Malignancy is a rare but serious cause of low back pain especially in young people

This is true that many cases of acute low back pain are caused by radicular pain due to discopathy, however, the history and physical examination in low risk patients as well as continuous radiography usually provide clues to the rare but potentially serious causes of low back pain such as malignancy. The patient is an 18-year-old man who referred to an orthopedist for the first time three months prior to the study with a complaint of a backache and received out-patient treatment. One month ago he visited a doctor for lack of improvement and aggravation of the symptoms. In X ray imaging from pelvis performed three months earlier, nothing was found except for a lesion that was probably differentiated from intestinal gas and not reported. However, by repeated X-ray a month later and because of lack of relocation of lesion created high doubt ex parte lytic lesion for the patient, A biopsy specimen was taken from this site. The primary result indicated sarcoma, while after immunohistochemistery, final result revealed peripheral malignancy nerve sheath tumor for patient. Malignant peripheral nerve sheath tumor (MPNST) are rare malignancies from the origin of peripheral nerve sheath cells. These tumors almost present as an enlarging mass from a peripheral nerve root. We should consider the importance of low back pain in a patient that does not have serious risk factors and inflammatory or mechanical nature of the pain because in some cases low back pain can indicate severe diseases.