TITLE:
Comparison between Metastatic Spinal Tumour of Unknown Primary Tumour with a Known Primary
AUTHORS:
Wissam Jassim Sagban, S.M.S. Ridha, Zaki Noah Hasan
KEYWORDS:
Metastatic Spinal Tumour, Metastatic Spinal Tumour of Unknown Primary
JOURNAL NAME:
World Journal of Neuroscience,
Vol.6 No.1,
February
3,
2016
ABSTRACT: Patients presented with
spinal metastases from unknown primary tumours are rare. In this research we
evaluated all patients with metastatic spinal tumour of unknown primary tumour,
all patients were evaluated pre-operatively and comparison was done to those
patients who had known primary tumour the study aimed to compare the group with
known primary and the group with the unknown primary regarding the: mean age,
gender, duration of symptoms, complication rate, region of the spine affected
by metastasis, presence or absence of other skeletal or visceral metastasis,
histological cell type and neurological outcome. Method: A retrospective study
was performed on 40 patients presented to Neuroscience hospital in Baghdad from
January 2010 till January 2014; all patients with metastatic spinal tumour were
included in our study. We reviewed all patients’ records including age, sex,
primary tumour, duration of their symptoms, neurological out come and
complications. Results: Out of the 40 patient who presented with spinal tumours
that underwent surgery duo to metastatic spinal tumour, five patients presented
with spinal compression duo to metastatic tumour of unknown primary tumour
(12.5%). The mean age was 64 years, 4 male and one female. For those with a
known primary tumour mean age was 61 year, 22 male 13 female. Duration of
symptoms prior to surgery was the same 180 days for those with unknown primary
and 190 day for those with known primary tumours. They also had similar
neurological outcome (80%) remain the same or improved post operatively for
those with unknown primary and (85.7%) for those with a known primary tumour,
and a similar complication rate for unknown primary was 25% versus 28% for
known. The primary site of metastatic spinal tumour of unknown primary was
confirmed after histopathology all shown adenocarcinoma four from the lung
(80%) and one from colorectal. While the most common known carcinoma site were
the lung 18 patient (51.4%), colorectal 8 (22.8%), breast 7 (20%), and renal 2
(5.71%). All patient who complain from secondary spinal metastasis with unknown
primary tumour didn’t show any other skeletal or visceral metastasis, while
those with a known primary tumour 6 patient out of 35 (17.1%) shown involvement
of other site, the indication of surgery was to remove cord compression and
restore neurological deficit. The most common site for metastasis was the
dorsal spine for those of an unknown primary tumour 4 out of 5 patients (80%),
and for those of a known primary tumour it was the lumbar area 28 out of 35
patient (80%). In conclusion metastatic spinal tumour of unknown primary was a
common condition; it has similar demographic features, complications, and
neurologic sequel with the spinal metastasis of known primary. Adenocarcinoma
of the lung is the most common primary tumour proved after histopathology for
spinal metastasis of unknown primary.