Todd Alin Eads1, Eyas M Hattab, Richard B Rodgers. 1. Department of Neurological Surgery, Indiana University School of Medicine, 545 Barnhill Drive, Indianapolis, IN 46202, USA. teads@iupui.edu
Abstract
STUDY DESIGN: A case report. OBJECTIVE: The authors present a rare case of metastatic nonfunctioning neuroendocrine tumor of the pancreas presenting as thoracic spinal cord compression. SUMMARY OF BACKGROUND DATA: Pancreatic endocrine tumors (PETs) are a slow-growing subset of pancreatic tumors. They can be classified as either functioning or nonfunctioning. To our knowledge, this is the second reported case of a PET presenting as spinal cord compression. METHODS: The clinical course, radiologic features, pathology, and outcome of the metastasis of PET are reported. RESULTS: A 59-year-old woman presenting with a 2-week history of midthoracic back pain and early signs of myelopathy. A computed tomography scan and magnetic resonance imaging revealed multiple mildly enhancing lesions within T5, T7, T8, and L1 vertebral bodies with ventral epidural and bilateral T8-T9 neuroforaminal soft tissue extension causing severe spinal canal stenosis. A computed tomography-guided biopsy was inconclusive, and we performed a T7-T9 laminectomy with T8 bilateral transpedicular decompression and T6 to T10 pedicle screw fixation and posterolateral fusion with subtotal resection of the tumor. Pathology was consistent with low-grade neuroendocrine tumor. The patient recovered well, and an octreotide scan ultimately revealed an area of abnormal uptake within the body of the pancreas. CONCLUSION: We have reported a rare case of a metastatic PET presenting as spinal cord compression.
STUDY DESIGN: A case report. OBJECTIVE: The authors present a rare case of metastatic nonfunctioning neuroendocrine tumor of the pancreas presenting as thoracic spinal cord compression. SUMMARY OF BACKGROUND DATA: Pancreatic endocrine tumors (PETs) are a slow-growing subset of pancreatic tumors. They can be classified as either functioning or nonfunctioning. To our knowledge, this is the second reported case of a PET presenting as spinal cord compression. METHODS: The clinical course, radiologic features, pathology, and outcome of the metastasis of PET are reported. RESULTS: A 59-year-old woman presenting with a 2-week history of midthoracic back pain and early signs of myelopathy. A computed tomography scan and magnetic resonance imaging revealed multiple mildly enhancing lesions within T5, T7, T8, and L1 vertebral bodies with ventral epidural and bilateral T8-T9 neuroforaminal soft tissue extension causing severe spinal canal stenosis. A computed tomography-guided biopsy was inconclusive, and we performed a T7-T9 laminectomy with T8 bilateral transpedicular decompression and T6 to T10 pedicle screw fixation and posterolateral fusion with subtotal resection of the tumor. Pathology was consistent with low-grade neuroendocrine tumor. The patient recovered well, and an octreotide scan ultimately revealed an area of abnormal uptake within the body of the pancreas. CONCLUSION: We have reported a rare case of a metastatic PET presenting as spinal cord compression.