Sumina Goel, MD

A 36-year-old healthy woman presented after several months of right hip pain not improved with physical therapy. Magnetic resonance image of the lumbar spine and pelvis revealed a compression fracture of the L2 vertebrae and abnormal signal enhancement of L4 and L5. Biopsy of the right iliac crest showed carcinoma of epithelial origin. Immunostains were not helpful in further characterizing the tumor. Full staging workup revealed bone only disease of the axial skeleton without a primary site of origin. The patient was treated with two cycles of chemotherapy for carcinoma of unknown primary site and palliative radiation to several painful bony lesions.