Metastatic Lung Cancer to Non-vascular Soft Tissue and Lumbar Spine Mimicking Postoperative Scar at L4-5 Non-union: A Case Report.
- 1Department of Orthopaedic Surgery, University of Arizona College of Medicine, Tucson, Arizona, United States of America.
- 2Department of Orthopaedic Surgery, Banner - University Medical Center Tucson/University of Arizona, Tucson, Arizona, United States of America.
- 3Department of Orthopaedic Surgery, Hamad Medical Corporation, Doha, Qatar.
Abstract
Soft-tissue metastases from lung cancer are uncommon, and metastatic involvement of a previous spinal surgical site is exceedingly rare. Such lesions may closely resemble expected post-operative tissue changes, creating a substantial diagnostic challenge. To the best of our knowledge, this is the first reported case of metastatic lung adenocarcinoma involving a non-vascular superficial compartment at the site of a prior lumbar fusion non-union. A 69-year-old man with a history of staged lumbar spine surgery presented for revision decompression and fusion. During the procedure, an approximately 2.5 × 5.1 cm mass superficial to the deep spinal fascia, initially suspected to represent post-surgical scarring, was identified. Frozen section revealed metastatic adenocarcinoma. Further workup identified a KRAS G12C-mutated lung adenocarcinoma with widespread metastases involving bone, lung, adrenal gland, and posterior lumbar soft tissues. Despite timely initiation of chemotherapy and radiotherapy after diagnosis, the patient died a few months later. Soft-tissue metastases to prior spinal surgical sites are exceedingly rare and may mimic post-operative changes. Surgeons should maintain suspicion for malignancy when encountering atypical tissue during revision spine procedures, as accurate and timely diagnosis is essential for appropriate oncologic staging and treatment planning.
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BibTeX
@article{sayegh2026metastatic,
title = {{Metastatic Lung Cancer to Non-vascular Soft Tissue and Lumbar Spine Mimicking Postoperative Scar at L4-5 Non-union: A Case Report.}},
author = {Jonathan Sayegh and Bryce Michael and Thadeus Carlyon and Emmanuel Brito and Isam Sami Moghamis and Abduljabbar Alhammoud},
journal = {Journal of orthopaedic case reports},
year = {2026},
month = nov,
doi = {10.13107/jocr.2026.v16.i11.8370},
url = {https://europepmc.org/article/MED/42997083},
note = {CC BY-NC},
}
RIS
TY - JOUR
TI - Metastatic Lung Cancer to Non-vascular Soft Tissue and Lumbar Spine Mimicking Postoperative Scar at L4-5 Non-union: A Case Report.
AU - Jonathan Sayegh
AU - Bryce Michael
AU - Thadeus Carlyon
AU - Emmanuel Brito
AU - Isam Sami Moghamis
AU - Abduljabbar Alhammoud
PY - 2026
DA - 2026/11/01
JO - Journal of orthopaedic case reports
DO - 10.13107/jocr.2026.v16.i11.8370
UR - https://europepmc.org/article/MED/42997083
AB - Soft-tissue metastases from lung cancer are uncommon, and metastatic involvement of a previous spinal surgical site is exceedingly rare. Such lesions may closely resemble expected post-operative tissue changes, creating a substantial diagnostic challenge. To the best of our knowledge, this is the first reported case of metastatic lung adenocarcinoma involving a non-vascular superficial compartment at the site of a prior lumbar fusion non-union. A 69-year-old man with a history of staged lumbar spine surgery presented for revision decompression and fusion. During the procedure, an approximately 2.5 × 5.1 cm mass superficial to the deep spinal fascia, initially suspected to represent post-surgical scarring, was identified. Frozen section revealed metastatic adenocarcinoma. Further workup identified a KRAS G12C-mutated lung adenocarcinoma with widespread metastases involving bone, lung, adrenal gland, and posterior lumbar soft tissues. Despite timely initiation of chemotherapy and radiotherapy after diagnosis, the patient died a few months later. Soft-tissue metastases to prior spinal surgical sites are exceedingly rare and may mimic post-operative changes. Surgeons should maintain suspicion for malignancy when encountering atypical tissue during revision spine procedures, as accurate and timely diagnosis is essential for appropriate oncologic staging and treatment planning.
SN - 2250-0685
SN - 2321-3817
ER -