Pathological vertebral compression fracture of C3 due to a breast cancer metastasis in a male patient.

STUDY

DESIGN

A case of vertebral body fracture due to metastatic breast cancer in a male patient and a review of the literature are presented.

OBJECTIVE

To draw attention to the possible adverse skeletal events in breast cancer patients, and the need of a watchful staff within the multidisciplinary team in charge.

SUMMARY OF BACKGROUND DATA: Breast cancer is a rare condition in men, the male/female ratio is 1 of 100 approximately; in both sexes bone metastases are the most common. The pathologic fracture by spinal metastases can cause intense pain with difficult management. Vertebroplasty has been used successfully to treat pain and improve functional status in patients with vertebral compression fractures due to metastases.

METHODS

A 43-year-old male patient was diagnosed of having breast epithelial carcinoma after histologic analysis of a femur fracture. Following reconstruction, the patient started rehabilitative treatment. In a control visit, he referred sudden cervical pain which was initially treated with nonsteroidal anti-inflammatory drugs and rest. The patient was seen in a later visit and complained about poor response to analgesia. For this reason, a radiologic study was carried out, showing signs of fracture of the third cervical vertebral body (C3), and was completed with magnetic resonance imaging where the diagnosis of osteolytic metastasis was confirmed.

RESULTS

After consulting the interventionist radiology team, vertebroplasty was carried out aiming to diminishing the pain. There were no postoperative complications and the patient's recovery from cervicalgia permitted the nonsteroidal anti-inflammatory drugs suspension. Two weeks after the vertebroplasty, the patient resumed his rehabilitative treatment without presenting cervical pain or mobility limitation.

CONCLUSION

Spinal metastases treatment may include combinations of radiotherapy, vertebroplasty, and bisphosphonates, which have proved analgesic effect and a decrease of bone complications; however, out of these options, only vertebroplasty allows rapid stabilization and analgesia.