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Small-cell lung carcinoma diagnosed only after cervical intradural metastasis caused hemiparesis


1 Department of Neurosurgery, Southern TOHOKU Research Institute for Neurosciences, Koriyama, Fukushima, Japan
2 Department of Respiratory Medicine, Southern TOHOKU Research Institute for Neurosciences, Koriyama, Fukushima, Japan
3 Department of Pathology, Southern TOHOKU Research Institute for Neurosciences, Koriyama, Fukushima, Japan

Correspondence Address:
Yoshitaka Hirano,
Department of Neurosurgery, Southern TOHOKU Research Institute for Neurosciences, 7-115 Yatsuyamada, Koriyama, Fukushima 963-8563
Japan
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/joss.joss_5_20

We present a rare case of intradural extramedullary metastasis of small-cell lung carcinoma in the cervical spine. Optimal treatment strategies, including the indication for decompressive surgery, are discussed. A 70-year-old male who first presented with nuchal region pain suddenly developed right hemiparesis and was referred to our emergency service. Magnetic resonance imaging of his brain was unremarkable, but additional scanning of the cervical spine revealed an intradural tumor at the right C1–C3 levels. Urgent decompressive surgery was carried out, and gross total removal of the tumor was achieved. The histopathological diagnosis was metastasis of small-cell lung carcinoma. Computed tomography of the lung and abdomen revealed a primary tumor in his left lung, with multiple metastases to the mediastinal lymph nodes, liver, and adrenal gland. The patient was being considered for chemotherapy after some improvement of his hemiparesis and pain, but died on the 13th day due to sudden aggravation of the general condition. There was probably no surgical indication for the present case. Careful assessment and management of the primary disease should be considered the top priority even in patients with emergent neuronal insult.


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    -  Hirano Y
    -  Fujimori D
    -  Omi F
    -  Masawa M
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