Metastatic Lung Cancer to Non-vascular Soft Tissue and Lumbar Spine Mimicking Postoperative Scar at L4–5 Non-union: A Case Report
Year: 2026
Type: article
Abstract: Introduction: Soft-tissue metastases from lung cancer are uncommon, and metastatic involvement of a previous spinal surgical site is exceedingly rare. Such lesions may closely resemble expected post-operative tissue changes, creating a substantial diagnostic challenge. To the best of our knowledge, this is the first reported case of metastatic lung adenocarcinoma involving a non-vascular superficial compartment at the site of a prior lumbar fusion non-union. Case Report: A 69-year-old man with a history of staged lumbar spine surgery presented for revision decompression and fusion. During the procedure, an approximately 2.5 × 5.1 cm mass superficial to the deep spinal fascia, initially suspected to represent post-surgical scarring, was identified. Frozen section revealed metastatic adenocarcinoma. Further workup identified a KRAS G12C-mutated lung adenocarcinoma with widespread metastases involving bone, lung, adrenal gland, and posterior lumbar soft tissues. Despite timely initiation of chemotherapy and radiotherapy after diagnosis, the patient died a few months later. Conclusion: Soft-tissue metastases to prior spinal surgical sites are exceedingly rare and may mimic post-operative changes. Surgeons should maintain suspicion for malignancy when encountering atypical tissue during revision spine procedures, as accurate and timely diagnosis is essential for appropriate oncologic staging and treatment planning.
Language: English
Subfield: Pulmonary and Respiratory Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $250
OpenAlex ID: W7225566016