Lung adenocarcinoma presenting as intramedullary spinal wire metastasis: Case report and assessment of literature.
J Clin Neurosci. 2018 Jun;52:124-131
Authors: Majmundar N, Shao B, Assina R
Intramedullary spinal wire metastasis (IMSCM) is a uncommon entity which lacks well-defined remedy tips, but sees rising incidence. We report a case of a 67-year-old man who introduced with extreme neck ache and numbness in his proper fourth and fifth digits, and was discovered to have a C5-7 IMSCM of beforehand unknown lung adenocarcinoma. He underwent gross whole resection of the IMSCM, afatinib, and radiation remedy. He had full reversal of his ache and sensory deficit, and remained ambulatory with none focal neurological deficit. Moreover, we carried out a literature assessment of authentic case sequence of IMSCM revealed between 1983 and 2016, representing 138 distinctive instances, and focus on varied therapies with a concentrate on surgical resection and common remedy of stage IV lung adenocarcinoma. 18.75% of instances of IMSCM had been an preliminary presentation of underlying malignancy. Quickly progressive ache and weak point was the most typical presentation, typically compromising ambulatory standing. Median survival ranged from three.eight to 11.6?months after remedy in sufferers who had been deceased at time of publication. Therapies included corticosteroids, chemotherapy, varied radiotherapies, and surgical resection. Surgical resection was discovered to significantly enhance signs and protect ambulatory standing, and was related to elevated survival time as much as double that of non-surgical therapies. Most authors advisable surgical resection solely in symptomatic sufferers with reversible deficits, to palliate signs and protect ambulation. IMSCM can herald an underlying malignancy, and surgical resection can protect ambulatory standing and palliate signs as nicely improve survival time in a subset of sufferers.
PMID: 29631755 [PubMed – indexed for MEDLINE]