Metastatic Squamous Cell Carcinoma of Sternum: An Oncological Curiosity

Jia Ying Soo; Nur Ayub Mohd Ali; Aishath Azna Ali; Firdaus Hayati; Nornazirah Azizan; Andee Dzulkarnaen Zakaria; Zainal Adwin Zainal Abidin; Mohd Ramzisham Abdul Rahman

doi:10.51200/bjms.v13i1.1160

Authors

Jia Ying Soo Department of Surgery, University Kebangsaan Malaysia Medical Centre, Jalan Yaacob Latif, Cheras, Kuala Lumpur, Malaysia
Nur Ayub Mohd Ali Division of Cardiothoracic Surgery, Departments of Surgery, University Kebangsaan Malaysia Medical Centre, Jalan Yaacob Latif, Cheras, Kuala Lumpur, Malaysia
Aishath Azna Ali Department of Surgery, University Kebangsaan Malaysia Medical Centre, Jalan Yaacob Latif, Cheras, Kuala Lumpur, Malaysia
Firdaus Hayati Department of Surgery, Faculty of Medicine and Health Sciences http://orcid.org/0000-0002-3757-9744
Nornazirah Azizan Department of Pathobiology and Medical Diagnostic, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Sabah, Malaysia
Andee Dzulkarnaen Zakaria Department of Surgery, School of Medical Sciences, Universiti Sains Malaysia, Kelantan, Malaysia
Zainal Adwin Zainal Abidin
Mohd Ramzisham Abdul Rahman Division of Cardiothoracic Surgery, Departments of Surgery, University Kebangsaan Malaysia Medical Centre, Jalan Yaacob Latif, Cheras, Kuala Lumpur, Malaysia

DOI:

https://doi.org/10.51200/bjms.v13i1.1160

Keywords:

squamous cell carcinoma, metastasis, sternum

Abstract

Skeletal metastasis is a frequent complication of cancer resulting in significant morbidity as well as mortality. We highlight a case of a 73-year-old gentleman with metastatic squamous cell carcinoma of the sternum. He denied dysphagia, shortness of breath, goitre, and presence of chronic non-healing ulcer. He was anaemic and carcinoembryonic antigen (CEA) was 18.7. Chest radiograph on lateral view showed a suspicious cortical irregularity. Computed tomography (CT) scan of thorax revealed an aggressive sternal lesion with soft tissue component. Ultrasound-guided biopsy was performed and the biopsy was consistent with metastatic squamous cell carcinoma. Squamous cell carcinoma has a predilection to metastasize via haematogenous spread, but direct extension of tumour into the bone is not frequently seen. Finding the primary cause is utmost importance either via imaging modalities or invasive procedures. Isolated secondary lesion is extremely rare but unfortunate among defaulters. We discuss its diagnostic work-up and treatment options conserved to manage this condition.