A 52-Year-Old Woman With Persistent Back Pain and Multiple Pulmonary Nodules.

A 52-year-old woman with a history of leiomyoma uteri and tobacco-use disorder in remission presented with 2 months of progressive back pain. Her pain was located between her shoulder blades and was described as constant with intermittent sharp, stabbing sensation. It was nonradiating and aggravated by inspiration. She denied fever, cough, shortness of breath, chest pain, or recent changes in weight or appetite. Two days prior, she was evaluated in the ED for similar symptoms and prescribed naproxen and cyclobenzaprine for suspected musculoskeletal pain. However, she received minimal relief, which prompted her visit. She underwent a total hysterectomy 13 years ago for benign uterine fibroid tumors. She had a 15-pack-year history but quit smoking 3 years ago. Family history was notable for colon and pancreatic cancer in her father and breast cancer in her maternal aunt.