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Biopsy of the paravertebral mass revealed metastatic squamous cell carcinoma. Given his symptomatology, and also as biopsy of the perianal warts revealed high-grade squamous intraepithelial lesion\/grade III anal intraepithelial neoplasia on histology with infection by human papillomavirus type 6, the primary was presumed to be anal. This was a case of sciatic pain which proved to be diagnostically challenging on initial presentation to primary care. This mode of presentation and pattern of metastasis are uncommon in anal cancer.<\/jats:p>","DOI":"10.1136\/bcr-2018-227563","type":"journal-article","created":{"date-parts":[[2019,7,15]],"date-time":"2019-07-15T08:25:11Z","timestamp":1563179111000},"page":"e227563","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":3,"title":["Unilateral leg weakness and pain secondary to metastatic anal squamous cell carcinoma"],"prefix":"10.1136","volume":"12","author":[{"given":"Temitope","family":"Ajala-Agbo","sequence":"first","affiliation":[{"name":"Department of General Surgery, Stoke Mandeville Hospital, Aylesbury, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pok Tin","family":"Tang","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Stoke Mandeville Hospital, Aylesbury, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tsetsegdemberel","family":"Bat-Ulzii Davidson","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Stoke Mandeville Hospital, Aylesbury, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2019,7,15]]},"reference":[{"key":"2025082711203859000_12.7.e227563.1","unstructured":"Cancer Research UK. 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