The prevalence of colorectal cancer in populations under 50 years has been increasing, statistics show. Worryingly, a great number of these individuals present to hospital in the advanced stages with atypical symptoms. Sometimes the condition is too advanced to treat once symptoms have been picked up.
Understanding cancer symptoms is critical for preventing end-stage diagnosis.
Unfortunately, however, clinics record a significant number of exceptional cases where patients’ bodies are plagued with cancer, but only atypical signs occur.
This was the case of one patient who experienced numbness in his legs for months before receiving a diagnosis.
The atypical case report was described in the Journal of Medical Case Reports in 2021.
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The 46-year-old Japanese man had initially been placed on antibiotics based on the suspicion of a bacterial infection, but his fever persisted.
During his hospital stay, he experienced a sudden onset of paralysis and numbness in both his legs.
Due to the persistence of his symptoms, the patient was subsequently brought to a separate unit where he underwent a series of tests to clarify the cause of his symptoms.
Researchers found a case of rare osteolytic bone metastasis as the manifestation of his colorectal cancer.
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The patient was finally diagnosed with advanced colorectal carcinoma with multiple bone metastases.
Due to the patient’s atypical presentation, it took one month from admission to the hospital to his definitive diagnosis.
“After a shared decision-making, the patients chose palliative care without chemotherapy,” noted his doctors.
“[…] He returned to the previous hospital, where he received palliative care, and died four weeks later.”
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Colon cancer metastasis to the bone is common, with a prevalence ranging between two and 24 percent.
It is uncommon, however, for bone metastasis to be the sole manifestation of colorectal cancer.
This occurs in roughly one to two percent of patients.
The first signs of colon cancer tend to be marked changes in bowel habits and include constipation, diarrhoea and narrow stools.
Many of these symptoms are misleading, however, as they’re also common features of other diseases like irritable bowel syndrome.
With regard to bowel changes, the only suspicious feature the patient spotted when going to the toilet was faecal and urinary incontinence.
His report states that he denied other classic symptoms like vomiting, diarrhoea, constipation, blood stool and weight loss.
According to the authors of the report, this reinforces the case for keeping an open mind when seeing patients with atypical presentations.
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