Bonilla CC, Durán PEG, Alexanderson RG

Language: Spanish
References: 15
Page: 289-293
PDF size: 189.66 Kb.

ABSTRACT

Background: Spinal cord compression is a complication in 5 to 14% of cancer cases, and first manifestation in almost 10%. There is little information about neoplasm with this first manifestation.
Objectives: To review epidemiologic, clinical and radiological data of spinal cord compression as first manifestation of metastatic cancer, and to propose diagnose guidelines for these patients.
Material and methods: We made a retrospective, descriptive study of 5 years in which we reviewed 360 files with spinal cord compression diagnosis of any etiology. We included male and female patients that counted on final diagnosis of spinal cord compression secondary to metastasis of primary initially unknown tumor. We obtained demographic aspects, clinical picture, and studies of magnetic resonance of medulla and histopathology reports.
Results: Twenty-seven patients had the spinal cord compression diagnosis as first manifestation of neoplasm. Seventeen of them were men (62.9%), with an average of age of 58 years. Most frequent clinical data was pain in back or radiculated pain (55.5% of the cases), as initial manifestation of the disease. The rest of patients had motor deficit and paresthesis. Thoracic column was the mainly affected segment (59.2%), two or more vertebral bodies were affected in 51.8%. In most cases spinal cord compression was secondary to hematology neoplasm (five multiple myeloma and two non-Hodgkin lymphomas), second most frequent was lung cancer and adenocarcinoma of prostate, five cases each one.
Conclusions: Spinal cord compression as first manifestation of neoplasm appears in almost 7.5% medullar compression cases, with hematology neoplasm, lung cancer and adenocarcinoma of prostate gland as the most frequents. All patient with spinal cord compression as initial manifestation of metastatic cancer must be studied for this neoplasm.

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