Vertebral Compression Fracture Related to Pancreatic Cancer With Osteoblastic Metastasis

Abstract

Compression fracture of the vertebral body is common in the older patients. The possible etiology like osteoporosis or cancer metastasis should be included as a possibility in the differential diagnosis for severe back pain, to prevent delays in diagnosis and treatment. More severe fractures can cause significant pain, leading to inability to perform activities of daily living, and life-threatening in the older patient.We report a rare case of a 61-year-old man suffering from severe lower back pain and intermittent abdominal fullness. He came to our clinic, where muscle power was normal, but could not stand up or change posture because of severe back pain. Plain film and magnetic resonance imaging of lumbar spine both revealed osteoblastic lesion at L2 spine. Abdomen computed tomography showed a mass at the pancreatic body. The pancreatic cancer with osteoblastic metastasis was diagnosed. After receiving multimodality therapy such as percutaneous vertebroplasty and pain controlling, we provided effective palliation of symptoms, aggressive rehabilitation program, and better quality of life.Our case highlights the benefits of multidisciplinary cancer treatment for such patient, preventing the complications such as immobilization accompanied with adverse effects like musculoskeletal, respiratory, and cardiovascular systems. All clinicians should be informed of the clinical findings to provide patients with suitable therapies and surveys.

Bone metastasis as primary presentation of pancreatic ductal adenocarcinoma: A case report and literature review

“…Chih et al reported a patient with L2 vertebra involvement treated with percutaneous vertebroplasty with an improvement of performance status and pain control. 40 Survival of our patient was lower than the median overall survival of a metastatic PDAC patient treated with firstline gemcitabine and nab-paclitaxel. In previous reports, we described a relationship between bone metastases and poorer prognosis in patients affected by gastric cancer and hepatocellular carcinoma.…”

“…Few reports described the role of surgery in the management of bone involvement in PDAC. Chih et al reported a patient with L2 vertebra involvement treated with percutaneous vertebroplasty with an improvement of performance status and pain control …”

Metastatic epidural spinal column compression due to pancreatic ductal adenocarcinoma causing subacute Cauda equina syndrome: A case report

“…One study identified seven patients from a database of 323 PDAC patients (2.2%) with skeletal metastases. [ 4 ] In this series, 57.1% of patients were symptomatic, with the most common metastatic locations being the vertebrae, hips, and ribs. Two additional studies reported small osteoblastic L2[ 9 ] and L3[ 7 ] vertebral body metastatic lesions due to pancreatic adenocarcinoma in the body of the pancreas.…”

MicroRNA Alterations for Diagnosis, Prognosis, and Treatment of Osteoporosis: A Comprehensive Review and Computational Functional Survey

“…In KEGG, as shown in Table 3, some of these pathways were specific to cancer development, such as pancreatic cancer and prostate cancer. Accumulated evidence has proved that bone metastasis and bone loss are significant symptoms in these cancers, especially in the later stages (Chih et al, 2016;Poulsen et al, 2019). According to previous reports, p53 signaling pathway is involved in regulating osteoblast production and apoptosis and affecting BMD (Zhen et al, 2014;Liu W. et al, 2015).…”