A Case of Carcinoma Metastasis of Unknown Primary Mimicking Spondylodiscitis in an HIV+ Patient

TL;DR

This case report describes an HIV+ patient with a metastatic carcinoma that mimicked spondylodiscitis, highlighting the diagnostic challenges in AIDS patients.

Contribution

The novelty lies in presenting a rare case of metastatic carcinoma mimicking spondylodiscitis in an AIDS patient, contributing to the limited literature on this condition.

Findings

The patient's spinal lesion was initially diagnosed as spondylodiscitis but was later found to be metastatic carcinoma.

The patient's postoperative ASIA score improved from C to D, indicating some functional recovery.

The patient ultimately died from sepsis related to an ICU infection, despite surgical intervention.

Abstract

In this case report, a case of carcinoma metastasis of unknown primary mimicking spondylodiscitis in a patient with acquired immunodeficiency syndrome (AIDS) is presented. A 50-year-old AIDS patient presented with a history of mechanical falls from his own level one month ago and leg weakness for the last three days. Spinal magnetic resonance imaging (MRI) revealed a compression fracture of the T4 vertebral body, spinal cord compression, and pathology compatible with spondylodiscitis. Posterior decompression and fusion were performed, and the patient benefited. The preoperative ASIA score was C, and the postoperative ASIA score was D. The sample taken from the lesion for pathology showed carcinoma metastasis. Tumor markers and whole-body computed tomography (CT) and MRI results did not support primary malignancy. Positron emission tomography was planned for further evaluation but could not be performed due to the poor general condition of the patient. During follow-up, the patient died of sepsis due to an intensive care unit infection. As new cases of carcinoma metastasis mimicking spondylodiscitis in AIDS patients are added to the literature, we will have more information about the diagnosis and treatment process.

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