Metastatic pancreatic endocrine tumor presenting as thoracic spinal cord compression.
METHODS
A case report.


OBJECTIVE
The authors present a rare case of metastatic nonfunctioning neuroendocrine tumor of the pancreas presenting as thoracic spinal cord compression.


BACKGROUND
Pancreatic endocrine tumors (PETs) are a slow-growing subset of pancreatic tumors. They can be classified as either functioning or nonfunctioning. To our knowledge, this is the second reported case of a PET presenting as spinal cord compression.


METHODS
The clinical course, radiologic features, pathology, and outcome of the metastasis of PET are reported.


RESULTS
A 59-year-old woman presenting with a 2-week history of midthoracic back pain and early signs of myelopathy. A computed tomography scan and magnetic resonance imaging revealed multiple mildly enhancing lesions within T5, T7, T8, and L1 vertebral bodies with ventral epidural and bilateral T8-T9 neuroforaminal soft tissue extension causing severe spinal canal stenosis. A computed tomography-guided biopsy was inconclusive, and we performed a T7-T9 laminectomy with T8 bilateral transpedicular decompression and T6 to T10 pedicle screw fixation and posterolateral fusion with subtotal resection of the tumor. Pathology was consistent with low-grade neuroendocrine tumor. The patient recovered well, and an octreotide scan ultimately revealed an area of abnormal uptake within the body of the pancreas.


CONCLUSIONS
We have reported a rare case of a metastatic PET presenting as spinal cord compression.
Eads
Todd Alin
TA
Department of Neurological Surgery, Indiana University School of Medicine, 545 Barnhill Drive, Indianapolis, IN 46202, USA. teads@iupui.edu
Hattab
Eyas M
EM
Rodgers
Richard B
RB
D018278:Carcinoma, Neuroendocrine / Q000150:complications / Q000556:secondary* / Q000601:surgery; D005260:Female; D006801:Humans; D007796:Laminectomy; D008159:Lumbar Vertebrae / Q000473:pathology / Q000601:surgery; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000150:complications / Q000473:pathology*; D011859:Radiography; D013117:Spinal Cord Compression / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D013123:Spinal Fusion; D013125:Spinal Neoplasms / Q000150:complications / Q000556:secondary* / Q000601:surgery; D013904:Thoracic Vertebrae / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D016896:Treatment Outcome