C8-T1 Radiculopathy Due to an Intradural Extramedullary Metastasis of a Pancreatic Neuroendocrine Tumor

Cabezas-Camarero, Santiago; Sastre, Javier; Polidura, María Carmen; Gómez-Ruíz, María Natividad; Subhi-Issa, Issa; Lera, Pedro Alonso; Paredes, Beatriz; Dı́az-Rubio, Eduardo

doi:10.1097/mpa.0000000000000515

Cited by 7 publications

(5 citation statements)

References 44 publications

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“…Surgical resection has been shown to be an effective treatment. 1,2,[6][7][8][9] Procedures for spinal decompression and resection of the intradural tumour have been shown to relieve associated pain and limb weakness seen with neuroendocrine tumours of the spinal cord, as in our patient. 1,2,6 Neuroendocrine tumours are highly vascular and frequently these tumours have a poor plane of demarcation from the nerve roots.…”

Section: Discussionsupporting

confidence: 59%

Primary intradural neuroendocrine tumour of spine: a rare pathology

et al. 2018

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Neuroendocrine tumour in central nervous system is a very rare pathology. We hereby report a primary intradural neuroendocrine tumour, second to the only other case reported in literature till now as per the best of our knowledge. The tumour was completely intradural, spanning across five segments in the lumbar spine and no primary tumour could be detected elsewhere in body. The patient underwent surgery followed by radiotherapy and showed symptomatic relief. This case report focusses on compiling the available literature on spinal carcinoids (both primary and metastatic) and discussing the relevant investigations and available treatment options for the same.

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Section: Discussionsupporting

confidence: 59%

Primary intradural neuroendocrine tumour of spine: a rare pathology

et al. 2018

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“…All patients underwent surgery after they failed nonsurgical treatment. After the surgery, their persistent pain disappeared [9][10][11][12][13][14]. In the present…”

Section: Discussionmentioning

confidence: 60%

“…Surgery was performed after four to six months of conservative treatment. In both cases, although the pain improved, the muscle weakness did not improve well [ 10 , 11 ]. The optimal timing for surgery for cervical radiculopathy due to spinal metastasis accompanying motor weakness is not yet established.…”

Section: Discussionmentioning

confidence: 99%

Surgical Treatment for Radiculopathy Due to Spinal Metastasis: A Report of Three Cases

Kitamura¹,

Maki²,

Furuya³

et al. 2021

Cureus

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Nonsurgical treatment is the first option in patients with radiculopathy due to spinal metastasis. However, we have to consider surgical management for patients who are resistant to conservative treatment. There are few reports of surgical treatment for radiculopathy due to metastatic spine tumors. We present cases in three patients who underwent surgery for radiculopathy due to spinal metastasis. Case 1 was in an 82-yearold woman with lumbar foraminal stenosis at L5-S1 due to breast cancer metastasis to the right L5-S1 intervertebral foramen. She underwent subtotal tumor resection and posterior lumbosacral decompression and fusion. After the surgery, she was able to walk without pain. Case 2 was in a 70-year-old woman with C8 radiculopathy and amyotrophy due to breast cancer metastasis to the right C7-T1 intervertebral foramen. She underwent anterior cervical decompression and fixation from C6 to T1. After the surgery, the pain in her left upper limb was relieved, but the muscle weakness of her left finger extension remained. Case 3 was in a 72-year-old woman with C8 radiculopathy and amyotrophy due to rectal cancer metastasis to the right side of the C7 vertebral body and pedicle. She underwent tumor resection and left C7-T1 facetectomy. Muscle weakness of her right finger extension and pain improved postoperatively. Surgery for radiculopathy due to spinal metastasis can improve pain in afflicted patients. Postoperative improvement of motor weakness due to spinal metastasis varies depending on the case. Surgery for radiculopathy due to spinal metastasis is indicated when patients have conservative treatment-resistant radiculopathy or amyotrophy that affects their activities of daily living.

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“…Neuroblastoma was two cases [13,60]. There was once case each of adrenal gland cancer [6], gastric cancer [29], anal cancer [30], glioblastoma [36], sinonasal carcinoma [37], germinoma [40], submandibular gland carcinoma [82], papillary carcinoma of the thyroid [62], muscle [31], lymphoreticular system [31], lacrimal gland [31], and a pancreatic neuroendocrine tumor [69]. There were 10 cases of <1 month, 18 cases between 1-3 months, 12 cases between 3-6 months, 15 cases between 6-12 months, six cases between 1-2 years, three between 2-3 years, and one case between 3-6 years.…”

Section: Discussionmentioning

confidence: 99%

“…The average life expectancy was 8.6 months and 84.6% patients died within one year. There were a total of 70 cases of which 55 were improved [5,6,8,10,11,13,14,[16][17][18]20,[23][24][25][28][29][30][31][32][33]35,[37][38][39][40][41][44][45][46][47][48][49]52,[54][55][56][57][58][59][61][62][63][64][65][66][67][68][69], eight remained unchanged [8,21,26,…”

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confidence: 99%

Intradural-Extramedullary Metastatic Tumor from Lung Cancer-A Case Report and Review

Sasaji¹

2017

MOJCR

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A 62-year-old male presented with a thoracic intradural-extramedullary metastasis from lung cancer. He complained of walking difficulty and bilateral lower leg numbness. He had a past history of lung adenocarcinoma three years prior. Thoracic spine magnetic resonance imaging showed that the tumor occupied the right subarachnoid space and spinal nerve roots had shifted to the left side at Th12. He was diagnosed with cauda equina syndrome by an intradural-extramedullary tumor. Surgery was performed (Th12 laminectomy) and we opened the dura mater and arachnoid membrane. The tumor was in the right side and was removed. After the operation, his neurological condition soon improved and he could walk with a cane. By four moths postoperatively, a metastatic brain tumor occurred and he had to use a wheel chair. He died one year after surgery. Immunohistochemical staining was positive for thyroid transcription factor-1 in both the lung adenocarcinoma and intraduralextramedullary tumor. We diagnosed a metastatic tumor. Including the present case, 102 cases of a metastatic intradural-extramedullary tumor have been reported and, thus, the condition may not be rare. In more than twenty years there have only been two case studies, which recommended both operative and non-operative methods. We reviewed the validity of an operation base on the prognosis and surgical results of previous reports. The average life expectancy was 8.6 months. The functional improvement rate was 78%. We recommend an operation for an intradural-extramedullary metastatic tumor because it improves the quality of a patients' short life. Keywords: IntroductionMetastases are by far the most common skeletal tumors seen by orthopedists, and the spine is the most common site of skeletal involvement [1]. A spinal epidural metastasis is the most common neoplastic myelopathy [2]. In a total of 1215 cases of primary lung cancer in an autopsy study, 20 (1.65%) revealed intradural parenchymal involvement [3]. Among 200 patients treated for symptomatic spinal metastases, a localized intradural extramedullary tumor was discovered in 10 cases [4]. Among 136 patients who underwent surgery for spinal metastases, an intradural extramedullary tumor was observed in two cases (1.5%) [5]. To our knowledge, Rogers et al. [6] were the first to report on an intradural-extramedurally metastatic tumor in 1958 since then, 101 cases have been reported in 66 articles . Including our case, the total number of reported cases is now 102. Many authors have described an intradural-extramedullary metastasis as a rare metastatic condition, however, we do not consider it to be rare given the number of reported cases.Two types of treatment have been reported for an intraduralextramedullary tumor, the recommended operative and nonoperative methods [4,18,31,38,45,63]. In two case studies, Perrin et al.[4] recommended a non-operative method and Chow et al.[30] recommended an operation. Both reports had a small number of cases (n=10). There have been no reviews of many cases that were n...

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C8-T1 Radiculopathy Due to an Intradural Extramedullary Metastasis of a Pancreatic Neuroendocrine Tumor

Cited by 7 publications

References 44 publications

Primary intradural neuroendocrine tumour of spine: a rare pathology

Primary intradural neuroendocrine tumour of spine: a rare pathology

Surgical Treatment for Radiculopathy Due to Spinal Metastasis: A Report of Three Cases

Intradural-Extramedullary Metastatic Tumor from Lung Cancer-A Case Report and Review

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