Spinal cord compression with manifestation primary of spinal metastasis

Abstract

Introduction: Spinal compression from unknown primary neoplasms occurs in 5 to 14% in cancer patients. The most common metastasis is secondary to lung, breast and prostate neoplasms. The objective of this study is to describe the clinical characteristics and to evaluate outcomes in patients with spinal compression from unknown primary neoplasms. Methods: We developed a retrospective, observational and descriptive study. Six patients were analyzed according to gender, age, location of injury, treatment and prognosis. These patients were analyzed from January 2008 and July 2011 at Emergency Hospital of Sergipe. Results: Six patients were identified. The median age was 52 years. Male gender was the most affected. The main complaint was pain, followed by motor deficit and sphincter disturbances. The thoracic region was involved in four cases, one cervical and one lumbar. The primary source was lung in three patients, thyroid in one, prostate in one and unknown in one. The CT and MRI were gold standard exams to the diagnosis. Four patients were undergoing decompressive laminectomy, a radiotherapy combined with chemotherapy was performed in three patients and only chemotherapy in two cases. There was death in four cases. Conclusions: Spinal compression can be a late manifestation of primary cancer metastasis. The prognosis of these patients is reserved in several cases due to advanced stage of the primary lesion when the diagnosis is made.