Rare Thymoma Metastases to the Spine: Case Reports and Review of the Literature

Achey, Rebecca; Lee, Bryan S.; Sundar, Swetha J.; Benzel, Edward C.; Krishnaney, Ajit A.

doi:10.1016/j.wneu.2017.11.161

Cited by 13 publications

(23 citation statements)

References 39 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Back pain and radiculopathy can often mimic the most common cause of spinal diseases, making timely diagnosis of spinal metastatic thymomas difficult without a high level of suspicion. [5,6]…”

Section: Discussionmentioning

confidence: 99%

“…To date, studies have revealed that the most important determinants of long-term survival in thymoma are completeness of resection, Masaoka stage, and Mueller–Hermelink histologic classification. [1,4,5] The 5-year survival rate of patients with distant metastasis of thymoma varied widely between 13.3% and 81% after multimodality treatment, including surgical resection of primary tumor, pleurectomy, chemotherapy, and radiotherapy. [3] A multidisciplinary approach is required to improve patients’ long-term outcomes.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Successful treatment of malignant thymoma with sacrum metastases

et al. 2018

View full text Add to dashboard Cite

Rationale:Malignant thymoma in the spine is a rare disease without standard curative managements so far. The objective of this article is to report a very rare case of recurrent malignant thymoma with sacrum metastases causing severe lumbosacral pain, which was presented with acute radiculopathy and treated with 2 operations combined with stabilization and cement augmentation. The management of these unique cases is not well-documented.Patient concerns:A 75-year-old man presented with lumbosacral pain, radiating pain and numbness of the left extremity. The patient underwent thymectomy in 2008, and posterior spinal cord decompression, tumor resection and a stabilization procedure in 2011. Pathologic results confirmed malignant thymomas of the spine. Imaging studies revealed the density of soft tissues, obvious bony destruction in the sacrum, and significant spinal cord obstruction.Diagnoses:We believe this is a less-documented case of metastatic thymoma of the sacral spine presenting with back pain and radiculopathy, and presenting as a giant solid tumor.Interventions:The patient underwent osteoplasty via a posterior approach. Pathologic results confirmed malignant thymomas of the sacral spine.Outcomes:The patient's neurological deficits improved significantly after the surgery, and the postoperative period was uneventful at the 6-month and 1-year follow-up visit. There were no other complications associated with the operation during the follow-up period.Lessons:This article emphasizes metastatic thymoma of the spine, although rare, should be part of the differential when the patient presents with back pain and radiculopathy. We recommend the posterior approach for spinal decompression of the metastatic thymoma when the tumor has caused neurological deficits. Osteoplasty by cement augmentation is also a good choice for surgical treatment.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Successful treatment of malignant thymoma with sacrum metastases

et al. 2018

View full text Add to dashboard Cite

show abstract

“…These included metastasis to the bony elements of the vertebrae (10 out of 16 cases)[234715] and growth of pleural nodules into the spinal canal through the intervertebral foramen (6 cases). [1681214] The latter lesions should be considered in the differential diagnosis of thoracic dumbbell-shaped lesions. Regarding the histological type, despite representing less than 10% of thymic tumors, three quarters of reported cases with thoracic spine involvement corresponded to thymic carcinomas.…”

Section: Discussionmentioning

confidence: 99%

“…[15] Involvement of the thoracic spine by thymic tumors is very rare and typically involves the vertebral bodies. [14] Here, we describe a thoracic spine dissemination of a pleural recurrence from thymoma through the intervertebral foramen, resulting in spinal cord compression, 21 years after initial diagnosis. Fortunately, it was successfully managed with secondary definitive surgery.…”

Section: Introductionmentioning

confidence: 99%

Thymoma dissemination through the thoracic intervertebral foramen: Pleural recurrence resulting in spinal cord compression

Prieto¹,

Tejerina²,

Santander³

et al. 2018

Surg Neurol Int

View full text Add to dashboard Cite

Background:Spinal dissemination of thymic tumors is rare but should be considered in the differential diagnosis of thoracic dumbbell-shaped lesions and/or vertebral tumors, irrespective of the time since the initial diagnosis.Case Description:A 63-year-old man, with a history of invasive type AB thymoma treated 21 years ago, newly presented to the hospital with a dumbbell-shaped T8-T9 lesion compressing the spinal cord. A review of the literature showed only 16 previous cases of thymic tumors with thoracic spine involvement. Here, we report the lengthiest interval between the initial tumor diagnosis and the detection of spinal involvement, that was secondary to a pleural recurrence from his thymoma. The patient did well following successful excision of the intraspinal mass which had encased the T8 nerve root.Conclusion:Spinal dissemination of thymic tumors can occur due to vertebral metastasis or to extension of a pleural recurrence through the intervertebral foramen. Definitive treatment for spinal lesions should be considered to provide adequate cord decompression.

show abstract

“…Extrathoracic metastases of thymic carcinomas are extremely rare entities and mainly occur in the lymph nodes, liver, and kidney. [1] Although thymoma and thymic carcinoma exhibit highly aggressive biological behavior, spinal metastasis is exceedingly rare. According to the World Health Organization, there are “organotypic” (types A, AB, B1, B2, and B3) and “nonorganotypic” (type C, thymic carcinomas) thymomas.…”

Section: Introductionmentioning

confidence: 99%

Surgical management of spinal metastases of thymic carcinoma

et al. 2019

View full text Add to dashboard Cite

Rationale:Metastatic thymic carcinoma in the spine is a rare disease with no standard curative managements yet. The objective of this study is to report a very rare case of spinal metastases of thymic carcinoma successfully operated by combination of instrumentation and cement augmentation together with adjuvant treatment. The management of these unique cases has yet to be well-documented.Patient concerns:A 57-year-old man presented with a 6-month history of continuous and progressive back pain. The patient, who had been diagnosed of thymic carcinoma (stage IV B) for 3 years, received surgical treatment of median sternotomy thymectomy, followed by 3 cycles of chemotherapy and 12 cycles of radiotherapy.Diagnosis:Magnetic resonance imaging (MRI) of spine showed spinal cord compression secondary to the epidural component of the T4 mass, with increased metastatic marrow infiltration of the left T4 vetebral body, which presented as a solid tumor. Post-operative pathology confirmed the diagnosis of spinal metastases of thymic carcinoma.Interventions:The patient underwent exploratory surgery, circumferential spinal cord decompression, cement augmentation and a stabilization procedure via a posterior approach.Outcomes:The patient's neurological deficits improved significantly after the surgery, and the postoperative period was uneventful at the 3-month follow-up visit. There were no other complications associated with the operation during the follow-up period.Lessons:Taken together, the lesion's clinical features, imaging results, and pathological characteristics are unique. Combined efforts of specialists from orthopedics, neurosurgery, thoracic surgery, and medical oncology led to the successful diagnosis and management of this patient. Metastatic thymic carcinoma of the spine, although rare, should be part of the differential diagnosis when the patient has a history of thymic carcinoma and presents with back pain and radiculopathy. We recommend the posterior approach for spinal decompression of the metastatic thymic carcinoma when the tumor has caused neurological deficits. Osteoplasty by cement augmentation is also a good choice for surgical treatment.

show abstract

Rare Thymoma Metastases to the Spine: Case Reports and Review of the Literature

Cited by 13 publications

References 39 publications

Successful treatment of malignant thymoma with sacrum metastases

Successful treatment of malignant thymoma with sacrum metastases

Thymoma dissemination through the thoracic intervertebral foramen: Pleural recurrence resulting in spinal cord compression

Surgical management of spinal metastases of thymic carcinoma

Contact Info

Product

Resources

About