Hori Takeshi, Yasuda Taketoshi, Suzuki Kayo, Kanamori Masahiko, Kimura Tomoatsu
Department of Orthopaedic Surgery, Faculty of Medicine, University of Toyama, Toyama 930-0194, Japan.
Oncol Lett. 2012 May;3(5):1105-1108. doi: 10.3892/ol.2012.622. Epub 2012 Feb 28.
Carcinoid tumors are neuroendocrine neoplasms derived from enterochromaffin cells. Skeletal metastases from carcinoid tumors are considered to be extremely rare. In this study, we present two cases of carcinoid tumors that metastasized to the bone. Furthermore, we review 50 published case reports and reveal the features of skeletal metastasis of carcinoid tumors. The first case involved a 59-year-old man with a history of multiple metastases of a lung carcinoid tumor. The patient complained of back pain and numbness in the lower limbs. Magnetic resonance imaging revealed metastases in the thoracic spine. A spinal decompression was performed and the symptoms were resolved. The second case involved a 74-year-old man had been diagnosed with a lung carcinoid tumor 15 years previously and complained of left thigh pain. A radiograph showed osteolytic lesions in the shaft of the left femur. We repaired the femur using an intramedullary nail following curettage of the tumor. A radiograph of the femur revealed a callus on the pathological fracture. The patient was able to walk using a crutch 3 months after surgery. We reviewed 50 cases that described skeletal metastasis from carcinoid tumors. The average age of the patients was 54.9 years and 33 patients (66%) were male. The most common site of skeletal metastasis was the spine. We also investigated the survival rate of patients who developed skeletal metastasis from carcinoid tumors. The findings showed that survival of patients who developed osteolytic skeletal metastasis was worse than that of patients who developed osteosclerotic skeletal metastasis.
类癌肿瘤是起源于肠嗜铬细胞的神经内分泌肿瘤。类癌肿瘤的骨骼转移被认为极其罕见。在本研究中,我们报告了两例发生骨转移的类癌肿瘤病例。此外,我们回顾了50篇已发表的病例报告,并揭示了类癌肿瘤骨骼转移的特征。第一例患者为一名59岁男性,有肺类癌肿瘤多处转移史。患者主诉背痛和下肢麻木。磁共振成像显示胸椎有转移灶。进行了脊柱减压手术,症状得到缓解。第二例患者为一名74岁男性,15年前被诊断为肺类癌肿瘤,主诉左大腿疼痛。X线片显示左股骨干有溶骨性病变。在刮除肿瘤后,我们使用髓内钉修复了股骨。股骨X线片显示病理性骨折处有骨痂形成。患者术后3个月能够拄拐行走。我们回顾了50例描述类癌肿瘤骨骼转移的病例。患者的平均年龄为54.9岁,33例(66%)为男性。骨骼转移最常见的部位是脊柱。我们还调查了发生类癌肿瘤骨骼转移患者的生存率。结果显示,发生溶骨性骨骼转移的患者生存率低于发生骨硬化性骨骼转移的患者。