Diagnostic dilemma: a rare cause of lower back pain

Low back pain is a common presentation with a wide differential diagnosis. One rare, but important, differential is malignant metastases to the spine. Primary breast cancers have a tendency to spread to bone. Male breast cancer is a rare phenomenon, accounting for less than 1% of all breast cancer cases. This report presents the case of a 54-year-old male who presented with signs and symptoms of low back pain that initially appeared to be due to radiculopathy after a work-related injury. After several interventions, visits and imaging studies, it was discovered that many of his symptoms were due to silent dissemination of male breast cancer. There is a lack of literature and guidelines on the work-up of male breast cancer. This case highlights the importance of keeping a high index of suspicion for all patients presenting with lower back pain, and the need for evidence and guidelines on the investigation and management of male breast cancer.