Hepatocellular carcinoma presenting as spinal cord compression in Native Americans with controlled hepatitis C: two case reports

Liaukovich, Maksim; Wu, Susan; Yoon, Sydney; Schäffer, Jürgen; Wang, Jen C.

doi:10.1186/s13256-018-1807-8

Cited by 5 publications

(2 citation statements)

References 28 publications

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“…Spinal cord compression as the initial presentation of HCC is exceedingly rare. In a case report by Liaukovich, two patients of age 64 years and 70 years, male, initially presented with the symptoms of spinal cord compression due to metastasis of HCC [ 5 ]. In a review of a series of 600 patients with spinal cord compression, HCC has been reported in less than 2% of cases, making it an infrequent feature of HCC [ 6 ].…”

Section: Discussionmentioning

confidence: 99%

Spinal Cord Compression as Initial Presentation in Hepatocellular Carcinoma

Kaur¹,

Malik²,

Kaur³

et al. 2021

Cureus

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Hepatocellular carcinoma (HCC) is the most common primary hepatic malignancy and aggressive neoplasms with high metastatic potential to the lung, regional lymph nodes, and bone. Metastatic spinal cord compression due to HCC is a rare, unusual initial presentation and is a neurosurgical emergency. We present two cases of HCC where spinal cord compression was the initial presentation before the diagnosis of HCC. Our first patient presented with bilateral flank pain. The biopsy of the chest wall showed HCC. However, a CT scan of the abdomen showed metastatic involvement of the T11 vertebra. He was found to have severe spinal canal stenosis on MRI of the back without neurological deficit. He underwent an emergent tumor decompression of the T11 vertebra with kyphoplasty. Our second patient was a young man who presented with cord compression symptoms, which included bilateral leg weakness and an inability to void. An urgent laminectomy with decompression of the lumbar spine was performed. He received radiotherapy for spinal metastasis and started systemic therapy for HCC. Unfortunately, he failed multiple lines of systemic therapy, and the progression of the disease complicated his clinical course with spinal cord compression for the second time.

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Section: Discussionmentioning

confidence: 99%

Spinal Cord Compression as Initial Presentation in Hepatocellular Carcinoma

Kaur¹,

Malik²,

Kaur³

et al. 2021

Cureus

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“…Epidemiological studies have reported that MSCC could be the initial presentation of malignancy up to 20%, [3][4][5] and it can occur in any cancer type. [10][11][12] Regardless of whether the site of the primary cancer is known or not, surgery does play a role in spinal metastases management because MSCC is an oncological emergency that necessitates immediate surgical intervention. According to a recent review, an integrated multidisciplinary approach is needed for the management of spinal metastases due to its complexity.…”

Section: Discussionmentioning

confidence: 99%

Metastatic Spinal Cord Compression as the First Manifestation of Malignancy – A Retrospective Study of Surgical Outcome from Single Institution Spine Tumor Registry

Ho¹,

Lai²,

Xiao³

et al. 2021

Preprint

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Given the limited studies addressing the issue about the effect of different surgical modalities for metastatic spinal cord compression (MSCC) as the first malignancy manifestation, we conducted a retrospective case-control study to evaluate the surgical outcome of MSCC as the first malignancy manifestation. A total of 59 patients who were suspected of having metastatic spinal cord compression and underwent surgery from 2008 to 2017 were enrolled in the study. All patients were categorized into either ‘debulking group’ or ‘palliative group’. The primary outcome was progression-free survival (PFS). The secondary outcomes were overall survival (OS), Frankel scale, and Karnofsky scores. All the outcomes were analyzed with a data cutoff of December 31, 2017. There was a significant difference between groups in progression-free survival (PFS) (p = 0.0036). However, there was no significant difference between groups in the overall survival (OS) (p = 0.8669). Age of onset, gender, duration of symptoms, and location of spinal metastasis, initial Frankel, initial Tomita scores, and initial Karnofsky performance scale showed no significant differences between groups. In conclusion, debulking surgery was shown to provide better neurological recoveries and could be considered first in patients with metastatic spinal cord compression as the first malignancy manifestation.

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