A rare metastases of a colorectal primary to the clavicle

Colorectal cancer is the third commonest cancer in the UK. The commonest site of colorectal cancer metastases is the liver, followed by lungs. Metastases to small bones are recognized but are a rare occurrence of colorectal malignancy.

A 92 year old lady presented with a swollen, fractured right clavicle following a fall. On follow up, a swelling of approximately 10cm was still noted in the area. A CT scan revealed a ten by ten centimetres mass arising from the clavicle and a 9cm mass arising from the left aspect of the sacrum. She was also found to have complete collapse of the left lung with an underlying mass and a mass within the right lung. Biopsy of the clavicular mass was suggestive of metastatic colorectal adenocarcinoma. She had undergone an anterior resection for Dukes C adenocarcinoma six years previously.

This case demonstrates the rare metastases of a colorectal primary to the clavicle, a clavicle metastases of this size has not been previously reported in literature.

A high index of suspicion for potential of small bone metastases has to be entertained in a patient presenting with a non-healing fracture and a history of colorectal carcinoma.