Intradural Extramedullary Metastasis of the Upper Thoracic Spine – Case Report and Literature Review

Abstract

Citation: Kehayov I, Genova S, Gicheva M, Nuri B, Kitov B. Intradural extramedullary metastasis of the upper thoracic spine -case report and literature review. Folia Med (Plovdiv) 2019;61(4):624-9. AbstractIntradural extramedullary metastases of systemic neoplasms are extremely rare and associated with progression of the underlying disease.We report a case of 46-year-old male operated on for moderately differentiated lung adenocarcinoma. Postoperatively, he underwent six courses of chemotherapy and radiotherapy. He developed progressive severe inferior paraparesis accompanied by excruciating pain between the shoulders two years later. Magnetic resonance imaging revealed metastases in the bodies of T2 and T3 vertebrae with adjacent intradural extramedullary lesion compressing the spinal cord. The patient underwent surgical decompression and vertebral body cement augmentation that lead to pain relief and partial neurological recovery. The histological examination was consistent with metastases from low differentiated pulmonary adenocarcinoma. Surgical resection of intradural extramedullary metastasis improves patient quality of life by reducing pain intensity and neurological deficit.

Intradural Extramedullary Spinal Metastases from Non-neurogenic Primary Tumors: A Systematic Review

“…Spine EBRT proved to be effective in patients with metastatic spinal cord compression to reduce postsurgical residual tumor volumes and prolong local control (75). In these pooled patients, locoregional spine EBRT mainly targeted the lesions of interest, but was also extended to other spine regions in case of multiple simultaneous IESMs and/or concurrent vertebral metastases (54,55,60). Targeted adjuvant SRS (with a 10 Gy dose) was used in the recent report of Pagano et al (64) with no radiation-induced adverse events, suggesting the feasibility and safety of this protocol for the management of IESMs.…”