CTICasesFirst Rib Metastasis from Occult Colon Cancer
Imaging findings
Cervical spine radiograph and CT chest show complete lytic destruction of the left first rib by a large, expansile soft-tissue mass. Biopsy and staging showed metastatic colon cancer from an occult primary site.
Key takeaways
Bone metastasis to the first rib is a rare presentation of occult malignancy, such as colon cancer. It can present clinically as shoulder pain, and can be easily missed on radiographs if the first rib contours are not carefully traced. Complete rib destruction should trigger a search for gastrointestinal or other primaries.
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