216, USADepartment of Internal Medicine, University of Mississippi Medical Center, 2500 North State Street, Jackson, MS 39216, USADepartment of Internal Medicine, University of Mississippi Medical Center, 2500 North State Street, Jackson, MS 39216, USAMalignant metastasis to the psoas muscle is rare. We report a case that clinically mimicked psoas abscess that was subsequently proven to be from metastatic disease secondary to adenocarcinoma of the duodenum. A 62-year-old male presented with a seven-month history of right lower quadrant abdominal pain and progressive dysphagia. CT scan of abdomen-pelvis revealed a right psoas infiltration not amenable to surgical drainage. Patient was treated with two courses of oral antibiotics without improvement. Repeated CT scan showed ill-defined low-density area with inflammatory changes involving the right psoas muscle. Using CT guidance, a fine needle aspiration biopsy of the right psoas was performed that reported metastatic undifferentiated adenocarcinoma. Patient underwent upper endoscopy, which showed a duodenal mass that was biopsied which also reported poorly differentiated adenocarcinoma. In this case, unresponsiveness to medical therapy or lack of improvement in imaging studies warrants consideration of differential diagnosis such as malignancy. Iliopsoas metastases have shown to mimic psoas abscess on their clinical presentation and in imaging studies. To facilitate early diagnosis and improve prognosis, patients who embody strong risk factors and symptoms compatible with underlying malignancies who present with psoas imaging concerning for abscess should have further investigations.http://dx.doi.org/10.1155/2014/986453 |
| spellingShingle | Kamel A. Gharaibeh Arnaldo Lopez-Ruiz Tauqeer Yousuf Psoas Muscle Infiltration Masquerading Distant Adenocarcinoma Case Reports in Gastrointestinal Medicine |
| title | Psoas Muscle Infiltration Masquerading Distant Adenocarcinoma |
| title_full | Psoas Muscle Infiltration Masquerading Distant Adenocarcinoma |
| title_fullStr | Psoas Muscle Infiltration Masquerading Distant Adenocarcinoma |
| title_full_unstemmed | Psoas Muscle Infiltration Masquerading Distant Adenocarcinoma |
| title_short | Psoas Muscle Infiltration Masquerading Distant Adenocarcinoma |
| title_sort | psoas muscle infiltration masquerading distant adenocarcinoma |
| url | http://dx.doi.org/10.1155/2014/986453 |
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