Xinjie Wu1, Yingna Qi2, Feng Yang3, Mingsheng Tan4, Jie Lin5. 1. Department of Spine Surgery, China-Japan Friendship Hospital, Beijing, P. R. China; Graduate School of Peking Union Medical College, Beijing, P. R. China. 2. Department of Spine Surgery, China-Japan Friendship Hospital, Beijing, P. R. China; Graduate School of Beijing University of Chinese Medicine, Beijing, P. R. China. 3. Department of Spine Surgery, China-Japan Friendship Hospital, Beijing, P. R. China. 4. Department of Spine Surgery, China-Japan Friendship Hospital, Beijing, P. R. China; Graduate School of Peking Union Medical College, Beijing, P. R. China. Electronic address: doctortan_123@126.com. 5. Department of Pathology, China-Japan Friendship Hospital, Beijing, P. R. China.
Abstract
BACKGROUND: Thymic carcinoid with spinal metastasis is an extremely rare entity. Clinically, the tumor presents either by its endocrine manifestations or by mechanical compression of surrounding structures. However, no previously published case studies have reported neck pain and neurologic deficit in the initial presentation of an atypical thymic carcinoid. CASE DESCRIPTION: A 56-year-old man, a nonsmoker, presented with a 12-month history of intermittent neck pain and a 1-month history of progressive numbness and weakness of the right upper limb. Cervical MRI showed multiple abnormal signals and C2 soft-tissue mass intruding into the vertebral canal. Cervical CT scan showed multiple bone lesions. The diagnosis of thymic carcinoid was obtained by preoperative lymph node biopsy. The patient underwent cervical laminectomy and occipitocervical fixation. Significant alleviation of pain and neurologic improvement were achieved. The postoperative pathological examination confirmed the diagnosis of thymic carcinoid. CONCLUSIONS: Neck pain and neurologic deficit could be the first presentation of thymic carcinoid with spinal metastasis. Palliative surgery is an effective method to improve quality of life in patients with thymic carcinoid with spinal metastasis.
BACKGROUND:Thymic carcinoid with spinal metastasis is an extremely rare entity. Clinically, the tumor presents either by its endocrine manifestations or by mechanical compression of surrounding structures. However, no previously published case studies have reported neck pain and neurologic deficit in the initial presentation of an atypical thymic carcinoid. CASE DESCRIPTION: A 56-year-old man, a nonsmoker, presented with a 12-month history of intermittent neck pain and a 1-month history of progressive numbness and weakness of the right upper limb. Cervical MRI showed multiple abnormal signals and C2 soft-tissue mass intruding into the vertebral canal. Cervical CT scan showed multiple bone lesions. The diagnosis of thymic carcinoid was obtained by preoperative lymph node biopsy. The patient underwent cervical laminectomy and occipitocervical fixation. Significant alleviation of pain and neurologic improvement were achieved. The postoperative pathological examination confirmed the diagnosis of thymic carcinoid. CONCLUSIONS:Neck pain and neurologic deficit could be the first presentation of thymic carcinoid with spinal metastasis. Palliative surgery is an effective method to improve quality of life in patients with thymic carcinoid with spinal metastasis.