Shigeki Taga
Kurashiki Municipal Hospital, Japan
Title: A case of endometrial cancer presenting with malignant spinal cord compression
Biography
Biography: Shigeki Taga
Abstract
Malignant spinal cord compression (MSCC) is one of the most disabling complications of cancer metastasis and an oncological emergency requiring prompt diagnosis and treatment.
A 65-year-old woman presented with vaginal bleeding and a huge uterine tumour. Cytological test of uterine cervix was negative and that of the endometrium was not possible. Magnetic resonance imaging (MRI) revealed a heterogeneous solid tumour and uterine leiomyosarcoma was suspected. She underwent total abdominal hysterectomy and bilateral salpingo-oophorectomy. Histopathologocal examination revealed mixed carcinoma (small cell carcinoma and endometrioid adenocarcinoma) of the endometrium. She presented with upper abdominal pain, back pain, cystoplegia and paraplegia of lower extremities postoperatively. Magnetic resonance imaging revealed bone metastasis with destruction of the eighth thoracic vertebral body as the sites of metastasis. She was diagnosed as having MSCC. Following administration of dexamethasone, she underwent vertebrectomy and posterior spinal fusion, and postoperative radiation therapy was performed to total of 20Gray in 4 fractions. The histopathological studies revealed malignant cells. We diagnosed this lesion as metastasis from endometrial cancer. However, her symptoms were not improved. Although she received two courses of systemic chemotherapy consisting of paclitaxel and carboplatin, CT scan of the chest revealed new lung metastatic lesion, and she selected the best supportive care. She died 4　months after hysterectomy.
Recent Publications:
1.Bohm, P. and Huber, J. (2002) The surgical treatment of bony metastases of the spine and limbs. Journal of Bone &Joint Surgery( Br), 84,521-529.
2. Klimo, P. Jr. Kestle, JR. and Schmidt, M.H. (2004) Clinical trials and evidence-based medicine for metastatic spine disease. Neurosurg Clin N Am,15,549-564.
3. Klimo, P. Jr. and Schmidt, M.H. (2004) Surgical management of spinal metastasis. Oncologist,9,188-196.
4. Loblaw, D.A., Perry J., Chambers, A. and Laperriere, N.J. (2005) Systematic review of the diagnosis and management of malignant extradural spinal cord compression: the Cancer Care Ontario Practice Guidelines Initiative's Neuro-Oncology Disease Site Group. Journal of clinical oncology, 23,2028-2037.
5.Schmidt,M.H., Klimo,P. Jr. and ,Vrionis, F.D.(2005) Metastatic spinal cord compression. Journal of the National Comprehensive Cancer Network, 3,711-709.