Early post-surgical recurrence of metastatic vertebral neuro-endocrine tumour treated effectively with chemo-radiotherapy

• Main Authors: Kaliya-Perumal Arun-Kumar, Tan Mark, Tee Seh Wee, Achudan Shaam, Yap Wai Ming, Oh Jacob Yoong Leong
• Format: Article
• Language: English
• Published: China Medical University 2019-03-01
• Series: BioMedicine
• Subjects: Metastasis; Myelopathy; Neuroendocrine tumours; Spinal cord compression; Concurrent chemoradiotherapy
• Online Access: https://biomedicine.edp-open.org/articles/bmdcn/full_html/2019/01/bmdcn2019090105/bmdcn2019090105.html

Spinal metastasis of neuro-endocrine tumours (NETs) usually arise from a primary in the lung. We encountered such a patient with NET metastasis to T6 vertebra causing severe cord compression. Considering the neurological status, immediate decompression surgery along with T3-T8 posterior stabilization was done. Early recurrence of the tumour causing near total obliteration of the spinal canal leading to significant neurological compromise was noted within one month of surgery. A second surgery at this stage was avoided due to the risk involved and concurrent chemo-radiotherapy was initiated. The tumour was sensitive to chemo-radiotherapy and rapid resolution was noted on subsequent follow-up visits. With appropriate rehabilitation, patient regained full power to become ambulant with support. This case report highlights a rare, early and aggressive recurrence of metastatic vertebral NET following index surgery which was effectively managed with chemo-radiotherapy.