Tumor neuroendocrino bien diferenciado intradural-extramedular primario del filum terminale. Presentación de un caso y revisión de la literatura / Primary well differentiated neuroendocrine tumor of the filum terminale. Case report and literature review

Objetivo: Presentar un caso de un tumor neuroendocrino primario bien diferenciado intradural-extramedular del filum terminale y revisar la literatura. Caso: Paciente de 68 años valorada tras presentar lumbociática de difícil control analgésico objetivándose una lesión intradural-extramedular lumbar. La lesión, en relación al filum terminal, fue resecada parcialmente siendo el diagnóstico anatomopatológico de tumor neuroendocrino bien diferenciado primario (carcinoide). Tras valoración multidisciplinaria, se decidió tratamiento radioterápico estereotáctico fraccionado. En los sucesivos controles no se evidenció progresión ni diseminación metastásica. Discusión: Los tumores neuroendocrinos son neoplasias heterogéneas derivadas predominantemente de células enterocromafines, en los cuales la quimioterapia tiene un rol muy limitado. Por otra parte, la radioterapia ha sido descrita en lesiones parcialmente resecadas. Conclusión: Los tumores neuroendocrinos primarios bien diferenciados con localización intradural-extramedular lumbosacra son una rareza excepcional. La resección quirúrgica aislada, o asociada a tratamiento adyuvante radioterápico en resecciones subtotales, podría ser considerada una estrategia terapéutica efectiva

Objective: To present a case of a well-differentiated primary intradural-extramedullary neuroendocrine tumor of the filum terminale and to conduct a literature review. Case: A 68-years old patient was assessed after presenting lower back pain and sciatica with ineffective pain relief. The patient presented an intradural-extramedullary lumbar lesion arising from the filum terminale, which was partially resected. The pathology diagnosis was a well-differentiated primary neuroendocrine tumor (carcinoid tumor). After a multidisciplinary evaluation, fractionated stereotactic radiotherapy was administered. No progression or metastatic spread was observed in successive assessments. Discussion: Neuroendocrine tumors are heterogeneous neoplasms derived predominantly from enterochromaffin cells, in which chemotherapy plays a very limited role. In contrast, radiotherapy has been described in partially resected lesions. Conclusion: Well-differentiated primary neuroendocrine tumors with intradural-extramedullary lumbosacral location are an exceptional rarity. Isolated surgical resection, or associated with an adjuvant radiotherapy treatment in subtotal resections, could be considered an effective therapeutic strategy

Primary well differentiated neuroendocrine tumor of the filum terminale. Case report and literature review. / Tumor neuroendocrino bien diferenciado intradural-extramedular primario del filum terminale. Presentación de un caso y revisión de la literatura.

OBJECTIVE: To present a case of a well-differentiated primary intradural-extramedullary neuroendocrine tumor of the filum terminale and to conduct a literature review. CASE: A 68-years old patient was assessed after presenting lower back pain and sciatica with ineffective pain relief. The patient presented an intradural-extramedullary lumbar lesion arising from the filum terminale, which was partially resected. The pathology diagnosis was a well-differentiated primary neuroendocrine tumor (carcinoid tumor). After a multidisciplinary evaluation, fractionated stereotactic radiotherapy was administered. No progression or metastatic spread was observed in successive assessments. DISCUSSION: Neuroendocrine tumors are heterogeneous neoplasms derived predominantly from enterochromaffin cells, in which chemotherapy plays a very limited role. In contrast, radiotherapy has been described in partially resected lesions. CONCLUSION: Well-differentiated primary neuroendocrine tumors with intradural-extramedullary lumbosacral location are an exceptional rarity. Isolated surgical resection, or associated with an adjuvant radiotherapy treatment in subtotal resections, could be considered an effective therapeutic strategy.