BACKGROUND: Testicular cancers are heterogenous neoplasms often found in young adults. They tend to metastasize to the chest, retroperitoneum, or neck, but rarely to the long bones or skeleton. However, they can cause neurologic compromise and should be considered in young male patients who present with symptoms of a spine lesion and no known primary cancer. METHODS: Two patients presented with back pain and a rapid progression of lower extremity weakness. Both underwent radiographic workup and emergency surgery. Metastatic workup revealed testicular cancer and widespread metastases. RESULTS: Both patients improved neurologically after surgery, but neither regained the ability to ambulate independently. They both underwent chemotherapy. One patient is alive at 1 year follow-up; the other died 9 months after surgery of widespread metastases. CONCLUSIONS: Vertebral metastases from testicular tumors, although rare, should be considered in young men presenting with spinal cord compression. Work-up should include magnetic resonance imaging (MRI) of the spine and computed tomography (CT) of the chest, abdomen, and pelvis. Urgent intervention may be required, as these two cases show that loss of neurologic function can be rapid and permanent.
BACKGROUND:Testicular cancers are heterogenous neoplasms often found in young adults. They tend to metastasize to the chest, retroperitoneum, or neck, but rarely to the long bones or skeleton. However, they can cause neurologic compromise and should be considered in young male patients who present with symptoms of a spine lesion and no known primary cancer. METHODS: Two patients presented with back pain and a rapid progression of lower extremity weakness. Both underwent radiographic workup and emergency surgery. Metastatic workup revealed testicular cancer and widespread metastases. RESULTS: Both patients improved neurologically after surgery, but neither regained the ability to ambulate independently. They both underwent chemotherapy. One patient is alive at 1 year follow-up; the other died 9 months after surgery of widespread metastases. CONCLUSIONS:Vertebral metastases from testicular tumors, although rare, should be considered in young men presenting with spinal cord compression. Work-up should include magnetic resonance imaging (MRI) of the spine and computed tomography (CT) of the chest, abdomen, and pelvis. Urgent intervention may be required, as these two cases show that loss of neurologic function can be rapid and permanent.
Authors: Christoph Oing; Anja Lorch; Carsten Bokemeyer; Friedemann Honecker; Jörg Beyer; Lars Arne Berger; Karin Oechsle Journal: J Cancer Res Clin Oncol Date: 2014-11-14 Impact factor: 4.553
Authors: Karin Oechsle; Carsten Bokemeyer; Christian Kollmannsberger; Frank Mayer; Lars Arne Berger; Christoph Oing; Friedemann Honecker Journal: J Cancer Res Clin Oncol Date: 2012-02-21 Impact factor: 4.553
Authors: Carlos Eduardo Salazar-Mejía; Edio Llerena-Hernández; David Hernández-Barajas; Oscar Vidal-Gutiérrez; Adriana González-Gutiérrez; Rolando Jacob Martínez-Granados; Blanca Otilia Wimer-Castillo Journal: Case Rep Oncol Med Date: 2018-10-08