Metastatic testicular cancer presenting as spinal cord compression: report of two cases.
BACKGROUND
Testicular cancers are heterogenous neoplasms often found in young adults. They tend to metastasize to the chest, retroperitoneum, or neck, but rarely to the long bones or skeleton. However, they can cause neurologic compromise and should be considered in young male patients who present with symptoms of a spine lesion and no known primary cancer.


METHODS
Two patients presented with back pain and a rapid progression of lower extremity weakness. Both underwent radiographic workup and emergency surgery. Metastatic workup revealed testicular cancer and widespread metastases.


RESULTS
Both patients improved neurologically after surgery, but neither regained the ability to ambulate independently. They both underwent chemotherapy. One patient is alive at 1 year follow-up; the other died 9 months after surgery of widespread metastases.


CONCLUSIONS
Vertebral metastases from testicular tumors, although rare, should be considered in young men presenting with spinal cord compression. Work-up should include magnetic resonance imaging (MRI) of the spine and computed tomography (CT) of the chest, abdomen, and pelvis. Urgent intervention may be required, as these two cases show that loss of neurologic function can be rapid and permanent.
Arnold
P M
PM
Section of Neurosurgery, The University of Kansas Medical Center, Kansas City, Kansas 66160, USA.
Morgan
C J
CJ
Morantz
R A
RA
Eckard
D A
DA
Kepes
J J
JJ
D000328:Adult; D001706:Biopsy; D003937:Diagnosis, Differential; D004824:Epidural Space / Q000473:pathology; D018237:Germinoma / Q000175:diagnosis* / Q000556:secondary* / Q000628:therapy; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D016609:Neoplasms, Second Primary / Q000175:diagnosis* / Q000628:therapy; D013117:Spinal Cord Compression / Q000175:diagnosis / Q000209:etiology*; D013125:Spinal Neoplasms / Q000150:complications / Q000175:diagnosis* / Q000556:secondary* / Q000628:therapy; D013131:Spine / Q000473:pathology; D013736:Testicular Neoplasms / Q000175:diagnosis* / Q000473:pathology* / Q000628:therapy; D000509:alpha-Fetoproteins / Q000378:metabolism
D000509:alpha-Fetoproteins