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Gharaibeh KA, Lopez-Ruiz A, Yousuf T. Psoas muscle infiltration masquerading distant adenocarcinoma. Case Rep Gastrointest Med. 2014;2014:986453doi: 10.1155/2014/986453.
Gharaibeh, K. A., Lopez-Ruiz, A., & Yousuf, T. (2014). Psoas muscle infiltration masquerading distant adenocarcinoma. Case reports in gastrointestinal medicine, 2014986453. https://doi.org/10.1155/2014/986453
Gharaibeh, Kamel A, et al. "Psoas muscle infiltration masquerading distant adenocarcinoma." Case reports in gastrointestinal medicine vol. 2014 (2014): 986453. doi: https://doi.org/10.1155/2014/986453
Gharaibeh KA, Lopez-Ruiz A, Yousuf T. Psoas muscle infiltration masquerading distant adenocarcinoma. Case Rep Gastrointest Med. 2014;2014:986453. doi: 10.1155/2014/986453. Epub 2014 Sep 22. PMID: 25309762; PMCID: PMC4189767.
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Case Rep Gastrointest Med. 2014;2014:986453. doi: 10.1155/2014/986453. Epub 2014 Sep 22.

Psoas muscle infiltration masquerading distant adenocarcinoma.

Case reports in gastrointestinal medicine

Kamel A Gharaibeh, Arnaldo Lopez-Ruiz, Tauqeer Yousuf

Affiliations

  1. Department of Internal Medicine, University of Mississippi Medical Center, 2500 North State Street, Jackson, MS 39216, USA.
  2. Department of Internal Medicine, University of Mississippi Medical Center, 2500 North State Street, Jackson, MS 39216, USA ; Division of Hospital Medicine, Department of Medicine, University of Mississippi Medical Center, 2500 North State Street, Jackson, MS 39216, USA.

PMID: 25309762 PMCID: PMC4189767 DOI: 10.1155/2014/986453

Abstract

Malignant metastasis to the psoas muscle is rare. We report a case that clinically mimicked psoas abscess that was subsequently proven to be from metastatic disease secondary to adenocarcinoma of the duodenum. A 62-year-old male presented with a seven-month history of right lower quadrant abdominal pain and progressive dysphagia. CT scan of abdomen-pelvis revealed a right psoas infiltration not amenable to surgical drainage. Patient was treated with two courses of oral antibiotics without improvement. Repeated CT scan showed ill-defined low-density area with inflammatory changes involving the right psoas muscle. Using CT guidance, a fine needle aspiration biopsy of the right psoas was performed that reported metastatic undifferentiated adenocarcinoma. Patient underwent upper endoscopy, which showed a duodenal mass that was biopsied which also reported poorly differentiated adenocarcinoma. In this case, unresponsiveness to medical therapy or lack of improvement in imaging studies warrants consideration of differential diagnosis such as malignancy. Iliopsoas metastases have shown to mimic psoas abscess on their clinical presentation and in imaging studies. To facilitate early diagnosis and improve prognosis, patients who embody strong risk factors and symptoms compatible with underlying malignancies who present with psoas imaging concerning for abscess should have further investigations.

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