Department of Anesthesiology, Tulane University Hospital, New Orleans, Louisiana, United States.
Department of Orthopedic Surgery, The University of Kansas School of Medicine-Wichita, Wichita, Kansas, United States.
Global Spine J. 2015 Oct;5(5):e65-8. doi: 10.1055/s-0035-1546417. Epub 2015 Mar 12.
Study Design Case report. Objective This case exemplifies the importance of a high index of suspicion when dealing with intractable pain and neurologic symptoms in patients with a history of cancer. Fallopian tube cancer is relatively uncommon, accounting for less than 0.2% of all female malignancies. Because of a low index of suspicion, it is often detected at an advanced stage. From an orthopedic perspective, osseous metastasis from primary fallopian tube malignancies is rare with only a few documented cases in the medical literature. Methods This case report documents a 68-year-old woman who developed back pain and leg weakness after undergoing surgical resection with adjuvant therapy of a primary fallopian tube adenocarcinoma. Her hospital course and follow-up are documented. Results Imaging revealed a compression fracture in the L1 vertebral body that when a biopsy confirmed a soft tissue diagnosis of a high-grade serous papillary adenocarcinoma of fallopian tube origin. The patient underwent a surgical decompression, posterior stabilization, and tumor debulking with postoperative resolution of her symptoms. Conclusions This is the first reported case of a spine metastasis from a fallopian tube serous carcinoma in a living patient. This case documents the diagnosis of a pathologic vertebral fracture due to metastasis of an atypical cancer.
研究设计 病例报告。目的 本病例说明了在处理有癌症病史的患者的难治性疼痛和神经症状时，保持高度怀疑的重要性。输卵管癌相对少见，占所有女性恶性肿瘤的比例不到 0.2%。由于怀疑程度低，它通常在晚期才被发现。从骨科的角度来看，原发性输卵管恶性肿瘤的骨转移很少见，在医学文献中只有少数几例有记录。方法 本病例报告记录了一位 68 岁的女性，她在接受原发性输卵管腺癌的手术切除和辅助治疗后出现背痛和下肢无力。记录了她的住院过程和随访情况。结果 影像学显示 L1 椎体压缩性骨折，活检证实为输卵管来源的高级别浆液性乳头状腺癌的软组织诊断。患者接受了手术减压、后路稳定和肿瘤切除术，术后症状缓解。结论 这是首例有活体患者输卵管浆液性癌脊柱转移的报道。本病例记录了由于非典型癌症转移导致病理性椎体骨折的诊断。
