Needle-tract seeding after percutaneous vertebroplasty: a case report.
METHODS
A case report.


OBJECTIVE
We report a case of needle-tract seeding (NTS) of adenocarcinoma of the lung in the thoracic spine that manifested after vertebroplasty (VP).


BACKGROUND
NTS after a biopsy is sometimes observed. However, NTS after an injection, as in VP, is a very rare complication.


METHODS
A 61-year-old female presented with a painful back mass and weakness in both lower extremities. She had been diagnosed with adenocarcinoma of the lung 2 years previously. The patient had complained of severe back pain 5 months before and was diagnosed with a metastatic pathological fracture of T4-T6. She underwent uneventful percutaneous VP at T4-T6 followed by radiation therapy at that time.


RESULTS
Magnetic resonance imaging revealed that the subcutaneous mass extended to the right T5 pedicle with an extension to the adjacent epidural space of T4-T7. Paramedian skin incision was made like a spindle and the back mass was totally removed with the covering skin and surrounding soft tissue. The tumor was connected with lamina, but ribs and pleura were clear. We performed T4-T7 laminectomy, right T5 pediculectomy, epidural tumor curettage, pedicle screw placement at T2-T3, T6-T9. Histological analysis confirmed the diagnosis of metastatic adenocarcinoma of the lung. The patient recovered after the operation, and her back pain and weakness had improved.


CONCLUSIONS
NTS can be caused by even VP in patients with a pathological fracture. NTS needs to be considered in cases where it is difficult to inject polymethyl methacrylate.
From *the Department of Neurosurgery, Konyang University Hospital, Konyang University College of Medicine, Daejeon Departments of †Radiology; and ‡Neurosurgery, Spine Center, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Republic of Korea.
Chang-Hyun
CH
Lee
Joon Woo
JW
Lee
Seung-Jae
SJ
Hyun
Ki-Jeong
KJ
Kim
Tae-Ahn
TA
Jahng
Hyun-Jib
HJ
Kim
D000230:Adenocarcinoma / Q000556:secondary* / Q000601:surgery / Q000628:therapy; D001416:Back Pain / Q000209:etiology; D001863:Bone Screws; D059186:Chemoradiotherapy, Adjuvant; D003131:Combined Modality Therapy; D003475:Curettage; D018450:Disease Progression; D004824:Epidural Space; D017809:Fatal Outcome; D005260:Female; D005598:Fractures, Spontaneous / Q000209:etiology; D006801:Humans; D007796:Laminectomy; D008175:Lung Neoplasms / Q000628:therapy; D008875:Middle Aged; D009366:Neoplasm Seeding; D012878:Skin Neoplasms / Q000209:etiology / Q000556:secondary / Q000601:surgery; D012983:Soft Tissue Neoplasms / Q000209:etiology / Q000556:secondary* / Q000601:surgery; D013123:Spinal Fusion; D013125:Spinal Neoplasms / Q000532:radiotherapy / Q000556:secondary* / Q000601:surgery; D040521:Subcutaneous Tissue; D013904:Thoracic Vertebrae / Q000293:injuries / Q000473:pathology / Q000601:surgery*; D054854:Vertebroplasty / Q000009:adverse effects* / Q000295:instrumentation