Metastasis of choriocarcinoma to lumbar and sacral column

Menegaz, Renato Augusto; Resende, Andréa Duarte; Silva, Cléber Sérgio da; Barcelos, Ana Cristina Macêdo; Murta, Eddie Fernando Cândido

doi:10.1016/j.ejogrb.2003.09.029

Cited by 18 publications

(21 citation statements)

References 5 publications

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“…After screening, 16 studies were found to be eligible for inclusion (1 prospective cohort study on radiosurgery (level II) [32]; 2 case series (level III) [28,33]; 4 retrospective case series (level IV) [2,10,34,35] and 9 case reports (level IV) [36][37][38][39][40][41][42][43][44]; Table 1). …”

Section: Resultsmentioning

confidence: 99%

Management of metastatic sacral tumours

et al. 2012

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Purpose Metastatic involvement of the sacrum is rare and there is a paucity of studies which deal with the management of these tumours since most papers refer to primary sacral tumours. This study aims to review the available literature in the management of sacral metastatic tumours as reflected in the current literature. Methods A systematic review of the English language literature was undertaken for relevant articles published over the last 11 years (1999)(2000)(2001)(2002)(2003)(2004)(2005)(2006)(2007)(2008)(2009)(2010). The PubMed electronic database and reference lists of key articles were searched to identify relevant studies using the terms ''sacral metastases'' and ''metastatic sacral tumours''. Studies involving primary sacral tumours only were excluded. For the assessment of the level of evidence quality, the CEBM (Oxford Centre of Evidence Based Medicine) grading system was utilised. Results The initial search revealed 479 articles. After screening, 16 articles identified meeting our inclusion criteria [1 prospective cohort study on radiosurgery (level II); 2 case series (level III); 4 retrospective case series (level IV) and 9 case reports (level IV)]. Conclusion The mainstay of management for sacral metastatic tumours is palliation. Preoperative angioembolisation is shown to be of value in cases of highly vascularised tumours. Radiotherapy is used as the primary treatment in cases of inoperable tumours without spinal instability where pain relief and neurological improvement are attainable. Minimal invasive procedures such as sacroplasties were shown to offer immediate pain relief and improvement with ambulation, whereas more aggressive surgery, involving decompression and sacral reconstruction, is utilised mainly for the treatment of local advanced tumours which compromise the stability of the spine or threaten neurological status. Adjuvant cryosurgery and radiosurgery have demonstrated promising results (if no neurological compromise or instability) with local disease control.

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Section: Resultsmentioning

confidence: 99%

Management of metastatic sacral tumours

et al. 2012

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“…Myelography showed a complete block with intact bony structures at the T5 level. Menegaz et al 15) reported on a 45-year-old woman with metastatic choriocarcinoma to the lumbar and sacral segments. The radiologic findings showed a predominantly extrathecal intracanalicular process extending from L2 to S1 and compressing the thecalradicular structures.…”

Section: Discussionmentioning

confidence: 99%

“…The lung and brain have been described as the most common sites for metastasis in the literature 1,2,4,11,12,15,20,21,23,25) . Yet, metastasis in the musculoskeletal system, such as the spine, is extremely rare and this can be seen from the scant reported cases 4,[14][15][16]20,21) . This current report presents an unusual metastatic choriocarcinoma in the lumbar spine and it extended to the epidural space.…”

Section: Discussionmentioning

confidence: 99%

“…Bony metastases secondary to choriocarcinoma are exceptional. Nonetheless, because the lung and brain are the most common sites of metastasis, many articles 1,2,4,11,12,15,[20][21][22][23]25) have emphasized that the possibility of choriocarcinoma should be borne in mind when observing parenchymal hemorrhage of the lung or any intracranial bleed in woman of child-bearing age. In our case, the pulmonary and cerebral hemorrhagic content existed and furthermore, a spinal hypervascular mass with feeder vessel was seen on arteriography.…”

Section: Discussionmentioning

confidence: 99%

“…The most common locations for metastases are the lung and the vulvo-vaginal region, and metastases are less commonly found in the brain and liver. Other sites of metastases, such as the skin, gastrointestinal tract, kidney, breast or bones, are extremely rare 2,4,11,12,15,[20][21][22][23][24] . In this study, we report on a case of metastatic choriocarcinoma that presented with intracerebral hemorrhage and pulmonary hemorrhage and it metastasized to the lumbar spine, and this metastasis to the spine radiologically mimicked an extraosseous extension of vertebral hemangioma.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

A Case of Lumbar Metastasis of Choriocarcinoma Masquerading as an Extraosseous Extension of Vertebral Hemangioma

Lee

Park

Chung

et al. 2010

J Korean Neurosurg Soc

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We report here on an uncommon case of metastatic choriocarcinoma to the lung, brain and lumbar spine. A 33-year-old woman was admitted to the pulmonary department with headache, dyspnea and hemoptysis. There was a history of cesarean section due to intrauterine fetal death at 37-weeks gestation and this occurred 2 weeks before admission to the pulmonary department. The radiological studies revealed a nodular lung mass with hypervascularity in the left upper lobe and also a brain parenchymal lesion in the parietal lobe with marginal bleeding and surrounding edema. She underwent embolization for the lung lesion, which was suspected to be an arteriovenous malformation according to the pulmonary arteriogram. Approximately 10 days after discharge from the pulmonary department, she was readmitted due to back pain and progressive paraparesis. The neuroradiological studies revealed a hypervascular tumor occupying the entire L3 vertebral body and pedicle, and the tumor extended to the epidural area. She underwent embolization of the hypervascular lesion of the lumbar spine, and after which injection of polymethylmethacrylate in the L3 vertebral body, total laminectomy of L3, subtotal removal of the epidural mass and screw fixation of L2 and L4 were performed. The result of biopsy was a choriocarcinoma.

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Diagnosis and management of a case of gestational trophoblastic neoplasia with lumbosacral metastases

Dela Cruz,

De La Peña,

Maglasang‐Lucas

et al. 2024

Intl J Gynecology & Obste

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Gestational trophoblastic neoplasia (GTN) with spinal metastasis is rare with few documented cases worldwide. Few studies have explored chemotherapy combined with radiotherapy in the treatment of such cases. However, because of its rarity, there is still no standardized treatment regimen. A 34‐year‐old Gravida 1 Para 0 (0010) was diagnosed with GTN with metastasis to the lumbosacral spine, resulting in conus medullaris syndrome with lumbar radiculopathy. She presented with a 14‐month history of amenorrhea, left lower extremity pain, and urinary and bowel retention. On examination, there was a 10.0 × 7.0 cm lumbosacral mass and atrophy of the left lower extremity. Transvaginal ultrasound showed a cul de sac mass, and diluted β‐human chorionic gonadotropin (β‐hCG) titer was markedly elevated at more than 1000 000 mIU/mL. Magnetic resonance imaging (MRI) of the lumbosacral spine showed an ill‐defined sacral mass measuring 13.3 × 11.5 × 6.3 cm with spinal canal, bone, muscle, and nerve root involvement. She was treated with 10 cycles of EMACO and palliative radiotherapy with 10 sessions of 30 Gy of external beam radiation therapy directed toward the lumbosacral mass. Repeat MRI showed a decrease in size of the mass to 6.6 × 8.2 × 4.1 cm with concurrent decrease in β‐hCG to 1.30 mIU/ml, and resolution of leg pain and urinary and bowel symptoms. She was declared to be in remission 3 months after the last cycle of EMACO.

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Metastasis of choriocarcinoma to lumbar and sacral column

Cited by 18 publications

References 5 publications

Management of metastatic sacral tumours

Management of metastatic sacral tumours

A Case of Lumbar Metastasis of Choriocarcinoma Masquerading as an Extraosseous Extension of Vertebral Hemangioma

Diagnosis and management of a case of gestational trophoblastic neoplasia with lumbosacral metastases

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