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Background: Spine pain is a common presenting complaint of patients who visit physicians and although spine cancer accounts for a very small percentage of cases of back pain, metastasis is a relatively common cause of spine pain in the elderly. The presentation of patients with spine cancers is highly variable, and in many cases the clinical findings of benign and cancerous causes of spine pain can be similar, often confounding the clinical picture. This can create difficulties in interpreting the clinical data available to the physician, particularly with a disease with such a devastating prognosis.
Objective: This manuscript discusses the more common causes of malignant lesions of the spine, including an overview of the incidence/prevalence data and clinical features of both primary and secondary malignancies. It also provides the reader with a clinical overview of patients with spine cancer.
Discussion: It is important to appreciate the myriad epidemiologic and clinical features of primary and secondary spine cancers. Patients with malignant skeletal lesions may be asymptomatic in the area of cancerous bone disease and, as a consequence, these lesions can be overlooked. This may result in dismal consequences for the patient, given the generally poor prognosis associated with spine cancers. Knowledge of the features discussed in this paper will assist the clinician in appropriately raising his/her index of suspicion for spine cancer in suitable clinical circumstances.