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Comments, Opinions, and Brief Case Reports
April 23, 2001

Tetraparesis by Isolated Cervical Spine Metastasis as Manifestation of Occult Cancer

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Copyright 2001 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.2001

Arch Intern Med. 2001;161(8):1113. doi:

It is plausible that certain rare or infrequently seen diseases might escape clinical diagnosis. Sometimes, however, this is a result of shortcomings of both physicians and patients—a short attention span or cursory treatment, impatience while taking the medical history, inaccurate clinical examination, misinterpreting signs and symptoms, poor patient compliance, and concomitant masking diseases.

A 76-year-old woman came to the emergency department complaining of headache, neck and scapular pain, and a inability to maintain an upright position or raise her upper limbs. Her medical history included hystero-ovariotomy plus radiotherapy for a uterine neoplasm at the age of 42 years and a hospital admission for depressive syndrome at the age of 67 years. Two months earlier, she had been admitted to another hospital complaining of neck and scapular pain. Radiography of the chest and cervical and thoracic spine, computed tomography (CT) of the thoracoabdominal area, and bone scintigraphy were performed, and the diagnosis on discharge was rheumatic polymyalgia and severe ostheoporosis.