Adenocarcinoma of the colon presenting as bone metastases of unknown primary- A case report

Edwin Maduakonam Dim, Timothy Eyo Nottidge, Uchenna Miriam Eberechukwu Dim, Emmanuel B Etuk, Joseph Chinedum Itie, Felix Uduma Uduma, Ita O Ita, Daniel E David


The liver and lung are the usual sites of distant metastasis from colorectal tumours. Bone metastasis in patients with colorectal carcinoma is considered extremely rare. It often signifies the terminal phase of colon carcinoma with a median survival of less than ten months. High index of suspicion is required, and the possibility or risk of osseous metastases arising from primary lesion in the colon should be borne in mind when assessing bony lesions that present initially as metastasis of unknown origin. We present a case of adenocarcinoma of the colon which remained undiagnosed until patient reported with a pathological fracture of the humerus and paraparesis




Osseous metastases, unknown primary, adenocarcinoma of the colon

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Assi R, Mukherji D, Haydar A, Saroufim M, Temraz S, Shamseddine A. Metastatic colorectal cancer presenting with bone marrow metastasis: a case series and review of literature. Journal of Gastrointestinal Oncology 2015;7(2):284-297. Available at

Schlüter K, Gassmann P, Enns A, et al. Organ-Specific Metastatic Tumour Cell Adhesion and Extravasation of Colon Carcinoma Cells with Different Metastatic Potential. American Journal of Pathology 2006; 169:1064-73.

Katoh M, Unakami M, Hara M, et al. Bone metastasis from colorectal cancer in autopsy cases. Journal of Gastroenterology 1995;30:615-8.

Teixeira LE, Miranda RH, Ghedini DF, et al. Early complications in the orthopaedic treatment of bone metastases. Rev Bras Ortop 2009; 44:519e23.

Utzschneider S, Wicherek E, Weber P, et al. Surgical treatment of bone metastases in patients with lung cancer. Int Orthop 2011;35:731e6.

Suresh Babu MC, Sunny Garg KC, Lakshmaiah K, Babu G, Kumar RV, Loknatha D, Abraham LJ, Rajeev LK, Lokesh KN, Rudresha AH, Rao SA. Colorectal cancer presenting as bone metastasis. Journal of Cancer Research and Therapeutics 2017; 13:80-3. DOI: 10.4103/0973-1482.181177.

Li AA, Cao ZY, Liu JM, Huang SH, Liu ZL. The risk factors for bone metastases in patients with colorectal cancer. Medicine 2018; 97:40(e12694).

Christensen TD, Jensen SG, Larsen FO, Nielsen DL. Systematic review: Incidence, risk factors, survival and treatment of bone metastases from colorectal cancer. Journal of Bone Oncology 13 (2018) 97–105.

Jimi S, Yasui T, Hotokezaka M, et al. Clinical features and prognostic factors of bone metastases from colorectal cancer. Surg Today 2013; 43:751–6.

Cassar N, Cresswell A, Moran B. Oligometastatic colorectal cancer: is single-site bony colorectal metastasis a treatable condition? Int J Colorectal Dis 2017;32:1229–31

Hung H, Chen JS, Yeh CY, et al. Preoperative alkaline phosphatase elevation was associated with poor survival in colorectal cancer patients. Int J Colorectal Dis 2017; 32:1775–8.

Dim EM, Yau CHR, Ho WYK, Lam YL. Profile of surgically treated metastatic bone tumours in a university hospital in Hong Kong. Journal of Orthopaedics, Trauma and Rehabilitation 2017; 24: 1-8.

Siddique I, Stirling AJ. Focus on the surgical management of spinal cord compression. J Bone Joint Surg Br 2010:1-5.

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