Clinical Case Database / Category: Patient Management

Pathological fractures: investigating unknown primary tumours

Publication details

Aneel Bhangu MBChB, MRCS, Richard Dias MBChB
Foundation Years Journal, volume 4, issue 1, p.23 (123Doc Education, London, January 2010)


A 60-year-old man had noticed some mild pain and localised swelling around his left hip for 3 months. He had been losing some weight and was a lifelong smoker. One morning, he stood up from a chair and heard a loud crack from his left hip. He was in immediate pain and was unable to mobilise. An ambulance brought him to hospital where an X-ray was taken (see Figure 1). A subsequent scan performed is shown in Figure 2.

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Aneel Bhangu MBChB, MRCS

ST3 General Surgery
Russells Hall Hospital
West Midlands Deanery

Richard Dias MBChB

Consultant Orthopaedic Surgeon
Department of Trauma and Orthopaedics
Royal Wolverhampton Hospitals NHS Trust
Wednesfield Road
Wolverhampton WV10 0QP


1. Duffy MJ (2001) Clinical uses of tumour markers: a critical review. Crit Rev Clin Lab Sci. June, 38(3):225–262
2. Dent JA (1997) Fractures in the elderly. In: JA Dent (ed.) Churchill's mastery of medicine and surgery. New York: Churchill and Livingstone, p. 27.
3. Gebhard M, Mankin HJ (1994) Management of bone tumours. In: PJ Morris and RA Malt, Oxford Textbook of Surgery, vol. 2. Oxford: Oxford University Press, pp. 2460–2463.
4. Pozzo C, Barone C, Kemeny NE (2008) Advances in neo-adjuvant therapy for colorectal cancer with liver metastases. Cancer Treat Rev. June, 34(4):293–301.
5. Wair JC (1994) Benign and malignant tumours of the lung. In: PJ Morris and RA Malt, Oxford Textbook of Surgery, vol. 2. Oxford: Oxford University Press, pp.1895–1912.


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T​he Foundation Years Clinical Cases Database is​ a selection of 600 peer-reviewed clinical cases in the field of patient safety and clinical practice, specifically focused on the clinical information needs of junior doctors, based around the Foundation Year Curriculum programme (MMC). The cases have been chosen to align with the Foundation Year Curriculum.

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