Colorectal Cancer Presenting as Sacral Pain at a Chiropractic Clinic

Ng, Gabriel Siu Nam; Chow, Isabel Si Wing

doi:10.7759/cureus.39277

Cited by 4 publications

(4 citation statements)

References 26 publications

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“…A patient's medical history and physical examination may reveal symptoms and signs suggestive of a sacral chordoma. While musculoskeletal conditions are commonly encountered by chiropractors [6], the present case highlights the importance of being vigilant for rare diseases, such as sacral chordomas, which may present with nonspecific clinical features mimicking more common musculoskeletal disorders [5,[7][8][9][10][11][12][13][14][15][16][17]. Both patients presented with symptoms suggestive of a sacral chordoma and the MRI findings were consistent with the typical features of a sacral chordoma.…”

Section: Discussionsupporting

confidence: 55%

Sacral Chordoma Presenting as Back Pain in the Chiropractic Clinic: A Case Report

Chan¹,

Ng²,

Cheong³

et al. 2023

Cureus

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Cases of lumbar and gluteal pain are commonly encountered in chiropractic clinics, with a broad differential diagnosis primarily centered on musculoskeletal conditions. This report presents the second documented case of sacral chordoma diagnosed at a chiropractic clinic and emphasizes the importance of considering alternative diagnoses and interdisciplinary collaboration in patient care. A 42-year-old man presented to a chiropractic clinic with complaints of lumbar and gluteal pain. The initial conservative management based on a presumptive musculoskeletal diagnosis was ineffective. Suspicion of an alternative etiology prompted a referral for imaging, which revealed a sacral chordoma. An interdisciplinary collaboration involving orthopedic surgeons, oncologists, radiologists, and other healthcare professionals was initiated to optimize the treatment outcomes of this rare and aggressive tumor. This case report underscores the importance of maintaining a high index of suspicion in cases of musculoskeletal presentations in chiropractic clinics and the critical role of advanced imaging in establishing a definitive diagnosis. Interdisciplinary collaboration is essential for managing complex conditions such as sacral chordomas, ensuring the delivery of the highest quality of care, and optimizing patient outcomes. Chiropractors play a crucial role in identifying, referring, and contributing to the management of patients with complex presentations as part of a comprehensive multidisciplinary treatment plan.

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Section: Discussionsupporting

confidence: 55%

Sacral Chordoma Presenting as Back Pain in the Chiropractic Clinic: A Case Report

Chan¹,

Ng²,

Cheong³

et al. 2023

Cureus

Self Cite

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“…Differentiating between musculoskeletal and systemic causes of pain presents challenges for healthcare providers, as they can manifest similar symptoms [17][18][19][20][21][22][23]. In our case, the patient's initial presentation of neck and back pain and lower extremity numbness and tenderness was consistent with a musculoskeletal origin.…”

Section: Case Presentationmentioning

confidence: 65%

Unmasking Acute Lymphoblastic Leukemia in a Chiropractic Patient With Musculoskeletal Complaints

Mok¹,

Cheong²,

Huang³

2023

Cureus

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A 67-year-old woman presented to a chiropractor with a four-week history of neck and low back pain, lower extremity paresthesia, profound fatigue, and cutaneous pallor. Previous cervical radiographs had revealed multilevel degenerative spondylosis. However, abnormal hematological indices, including severe thrombocytopenia and anemia, prompted concerns of an underlying hematopoietic malignancy. Interdisciplinary collaboration facilitated expedient hematological assessment, confirming acute lymphoblastic leukemia (ALL), as evidenced by lymphoblasts in a peripheral blood smear and bone marrow biopsy. Karyotyping detected a Philadelphia chromosomal mutation; the patient therefore received oral targeted tyrosine kinase inhibition coupled with serial intrathecal chemotherapy. Complete remission was achieved. However, sensorimotor symptoms persisted due to herpetic neuralgia secondary to immunosuppression. This complex case underscores the role of chiropractors as primary contact clinicians in identifying sinister pathologies underlying musculoskeletal complaints via judicious history-taking, physical evaluation, and interpretation of investigational findings. Interprofessional collaboration is pivotal in formulating an effective therapeutic strategy to improve the prognosis of patients with this disease.

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“…Furthermore, this strategy augmented intra-tumoral and draining lymph node antigen cross-presentation and amplified the production of type-I interferons (IFNs) compared to treatment with CpG alone. These findings highlight how thermal FUS promotes a tumor microenvironment conducive to immune activation by releasing DAMPs, stimulating T lymphocyte responses against tumor cells, and improving antigen presentation [52]. One of the earliest clinical investigations into HIFU involved applying the ultrasound-guided Model JC HIFU system (HAIFU Technology Co., Ltd., Chongqing, China) to treat colorectal cancer patients [53].…”

Section: Immune Modulation Using Therapeutic Focused Ultrasound In Co...mentioning

confidence: 99%

Focused Ultrasound as Targeted Therapy for Colorectal Cancer: A Comprehensive Review

Farooqi,

Mahnoor,

Delgado

et al. 2024

Gastrointestinal Disorders

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Traditional cancer treatments have not significantly improved the survival rates for individuals with colorectal cancer. As a result, there is a dire need to explore novel treatment modalities that can target cancer-specific niches, transform cold colorectal tumors into hot ones, and disrupt the tumor niche. Therapeutic focused ultrasound, recognized for its capacity to induce thermal and mechanical impacts on tissue, can potentially eliminate cancer cells and elicit the body’s anticancer reaction by disrupting the tumor microenvironment. This article provides an overview of recent developments in employing therapeutic focused ultrasound (TFUS) to enhance the body’s natural defenses against colorectal cancers. It also discusses studies examining the utility of TFUS in treating colorectal cancer patients and recent research indicating its potential to stimulate the body’s anticancer response in various in vitro and in vivo colorectal cancer models. Furthermore, it explores the therapeutic effects of TFUS on the immune system in colorectal cancers. This article also highlights the safety and effectiveness of TFUS in managing colorectal cancer, providing relief from pain, and potentially improving survival rates. Given the indications that TFUS may bolster the body’s immune response and augment the impacts of TFUS therapy in clinical and preclinical colorectal cancer models, it has the potential to emerge as a pivotal tool in clinical settings.

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Colorectal Cancer Presenting as Sacral Pain at a Chiropractic Clinic

Cited by 4 publications

References 26 publications

Sacral Chordoma Presenting as Back Pain in the Chiropractic Clinic: A Case Report

Sacral Chordoma Presenting as Back Pain in the Chiropractic Clinic: A Case Report

Unmasking Acute Lymphoblastic Leukemia in a Chiropractic Patient With Musculoskeletal Complaints

Focused Ultrasound as Targeted Therapy for Colorectal Cancer: A Comprehensive Review

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