Metastatic Colorectal Cancer Presenting as Spinal Cord Compression and Mimicking Tuberculosis.

A 69-year-old male presented to the ED with a three-week history of back pain and progressive bilateral lower limb weakness. Initial imaging raised concerns for discitis and spinal cord compression (SCC). Further investigations, including MRI, CT, PET-CT, and biopsy, revealed metastatic adenocarcinoma of likely lower gastrointestinal origin, complicated by pulmonary embolism and multiple pulmonary nodules. The case emphasizes the diagnostic challenges when malignancy mimics infectious processes such as tuberculosis and highlights the critical role of imaging, tissue biopsy, and multidisciplinary management in patients presenting with SCC.