Spinal extra-dural metastasis from Merkel cell carcinoma: a rare cause of paraplegia.

Abstract

We report a rare case of Merkel cell carcinoma with extra-dural spinal metastasis causing paraplegia. There are only four reported cases in literature. A 57-year-old lady presented with a breast lump, multiple truncal skin swellings, low back pain and rapidly progressive paraplegia. MRI showed multiple epidural soft tissue masses causing neural compression. A biopsy from the truncal skin lesion was diagnosed as Merkel cell carcinoma (MCC). Posterior decompression and tumor debulking at all three sites of neural compression was performed. Histopathology of the epidural tumor was consistent with MCC and the diagnosis was confirmed by immuno-histochemistry staining for cytokeratin-20. She was started on chemotherapy and radiotherapy. One month after diagnosis she died due to extensive metastasis. The short term palliative response seen in our patient demonstrates the poor prognosis for patients with spinal metastasis.

• Authors: Kamath Vijay, Krishna Venkateswaran, Ajoy P Shetty, S Rajasekaran
• Journal: European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society (Eur Spine J) Vol. 17 Suppl 2 Pg. S267-70 (Sep 2008) ISSN: 1432-0932 [Electronic] Germany
• PMID: 18057968 (Publication Type: Case Reports, Journal Article)

Chemical References

• Biomarkers, Tumor
• Keratin-20

Topics

• Biomarkers, Tumor (analysis, metabolism)
• Biopsy
• Breast Neoplasms (secondary)
• Carcinoma, Merkel Cell (secondary, therapy)
• Decompression, Surgical
• Disease Progression
• Epidural Space (pathology)
• Fatal Outcome
• Female
• Humans
• Keratin-20 (analysis, metabolism)
• Magnetic Resonance Imaging
• Middle Aged
• Neoplasm Metastasis (pathology, therapy)
• Neurosurgical Procedures
• Paraplegia (etiology, pathology, physiopathology)
• Skin Neoplasms (pathology, therapy)
• Spinal Cord Compression (etiology, pathology, physiopathology)
• Spinal Neoplasms (secondary, therapy)
• Treatment Failure