ABSTRACT
The authors describe a case of choriocarcinoma that metastasized to the cerebral cortex, vertebral body, and intramedullary spinal cord. A 21-year-old woman presented with sudden headache, vomiting and a visual field defect. Brain computed tomography and magnetic resonance examinations revealed an intracranial hemorrhage in the left temporo-parietal lobe and two enhancing nodules in the left temporal and right frontal lobe. After several days, the size of the hemorrhage increased, and a new hemorrhage was identified in the right frontal lobe. The hematoma and enhancing mass in the left temporo-parietal lobe were surgically removed. Choriocarcinoma was diagnosed after histological examination. At 6 days after the operation, her consciousness had worsened and she was in a state of stupor. The size of the hematoma in the right frontal lobe was enlarged. We performed an emergency operation to remove the hematoma and enhancing mass. Her mental status recovered slowly. Two months thereafter, she complained of paraplegia with sensory loss below the nipples. Whole spine magnetic resonance imaging revealed a well-enhancing mass in the thoracic intramedullary spinal cord and L2 vertebral body. Despite chemotherapy and radiotherapy, the patient died 13 months after the diagnosis.
Subject(s)
Female , Humans , Pregnancy , Young Adult , Brain , Cerebral Cortex , Choriocarcinoma , Consciousness , Emergencies , Frontal Lobe , Headache , Hematoma , Hemorrhage , Intracranial Hemorrhages , Magnetic Resonance Imaging , Magnetic Resonance Spectroscopy , Neoplasm Metastasis , Nipples , Paraplegia , Spinal Cord , Spine , Stupor , Visual Fields , VomitingABSTRACT
Intramedullary spinal cord metastases occurring from any malignant tumor are usually accompanied by frequent metastases in the intracranium. The clinical features of this disease have been described as the rapid progression of neurologic deficit that can lead to complete paraplegia. In this case, the authors treated a 76-year-old woman, who was diagnosed with an intramedullary spinal cord metastasis arising from a small cell lung cancer without an invasion of the brain, with decompressive surgery and posterior instrumentation. The patient suffered from weakness of her legs, walking difficulties, and urinary and fecal incontinence. Her preoperative neurologic symptoms were improved significantly after surgery. The patient did not want to have further treatment for the primary cancer, and she died from pneumonia caused by aggravation of the underlying disease 3 months after surgery. We report this rare case, which was diagnosed as a metastasis of a small cell lung cancer postoperatively, with a review of the relevant literature.
Subject(s)
Aged , Female , Humans , Brain , Fecal Incontinence , Leg , Neoplasm Metastasis , Neurologic Manifestations , Paraplegia , Pneumonia , Small Cell Lung Carcinoma , Spinal Cord , WalkingABSTRACT
Intramedullary spinal cord metastasis (ISCM) has rarely been reported in patients wit carcinomas. In about half the ISCM reported the primary origins are lung cancer, with small cell lung cancer responsible for almost all reported cases. Thus, ISCM from small cell lung cancer is relatively well documented, but ISCM from nonsmall cell lung cancer is rarely diagnosed prior to the patients' demise, so very little data about such patients is available. Spine MRI is the most sensitive technique for diagnosing ISCM. ISCM are now being encountered with increasing frequency due to the increasing survival rates of lung cancer patients, and the development of new imaging technique. We reported a case of an ISCM from non-small cell lung cancer with a brief review of the literature.
Subject(s)
Humans , Carcinoma, Non-Small-Cell Lung , Lung Neoplasms , Magnetic Resonance Imaging , Neoplasm Metastasis , Small Cell Lung Carcinoma , Spinal Cord , Spine , Survival RateABSTRACT
Intramedullary spinal cord metastasis (ISCM) has rarely been reported in patients wit carcinomas. In about half the ISCM reported the primary origins are lung cancer, with small cell lung cancer responsible for almost all reported cases. Thus, ISCM from small cell lung cancer is relatively well documented, but ISCM from nonsmall cell lung cancer is rarely diagnosed prior to the patients' demise, so very little data about such patients is available. Spine MRI is the most sensitive technique for diagnosing ISCM. ISCM are now being encountered with increasing frequency due to the increasing survival rates of lung cancer patients, and the development of new imaging technique. We reported a case of an ISCM from non-small cell lung cancer with a brief review of the literature.
Subject(s)
Humans , Carcinoma, Non-Small-Cell Lung , Lung Neoplasms , Magnetic Resonance Imaging , Neoplasm Metastasis , Small Cell Lung Carcinoma , Spinal Cord , Spine , Survival RateABSTRACT
Intramedullary spinal cord metastasis is rare, but is being encountered with increasing frequency with the availability of more sensitive imaging techniques. RI is the most sensitive of these techniques, though it cannot differentiate between intramedullary spinal cord metastasis and other cord pathologies. Occasionally, therefore, surgical biopsy is indicated though optimal treatment after diagnosis remains controversial. Radical resection, radiation and chemotherapy significantly prolong survival, but many patients survive less than one year. The authors have encountered two cases of intramedullary spinal cord metastasis of small cell carcinoma of the lung. These are reviewed, together with literature describing adequate evaluation and management.
Subject(s)
Humans , Biopsy , Carcinoma, Small Cell , Diagnosis , Drug Therapy , Lung , Neoplasm Metastasis , Pathology , Spinal CordABSTRACT
PURPOSE: Primary sphenoid carcinoma is rare. It accounts for 0.3% of all primary paranasal sinus malignancies. Because of the rarity of sphenoid carcinoma, large series of patients with outcome and survival statistics are currently unavailable. So we followed up the 1 case of sphenoid sinus carcinoma treated in our hospital and reported the course of the disease. METHODS AND MATERIALS : In a review of case reports and small series of patients, 2-year survival was 7%. Our case is alive at 29 months after diagnosis of sphenoid sinus carcinoma. Intramedullary spinal cord metastasis (ISCM) is an unusual complication of cancer. In our case rapidly progressive paraparesis and urinary retention developed at 25 months after diagnosis of sphenoid sinus carcinoma. MRI of the thoracic spines showed the intramedullary spinal cord tumor mass at T3 and T4 level with accompanying syringomyelia.Here we report a case of ISCM associated with syringomyelia which has developed after primary sphenoid sinus carcinoma with a review of literature about the clinical behavior and treatment of this lesion.