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Spinal cord compression by a solitary metastasis from a low grade leydig cell tumour: a case report and review of the literature.

Samoladas EP, Anbar AS, Lucas JD, Fotiadis H, Chalidis BE - World J Surg Oncol (2008)

Bottom Line: At 2 years follow-up visit the patient is neurologically stable and disease free without other organs metastases.This is the first case in English literature, which shows that spinal metastases could occur even in the early stage of Leydig cell tumour, without other organs involvement.Aggressive surgical management of spinal metastases combined with post operative radiotherapy can give a better chance for long survivorship.

View Article: PubMed Central - HTML - PubMed

Affiliation: Spinal Unit, Guy's Hospital, London, UK. msamolad@gmail.com

ABSTRACT

Background: Leydig tumour is rare and there are only three cases with metastatic disease reported.

Case presentation: A 52 year-old Caucasian male was admitted, on emergency basis to the Orthopaedic Department with six weeks history of increasing midthoracic back pain, change in gait, poor balance, subjective weakness and numbness of the lower trunk and legs. MRI scan showed change in the signal intensity of T4 and T5 vertebral body but their height were maintained. Urgent T4 and T5 corpectomies, decompression of the spinal cord and reconstruction of the vertebral bodies were performed followed by radiotherapy. Neurological status significantly improved with a mild residual numbness over the dorsum of the right foot. The histology of the excised tumour was identical to the primary. At 2 years follow-up visit the patient is neurologically stable and disease free without other organs metastases.

Conclusion: This is the first case in English literature, which shows that spinal metastases could occur even in the early stage of Leydig cell tumour, without other organs involvement. Aggressive surgical management of spinal metastases combined with post operative radiotherapy can give a better chance for long survivorship.

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Related in: MedlinePlus

Lateral X ray of Thoracic spine.
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Related In: Results  -  Collection

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Figure 2: Lateral X ray of Thoracic spine.

Mentions: X-rays of the thoracic spine revealed a sclerotic appearance of the T4 vertebral body (Figure 1 &2) and an urgent Magnetic Resonance Imaging (MRI) showed quite dramatic change in the appearance of T4 compare to the previous CT despite the maintenance of vertebral body height. Furthermore, T5 vertebral body was also involved, but to a lesser extent. There was a soft tissue expansion into the extradural space causing spinal cord compression (Figure 3).


Spinal cord compression by a solitary metastasis from a low grade leydig cell tumour: a case report and review of the literature.

Samoladas EP, Anbar AS, Lucas JD, Fotiadis H, Chalidis BE - World J Surg Oncol (2008)

Lateral X ray of Thoracic spine.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2483278&req=5

Figure 2: Lateral X ray of Thoracic spine.
Mentions: X-rays of the thoracic spine revealed a sclerotic appearance of the T4 vertebral body (Figure 1 &2) and an urgent Magnetic Resonance Imaging (MRI) showed quite dramatic change in the appearance of T4 compare to the previous CT despite the maintenance of vertebral body height. Furthermore, T5 vertebral body was also involved, but to a lesser extent. There was a soft tissue expansion into the extradural space causing spinal cord compression (Figure 3).

Bottom Line: At 2 years follow-up visit the patient is neurologically stable and disease free without other organs metastases.This is the first case in English literature, which shows that spinal metastases could occur even in the early stage of Leydig cell tumour, without other organs involvement.Aggressive surgical management of spinal metastases combined with post operative radiotherapy can give a better chance for long survivorship.

View Article: PubMed Central - HTML - PubMed

Affiliation: Spinal Unit, Guy's Hospital, London, UK. msamolad@gmail.com

ABSTRACT

Background: Leydig tumour is rare and there are only three cases with metastatic disease reported.

Case presentation: A 52 year-old Caucasian male was admitted, on emergency basis to the Orthopaedic Department with six weeks history of increasing midthoracic back pain, change in gait, poor balance, subjective weakness and numbness of the lower trunk and legs. MRI scan showed change in the signal intensity of T4 and T5 vertebral body but their height were maintained. Urgent T4 and T5 corpectomies, decompression of the spinal cord and reconstruction of the vertebral bodies were performed followed by radiotherapy. Neurological status significantly improved with a mild residual numbness over the dorsum of the right foot. The histology of the excised tumour was identical to the primary. At 2 years follow-up visit the patient is neurologically stable and disease free without other organs metastases.

Conclusion: This is the first case in English literature, which shows that spinal metastases could occur even in the early stage of Leydig cell tumour, without other organs involvement. Aggressive surgical management of spinal metastases combined with post operative radiotherapy can give a better chance for long survivorship.

Show MeSH
Related in: MedlinePlus