Epidemiological, Clinical, Diagnostical and Histopathological Aspects of Medular Compressions of Metastatic Origin

Abstract

Background: according to the World Health Organization (WHO) in 2019, cancer metastasis constitutes a fast proliferation of abnormal cells which spread to other organs. Bone is the third most targeted organ behind the lungs and the liver, and the most frequent bone's localizations are; the spine, pelvic bone and the ribs. Metastatic spinal compressions constitutes, a well-defined clinical entity of which the prevalence and incidence depends on the primitive tumor, Objective: To study the epidemiological, clinical, diagnosis and the histopathologic aspect of spinal cord metastatic compressions. Patients and method: It was a retrospective descriptive study over a period 10 years in the Douala General and Laquintinie Hospitals. We included in our study patients with slow spinal compression since January 1st 2010 to December 31st 2019. We included in our study, filled patients medical reports suffering of a primitive tumor which spread to the spine, with pathological and radiological evidence. Results: we recruited a total of 125 patients of which 68% where male and 32% female with a sex-ratio of 2.12, the mean age was 55.8 ± 15.397. The most frequent spine localization of metastasis was the lumbar region 57.1%. The spine pain was the main symptom seen in 98.4% associated to radicular nerf pain in 33.6%, sensibility and motor dysfunctions represented 94% and 92% respectively, and urinary dysfunction represented 44.8%. The diagnosis was essentially based on spine X-rays and was being realized in 64.8% of cases. Lytic lesions and bone condensation were the main abnormalities viewed with 22.4%. The second group of imaging was the CT-Scan and MRI done in 62.4%. The most represented primitive tumor was the prostate cancer 59 cases (47.25%) with adenocarcinoma as the main histological type 56 cases. Breast cancer came next with 32 cases (25.6%), invasive ductal carcinoma as the most represented histological type 26 cases (20.6%). The lung cancer came at the third position with 7 cases (10.4%) with the small cell carcinoma been the most represented histological type with 4.8%. Conclusion: spinal cord compression of metastatic origin is a frequent pathology in patients with osteophilic tumor, despite adequate measures, the prognosis remains unresolved. Emphasis should be placed on raising awareness of different early diagnostic measures.

Apport de l’IRM dans le diagnostic étiologique de la compression médullaire lente à Lomé : à propos de 72 cas

“…Les sujets de sexe masculin représentaient 58,33% (n=42) avec une sex-ratio de 1,4. Cette prédominance masculine est observée également dans la littérature[9,10].…”