| Popis: |
Introduction: Despite the highly aggressive behaviour of thymic carcinomas, extra-thoracic metastasis and specifically spinal metastasis are very rare and sparsely reported. For that reason, the survival and the natural course of the disease are not yet clearly elucidated. Materials and Methods: We report on one patient with spinal metastasis from thymic carcinoma who had surgical removal performed in our institute, following progressive weakness of both legs associated with flank and lower back pain. The patient had a paravertebral and anterior intracanalar epidural mass compressing the spinal cord at the T12 level. The clinical, radiological, surgical and pathological features of this abnormality are discussed and the case reviewed. Results: A laminectomy at T12 and partially at T11 and L1 were performed via a posterior approach and the histopathological diagnosis was a metastasis from a thymic origin. The patient presented a mild improvement of the presenting neurological deficits and the back pain was relieved completely, with no observed complications. The period from the primary diagnosis to spinal metastasis was 3 years. Posteriorly, the patient presented 2 episodes of seizures, leading to the diagnosis of 2 ring-enhancing lesions in the right hemisphere (on CT), with no further histological or imagiological investigation. She was proposed for adjuvant spinal and holocranial radiotherapy, but died approximately one moth after surgery due to pulmonary complications associated with disease progression. Conclusions: Spinal metastasis of thymic carcinoma are very rare, and we could find only a few cases reported. Due to its rarity, there are no treatment guidelines. Even so, we suggest that appropriate surgical removal of the metastatic lesion is necessary to treat refractory severe pain and a potential reversible neurologic deficit, in order to preserve the patient’s quality of life. |
