title: Surgical management of carcinoid tumors metastatic to the spine: Report of three cases.
abstract: BACKGROUND
  Carcinoid tumors are rare, slow-growing neuroendocrine tumors that most frequently arise from the gastrointestinal tract or the lungs. Common sites of carcinoid metastases include lymph nodes, liver, lungs, and bone, with rare metastasis to the spine. We report three patients who presented with spinal cord compression secondary to carcinoid metastases to the spine.
  
  
  METHODS
  Three patients presented with symptoms characteristic of spinal cord compression, including neck pain, radiculopathy, thoracic pain, weakness and numbness. All three patients underwent radiographic work-up and surgical treatment.
  
  
  RESULTS
  One patient continued to have decreased strength in her right upper extremity, but was able to participate in physical therapy; another patient's numbness eventually resolved after completion of physical therapy; and the third patient's pain dramatically improved after surgery. One patient died more than two years post-surgery due to widespread metastasis; the other two remain alive more than two years post-surgery.
  
  
  CONCLUSIONS
  Carcinoid tumor metastases rarely cause spinal cord compression, but should be considered when patients present with neurological symptoms consistent with cord compression. Work-up should include magnetic resonance imaging (MRI), computed tomography (CT) of the spine, and perhaps CT-guided biopsy. Surgery is indicated for symptomatic spinal cord compression in patients with carcinoid tumors.
authors.affiliation: University of Kansas Medical Center, 3901 Rainbow Blvd, MS 3021, Kansas City, KS 66160, United States. parnold@kumc.edu
authors.forename: Paul M
authors.initials: PM
authors.lastname: Arnold
authors.forename: Heather E
authors.initials: HE
authors.lastname: Floyd
authors.forename: Karen K
authors.initials: KK
authors.lastname: Anderson
authors.forename: Kathy L
authors.initials: KL
authors.lastname: Newell
mesh_terms: D002276:Carcinoid Tumor / Q000473:pathology / Q000601:surgery*; D019299:Decompression, Surgical / Q000379:methods*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D016609:Neoplasms, Second Primary / Q000601:surgery; D013125:Spinal Neoplasms / Q000473:pathology / Q000556:secondary* / Q000601:surgery*