title: Spinal Cord Ischemia Secondary to Epidural Metastasis from Small Cell Lung Carcinoma.
abstract: BACKGROUND Spinal cord ischemia is an uncommon event that is mainly caused by dissociation of the ascending aorta as a complication after aortic surgery. Spinal arteries can develop collateral circulation; therefore, the frequency of spinal infarction is about 1% of that in the brain. Few cases of spinal cord ischemia developing in the course of lung cancer have been reported. CASE REPORT We presented the case of a 56-year-old man with small cell lung carcinoma, cT4N2M1a (stage IV). He was treated with irradiation and 2 courses of platinum and etoposide combination chemotherapy. He complained of back pain followed by quadriplegia and sensory disturbance after cessation of chemotherapy. With a diagnosis of spinal cord metastasis, steroids were administered. However, diaphragmatic paralysis appeared a few hours later. He was started on palliative care and died after 6 days. Autopsy showed epidural metastasis and spinal ischemia at the C5 level. CONCLUSIONS Epidural metastasis can compress the spinal artery and cause circulatory disorders. Spinal cord ischemia should be considered in patients with rapid paralysis in the course of lung cancer.
authors.affiliation: Department of Respiratory Medicine, Chutoen Medical Center, Kakegawa, Shizuoka, Japan.
authors.forename: Hirotoshi
authors.initials: H
authors.lastname: Yasui
authors.affiliation: Department of Respiratory Medicine, Nagoya University Hospital, Nagoya, Aichi, Japan.
authors.forename: Naoya
authors.initials: N
authors.lastname: Ozawa
authors.affiliation: Department of Respiratory Medicine, Chutoen Medical Center, Kakegawa, Shizuoka, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Mikami
authors.affiliation: Department of Respiratory Medicine, Chutoen Medical Center, Kakegawa, Shizuoka, Japan.
authors.forename: Kenji
authors.initials: K
authors.lastname: Shimizu
authors.affiliation: Department of Respiratory Medicine, Chutoen Medical Center, Kakegawa, Shizuoka, Japan.
authors.forename: Takahiro
authors.initials: T
authors.lastname: Hatta
authors.affiliation: Department of Respiratory Medicine, Chutoen Medical Center, Kakegawa, Shizuoka, Japan.
authors.forename: Nami
authors.initials: N
authors.lastname: Makino
authors.affiliation: Department of Pathology, Hamamatsu University Hospiital, Hamamatsu, Shizuoka, Japan.
authors.forename: Mayu
authors.initials: M
authors.lastname: Fukushima
authors.affiliation: Department of Pathology, Hamamatsu University Hospital, Hamamatsu, Shizuoka, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Baba
authors.affiliation: Department of Respiratory Medicine, Chutoen Medical Center, Kakegawa, Shizuoka, Japan.
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Makino
mesh_terms: D002574:Cervical Vertebrae / Q000473:pathology; D015174:Epidural Neoplasms / Q000150:complications* / Q000556:secondary*; D017809:Fatal Outcome; D006801:Humans; D008175:Lung Neoplasms / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D055752:Small Cell Lung Carcinoma / Q000473:pathology / Q000556:secondary*; D020760:Spinal Cord Ischemia / Q000209:etiology*