Psoas abscess: a rare metastatic presentation of asymptomatic carcinoma of the cervix
Keywords:
metastatic, iliopsoas abcess, psoas abscess, asymptomatic, carcinoma cervixAbstract
Isolated metastasis to the iliopsoas muscle is rare and is often misdiagnosed as psoas abcess, especially when it is the only presenting feature in the absence of a known primary tumour. A 52-year-old woman presented to us with a clinicoradiological diagnosis of psoas abscess. Initially, the patient was managed as a case of tubercular psoas abscess. However, later on, when the disease had not responded to antitubercular therapy, a cytological examination of aspirated material was performed, which confirmed it as being malignant in origin. While searching for primary malignancy, a small growth on the cervix was noticed. A biopsy and histopathological examination confirmed the diagnosis of squamous cell carcinoma of the cervix. A final diagnosis of squamous cell carcinoma of the cervix with isolated iliopsoas muscle metastasis was proposed. This case highlights an unusual site of metastasis in an asymptomatic primary tumour which was diagnosed retrospectively.Downloads
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- Fig 1: Contrast enhanced CT scan demonstrates a large area of low attenuation involving left iliopsoas muscle(arrow)
- Fig 2: Coronal reconstruction demonstrates an area of low attenuation in the iliopsoas musculature on left side (arrow)
- Fig 3: Microscopic appearance of aspirate from psoas abscess, showing sheets of malignant squamous cells with hyperchromatic nucleus and conspicuous nucleoli (inset), (haematoxylin & eosin stain)
- Fig 4: Histological examination of cervical biopsy shows strips of malignant squamous cells with intracytoplasmic keratinisation (inset) along with area of necrosis and haemorrhage (haematoxylin & eosin stain)
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South African Journal of Gynaecological Oncology (SAJGO) Copyright is held by South African Society of Gynaecologic Oncology (SASGO). Copyright of the articles is held by the authors. The work is licensed under a Creative Commons Attribution-Non-Commercial Works 4.0 South Africa License (CC BY NC). Material submitted for publication in the SAJGO is accepted provided it has not been published elsewhere. The SAJGO does not hold itself responsible for statements made by the authors. The opinions expressed in this publication are those of the authors. They do no purport to reflect the opinions or views of SASGO or its members.