Thoracic laminectomy with spinal fixation in a nonambulatory patient with metastatic vertebral tumor from endometrial carcinoma

• Published in: The journal of obstetrics and gynaecology research Vol. 42; no. 10; pp. 1395 - 1399
• Main Authors: Takeshita, Sho, Todo, Yukiharu, Okamoto, Kazuhira, Minobe, Shinichiro, Kato, Hidenori
• Format: Journal Article
• Language: English
• Published: Australia 01.10.2016
• Subjects: Decompression, Surgical; endometrial cancer; Endometrial Neoplasms - complications; Endometrial Neoplasms - diagnosis; Endometrial Neoplasms - pathology; fall limping; Female; Humans; Laminectomy; Lung Neoplasms - secondary; Magnetic Resonance Imaging; metastatic spinal tumor; Middle Aged; Spinal Cord - diagnostic imaging; Spinal Cord - pathology; Spinal Cord - surgery; Spinal Cord Compression - complications; Spinal Cord Compression - surgery; spinal fixation; Spinal Neoplasms - diagnostic imaging; Spinal Neoplasms - pathology; Spinal Neoplasms - radiotherapy; Spinal Neoplasms - secondary; Treatment Outcome; endometrial cancer; metastatic spinal tumor; laminectomy; spinal fixation; fall limping
• ISSN: 1341-8076; 1447-0756
• DOI: 10.1111/jog.13054

Vertebral metastasis from endometrial cancer is a rare event and requires emergency treatment at the onset of neurologic symptoms caused by spinal cord compression. We report a case of a metastatic vertebral tumor, according to the International Federation of Gynecology and Obstetrics classification, of stage IVb endometrial cancer with multiple lung metastases. Emergency irradiation to the spinal tumor was conducted as a result of a loss of ambulation. Thoracic laminectomy with spinal fixation was subsequently performed because the patient remained nonambulatory and her neurological function deteriorated. Spinal decompression surgery enabled her to regain the ability to walk. Complete remission was achieved by subsequent pelvic surgery followed by combined chemotherapy consisting of docetaxel and carboplatin. Finally, the patient had no evidence of disease 45 months after the initial treatment. Early recognition and expeditious treatment is crucial for neurological recovery from metastatic spinal cord compression.