title: C8-T1 Radiculopathy Due to an Intradural Extramedullary Metastasis of a Pancreatic Neuroendocrine Tumor: Case Report and Review of the Literature.
abstract: Pancreatic neuroendocrine tumors (pNETs) are usually well-to-moderately differentiated neuroendocrine tumors (NETs) that most often metastasize to the liver and lymph nodes with other locations being uncommon. We present a case of intradural pNET metastasis and conduct a review of the literature. Forty-five cases, including the case presently reported, of spinal cord compression due to well-differentiated NETs were found: carcinoid (80%), pNET (13.3%), and NETs of unknown primary (6.7%). Seventy-eight percent of cases consisted of extradural compressions from vertebral bone metastases, whereas there were only 5 cases of intradural extramedullary spinal cord compression. Most cases were managed with surgery and/or radiotherapy with a good clinical outcome in the majority. We report the first case of a pNET intradural extramedullary metastasis and conduct the largest review to date of an infrequent complication of well-differentiated NETs such as malignant spinal cord compression. Aggressive local treatment is warranted in most cases because it usually achieves neurologic improvement and symptomatic relief in patients who may still have a long life expectancy.
authors.affiliation: From the Departments of *Medical Oncology and †Radiology, ‡Pathology Laboratory, and §Department of Neurosurgery, Hospital Universitario Clínico San Carlos, Madrid, Spain. Centre Affiliated to the 'Red Temática de Investigación Cooperativa (RD12/0036/006)", Instituto Carlos III, Spanish Ministry of Economy and Competitivity.
authors.forename: Santiago
authors.initials: S
authors.lastname: Cabezas-Camarero
authors.forename: Javier
authors.initials: J
authors.lastname: Sastre
authors.forename: María Carmen
authors.initials: MC
authors.lastname: Polidura
authors.forename: María Natividad
authors.initials: MN
authors.lastname: Gómez-Ruíz
authors.forename: Issa
authors.initials: I
authors.lastname: Subhi-Issa
authors.forename: Pedro
authors.initials: P
authors.lastname: Alonso Lera
authors.forename: Beatriz García
authors.initials: BG
authors.lastname: Paredes
authors.forename: Eduardo
authors.initials: E
authors.lastname: Díaz-Rubio
mesh_terms: D000369:Aged, 80 and over; D017809:Fatal Outcome; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D018358:Neuroendocrine Tumors / Q000000981:diagnostic imaging* / Q000473:pathology; D010190:Pancreatic Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D000072078:Positron Emission Tomography Computed Tomography / Q000379:methods; D011843:Radiculopathy / Q000000981:diagnostic imaging* / Q000209:etiology; D013117:Spinal Cord Compression / Q000000981:diagnostic imaging* / Q000209:etiology; D013120:Spinal Cord Neoplasms / Q000150:complications / Q000000981:diagnostic imaging* / Q000556:secondary