Sciatica caused by spinal epidural abscess as the initial clinical presentation of colon cancer: a rare case report and review of literature

Abstract

Abstract Colorectal cancer is one of the most frequently diagnosed forms of cancer, and it is associated with several common symptoms and signs. Sciatica is not considered one of these. However, in this article, we present a case of colorectal cancer manifesting symptoms of sciatica alone. The sciatica was the result of a spinal epidural abscess caused by the pathogen Streptococcus gallolyticus diagnosed by intraoperative pus culture. Although without typical signs of colorectal cancer, the presence of this pathogen prompted further tumor evaluation, ultimately leading to the discovery of a sigmoid adenocarcinoma. In rare cases, sciatica caused by S. gallolyticus infection of the spinal epidural space may serve as the initial presentation of colorectal cancer. Physicians should be aware of the strong association between S. gallolyticus and colorectal cancer. Based on what we currently know about the condition, we recommend a systematic assessment of occult neoplasia for patients with S. gallolyticus infection.