Thymoma metastatic to the extradural spine.

BACKGROUND: Spinal epidural metastases are the most common spinal tumor, occurring in 10% of cancer patients. Malignant thymoma is a mediastinal tumor, with extrathoracic metastases occurring in 15% of patients to liver, kidney, and bone. Spinal metastasis is exceptionally rare. We present a case of thymoma with extradural metastasis and discuss the relevant literature. CASE REPORT: We describe a 45-year old man presenting with back pain and hypoesthesia twelve years after a diagnosis of thymoma. A review of the literature reveals few cases of thymoma metastatic to the extradural spine. We describe a novel surgical approach allowing ventral spinal cord decompression through a posterior incision.
CONCLUSION: Spinal epidural metastases should be suspected in all cancer patients with back pain. Early detection of epidural metastases may enable improved pain control and preservation of spinal stability, ambulation and sphincter control.