Background: Secondary bone deposits is a common occurrence of malignancies in the body, and often the only finding pointing towards an unknown primary. However, the clinical features and histopathological evaluation may diagnose a de-novo bone malignancy, making it difficult to differentiate from the secondary deposits to bone. In cases of doubt, immunohistochemistry helps in localizing the primary causing secondary bone metastasis. Here we have the case report of a male patient aged 54 years that presented to the oncology OPD in Justice K. S. Hegde Charitable Hospital with complaints of pain with swelling over the left scapular region noticed 15 days back. After extensive clinical evaluation and radiological studies, patient was diagnosed to have metastatic adenocarcinoma deposits to the left scapula. However, even with extensive immunohistochemistry marker study being performed on the biopsy, a primary lesion couldn’t be located.

Keywords: Immunohistochemistry, metastasis, scapula, unknown primary.

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Dr Amulya Cherukumudi

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