Hadgaonkar Shailesh, Zawar Amogh, Patel Anoop, Kothari Ajay, Shyam Ashok, Sancheti Parag
Department of Orthopedics, Sancheti Institute of Orthopedics and Rehabilitation, Pune, Maharashtra, India.
Department of Orthopedics, University of Dundee, Dundee, Scotland, United Kingdom.
Surg Neurol Int. 2020 Jul 11;11:185. doi: 10.25259/SNI_343_2020. eCollection 2020.
Metastatic spinal cord compression with carcinoid tumor as primary is a rare entity with its own diagnostic dilemmas and surgical challenges. Most of these neuroendocrine tumors arise from the gastrointestinal tract or lungs with metastasis to spine in <2% cases. Early diagnosis in an orderly manner is of significance as most of it is delayed due to slowly developing symptoms. Furthermore, prompt management has been an important factor as morbidity and mortality are high in such cases and surgical intervention if needed, which can be a challenge due to disturbed alignment, complex regional anatomy, and careful handling of spinal cord.
The authors describe a case report on similar lines of a middle aged gentleman presenting with low back pain and weakness in both lower limbs which on further investigations revealed a pathological fracture causing spinal cord compression due to metastasis from small cell carcinoma in the lungs, managed with surgical intervention, and subsequently with radiotherapy.
Secondary metastatic deposits in the lumbar vertebrae due to carcinoid tumors in the lungs are a rare entity and can be difficult to diagnose and manage further. However, it should be included in the list of differential diagnosis. The case report emphasizes on using investigative modalities such as PET-CT scan to aid an early diagnosis and plan further treatment plan as early as possible to offer a better quality of life to the patients.
以类癌肿瘤为原发灶的转移性脊髓压迫是一种罕见的疾病，有其自身的诊断难题和手术挑战。这些神经内分泌肿瘤大多起源于胃肠道或肺部，转移至脊柱的病例不到2%。由于症状发展缓慢，大多数病例诊断延迟，因此有序进行早期诊断具有重要意义。此外，及时处理一直是一个重要因素，因为此类病例的发病率和死亡率很高，如需进行手术干预，由于脊柱排列紊乱、局部解剖结构复杂以及对脊髓的谨慎处理，这可能是一项挑战。
作者描述了一例类似病例报告，一名中年男性出现腰痛和双下肢无力，进一步检查发现因肺部小细胞癌转移导致病理性骨折，压迫脊髓，经手术干预，随后进行放疗。
肺部类癌肿瘤导致腰椎继发性转移瘤是一种罕见的疾病，可能难以进一步诊断和处理。然而，应将其列入鉴别诊断清单。该病例报告强调使用正电子发射断层扫描（PET-CT）等检查手段辅助早期诊断，并尽早制定进一步的治疗方案，以提高患者的生活质量。
