Introduction:
Spine is the most common destination for tumor metastasis after lung and liver1 and spine metastasis are the most frequent spinal tumors2. Up to 40 percent of patients with tumor are shown to have spine metastasis3. Recognition of spinal involvement in those with cancer is important as the spine involvement is first presenting finding in around 10 percent of patients with cancers2. Also, symptomatic spinal cord compression due to spine metastasis can lead to an irreversible spinal cord injury within only a week in around one third of cases4. Recently, due to improvement in diagnostic and therapeutic armamentarium, the prevalence of spinal metastasis has increased significantly3, 5, 6. So, the need to appropriately diagnose and manage spinal metastasis is strongly felt.
In the following, we present a case of a metastatic vertebral (L1) involvement referred to our clinic with an atypical presentation of severe inguinal pain. Then, we further delineate the diverse clinical manifestation of metastatic spinal diseases reported in the literature.