Metastatic Disease - Endometrial Carcinoma

A 53 year-old woman with known endometrial cancer presented with a one month history of mid-back pain followed by rapidly progressive paraplegia and incontinence.

Outline the Tumor               Show the Gadolinium Enhancement

Neoplastic Spinal Cord Compression: MRI scans of the thoracic spine; (Left) T2-weighted; (Middle) T1-weighted; (Right)T1-weighted with gadolinium. Note the tumor arising from the vertebral body at T8 that compresses the thoracic spinal cord. On the gadolinium image, the lesion enhances. Also note the characteristic convex shape of a mass that arises from the extradural compartment.

Metastatic tumors that affect the spine often begin as a metastasis to bone, especially the pedicle. As they grow, they cause local pain. They then enlarge further and affect the exiting nerve root at that level resulting in a clinical radiculopathy. Only later do they grow and compress the spinal cord or cauda equina, depending on their location. Clinical signs of spinal cord compression typically appear acutely over hours to days. They are a neurological / neurosurgical emergency usually requiring a combination of high dose corticosteroids, radiation and surgical decompression.

Revised 11/25/06
Copyrighted 2006. David C Preston