Differential Diagnosis for Cancer Starting with Mid Back Pain

• Single Most Likely Diagnosis
  • Pancreatic cancer: Mid back pain is a common presenting symptom of pancreatic cancer, especially when the tumor is located in the body or tail of the pancreas, as these areas can cause referred pain to the mid back due to the proximity of the pancreas to the spine and the shared nerve roots.
• Other Likely Diagnoses
  • Lung cancer: Lung tumors, especially those located in the posterior or apical regions, can cause mid back pain due to invasion into the ribs, vertebrae, or nerves.
  • Breast cancer with metastasis: While breast cancer primarily presents with symptoms related to the breast, metastasis to the spine or ribs can cause mid back pain.
  • Esophageal cancer: Esophageal tumors can cause mid back pain, especially if they invade nearby structures such as the spine or nerves.
• Do Not Miss Diagnoses
  • Spinal cord compression: This is a medical emergency that can result from any cancer that metastasizes to the spine, leading to neurological deficits and potentially permanent paralysis if not promptly treated.
  • Adrenal gland tumors: Although rare, tumors of the adrenal glands can cause mid back pain and have significant implications for hormone regulation and overall health.
• Rare Diagnoses
  • Retroperitoneal sarcomas: These are rare tumors that arise in the retroperitoneal space, which can cause mid back pain due to their location and potential invasion into surrounding structures.
  • Neurogenic tumors: Tumors arising from the nerves, such as neurofibromas or schwannomas, can cause mid back pain, especially if they compress or invade the spinal cord or surrounding nerves.