Case Series of Rare Thymoma Metastases to the Spine and Complete Literature Review.

Case Series of Rare Thymoma Metastases to the Spine and Complete Literature Review.

World Neurosurg. 2017 Dec 06;:

Authors: Achey RL, Lee BS, Sundar S, Benzel EC, Krishnaney AA

Abstract
BACKGROUND: We report a series of three cases of metastatic thymoma to the spine with spinal cord compression. An extensive literature review of thymic metastases to the spine was completed in order to provide a comprehensive appraisal of current prognostic indicators and potential treatment algorithms to help guide clinicians in treatment management.
CASE DESCRIPTIONS: Between 2000 and 2017, three patients were diagnosed with thymic metastases to the spine at our institution. Metastasis presentation occurred from two to eight years following initial diagnosis with thymic cancer. All three patients presented with signs and symptoms of spinal cord/cauda equina compression, and underwent surgical intervention. Post-operative treatments varied amongst all three: one receiving chemotherapy, another undergoing radiation, and the third having had no further treatment due to extensive systemic disease.
CONCLUSIONS: Upon review of the literature, 16 case reports/series described 28 total patients with spine metastases secondary to thymoma/thymic carcinoma. Presentation varied widely, including age, neurological deficits, time from initial diagnosis to metastasis, and histological grading. The only widely accepted prognostic factor is completeness of tumor resection, while clinical staging and/or histological type may also have prognostic value. Thus, gross total resection and spinal decompression should be prioritized in cases of surgical intervention. Chemotherapy and radiotherapy are generally recommended. However, given the lack of standardized treatment algorithms, individualized regimens should be formulated on a case-specific basis.

PMID: 29223525 [PubMed - as supplied by publisher]

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