Spinal metastasis from lung cancer fifteen years after surgery presenting a pseudohemangioma appearance of the vertebra: a case report.
METHODS
Case report.


OBJECTIVE
To describe a case of solitary metastasis of the seventh thoracic vertebra (T7) from lung cancer 15 years after surgery.


BACKGROUND
Late recurrence of the bone over 5 years after curative surgery for lung cancer is highly exceptional. In addition, bone metastasis from lung cancer showing a coarse trabecular pattern of the vertebra on computed tomography (CT) is quite unusual.


METHODS
A case of solitary metastasis of T7 from lung cancer 15 years after surgery showing a pseudohemangioma appearance of the vertebra on CT is presented.


RESULTS
A 66-year-old man presented with a 2-month history of gradually progressed numbness and muscle weakness of the bilateral leg, with a more recently developed spastic gate. He had undergone a left lower lobectomy for lung cancer 15 years previously. Magnetic resonance imaging showed an ill-defined mass lesion involving the entire vertebral body of T7 with extension into the posterior element and surrounding soft tissue, which resulted in moderate spinal canal stenosis. CT showed a coarse trabecular pattern at T7 with a mild compression fracture. No other lesion was detected by whole-body CT and bone scintigraphy. Tumor resection and T5-T9 posterior spinal fusion had been performed, and a pathologic diagnosis of metastatic pulmonary adenocarcinoma of the bone was established. Additional radiation therapy (40 Gy) was added, and the patient recovered and continued to survive uneventfully at the 3-month follow-up.


CONCLUSIONS
We have reported a rare case of solitary metastasis to T7 appearing 15 years after surgery for lung cancer. The incidence of lung cancer recurrence more than 5 years after surgery is exceedingly low; however, even in patients with lung cancer, late occurrence of bone metastasis should be considered and included in the differential diagnosis of a pseudohemangioma appearance of the vertebra.
Inaoka
Tsutomu
T
Department of Radiology, Asahikawa Medical College, Asahikawa, Japan. tinaoka@asahikawa-med.ac.jp
Takahashi
Koji
K
Aburano
Tamio
T
Miyokawa
Naoyuki
N
Tandai
Susumu
S
Kobayashi
Tetsuya
T
Matsuno
Takeo
T
D000368:Aged; D003937:Diagnosis, Differential; D006391:Hemangioma / Q000000981:diagnostic imaging* / Q000209:etiology; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging* / Q000601:surgery; D008297:Male; D011859:Radiography; D013125:Spinal Neoplasms / Q000000981:diagnostic imaging* / Q000556:secondary*; D013904:Thoracic Vertebrae / Q000000981:diagnostic imaging*; D013997:Time Factors