Post-laminectomy long-term survival of a patient with spinal cord compression secondary to metastatic prostate cancer

Saito, Seiichi; Hoshi, Senji; Sakai, Kiyohide; Chiba, Yutaka; Saitō, Hideo; Hatori, Masahito; Endoh, Mareyuki; Arai, Yoichi

doi:10.1007/s10147-004-0431-3

Int J Clin Oncol

2004

DOI: 10.1007/s10147-004-0431-3

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Post-laminectomy long-term survival of a patient with spinal cord compression secondary to metastatic prostate cancer

Seiichi Saito

Senji Hoshi

Kiyohide Sakai

et al.

Abstract: Spinal cord compression is a skeletal-related event in advanced malignancies and is associated with serious morbidity and poor prognosis. Despite the palliative nature of laminectomy treatment, it is important to prevent neurological deficits and relieve pain as a means to improve quality of life. Here we report on a prostate cancer patient with spinal cord compression who became ambulant from paraparesis after he underwent a decompression laminectomy; he survived for 9.5 years with good quality of life.

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“…In fact, metastatic disease from the breast is the most prevalent of all spinal tumors (1). The symptoms of spinal cord compression, such as paraplegia, quadriplegia and vesicorectal disturbance, are aggravated with the progression of the disease over time (2,3). Back pain is the most common symptom several months before the onset of neurological symptoms, followed by sensory loss and autonomic dysfunction, such as urinary retention and constipation.…”

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Dysuria Caused by Pelvic Metastasis from Breast Carcinoma was Alleviated by Multi-Modality Therapy with Zoledronic Acid

et al. 2010

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Osseous metastases are frequently observed in association with breast carcinoma. The neurological defects produced by spinal cord compression or nerve root compression because of osseous metastasis are occasionally seen and are refractory. Usually, paralysis which occurs more than 24-48 hours after the onset is irreversible, and the patient is unlikely to recover no matter what therapeutic procedures are performed. We herein present a case of pelvic metastasis from breast carcinoma. Dysuria of the patient caused by damage to the lower urination center located in the sacral spinal cord was alleviated by multi-modality therapy with zoledronic acid (ZOL).A 58-year-old woman was admitted to the hospital to be treated for complete urinary retention. The patient had experienced left gluteal pain for 4 months. Irradiating pain in the thigh was also recognized. A subsequent dynamic magnetic resonance imaging examination demonstrated a pelvic tumor. A histopathological examination of a needle biopsy specimen of the pelvic tumor showed that the tumor appeared to be a metastatic adenocarcinoma, which was most likely to be a metastasis of breast carcinoma because estrogen receptor was positive, while CK7 and CK20 were negative. A 20-mm breast carcinoma in the lower-lateral quadrant of the breast was diagnosed by a pathological study of a core needle biopsy specimen. The pelvic metastasis from the breast carcinoma was confirmed, because, histopathologically, the cancer cells were similar to that of the pelvic tumor showing low atypical cells and mitotic figures and, immunohistochemically, both the breast and the pelvis tumor were estrogen receptor positive, progesterone receptor negative and C-erbB-2 negative. No other disease was detected in any organ. The breast carcinoma was not resected because it was unlikely to change the prognosis of the patient. Initially, the intravesical pressure was decompressed with bladder catheterization. A week after admission, radiotherapy was administered with 50 Gy to the pelvic tumor. Subsequently, endocrine therapy using 25 mg ⁄ day exemestane, aromatase inhibitor and bisphosphonate therapy using 90 mg pamidronate disodium per month was administered. In the meantime, the patient was given distigmine bromide (quaternary ammonium base) and urapidil (a1-blocker). Intermittent self-catheterization was not administered because of discomfort. Two months after the initiation of the therapy, an intrathecal phenol block was administered because of the ongoing gluteal pain and irradiating pain to the thigh. Three months after admission, ZOL 4 mg ⁄ month was administered in place of pamidronate disodium. Two days later the patient felt uresiesthesia and was able to urinate with no residual urine a month after the first treatment of ZOL. The dysuria disappeared completely and has not flared up again for 2 years, although some slight gluteral pain has been still observed. The pelvic tumor and breast tumor showed approximately 47% and 55% shrinkage, respectively ( Figs. 1 and 2).In breast carcinoma, oss...

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Dysuria Caused by Pelvic Metastasis from Breast Carcinoma was Alleviated by Multi-Modality Therapy with Zoledronic Acid

et al. 2010

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Quality of life in patients with malignant spinal cord compression: a systematic review

Gojsevic,

Shariati,

Chan

et al. 2023

Support Care Cancer

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Post-laminectomy long-term survival of a patient with spinal cord compression secondary to metastatic prostate cancer

Cited by 2 publications

References 3 publications

Dysuria Caused by Pelvic Metastasis from Breast Carcinoma was Alleviated by Multi-Modality Therapy with Zoledronic Acid

Dysuria Caused by Pelvic Metastasis from Breast Carcinoma was Alleviated by Multi-Modality Therapy with Zoledronic Acid

Quality of life in patients with malignant spinal cord compression: a systematic review

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