Case Report
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World J Gastroenterol. Oct 14, 2014; 20(38): 14063-14067
Published online Oct 14, 2014. doi: 10.3748/wjg.v20.i38.14063
Intramedullary spinal cord metastasis from pancreatic neuroendocrine tumor
Jung Ho Kim, Chang Lim Hyun, Sang Hoon Han
Jung Ho Kim, Department of Internal Medicine, Gachon University Gil Medical Center, Namdong-gu 405-760, South Korea
Chang Lim Hyun, Department of Pathology, Jeju National University School of Medicine, Jeju-si 890-716, South Korea
Sang Hoon Han, Department of Internal Medicine, Jeju National University School of Medicine, Jeju-si 890-716, South Korea
Author contributions: Kim JH and Han SH contributed to the designing, drafting, editing and approval of the final version of this manuscript; Hyun CL supported pathologic data.
Supported by Grant from Gachon University Gil Medical Center, No. 2013-37
Correspondence to: Sang Hoon Han, MD, Department of Internal Medicine, Jeju National University School of Medicine, 1753-3 Ara-1dong, Jeju-si 890-716, South Korea. btfulo@gmail.com
Telephone: +82-64-7548121 Fax: +82-64-7171131
Received: May 20, 2014
Revised: July 25, 2014
Accepted: September 12, 2014
Published online: October 14, 2014
Processing time: 149 Days and 0.2 Hours
Abstract

Intramedullary spinal cord metastasis (ISCM) is very rare and its optimal treatment remains controversial. Pancreatic neuroendocrine tumor (pNET) is a rare tumor that usually presents with hepatic metastasis. Hepatic failure due to tumor progression is the major cause of death in cases of pNET. To date, no report has described a case of ISCM from pNET. Although spinal cord metastasis of a solid tumor is uncommon, it is a critical condition that can cause a potentially irreversible loss of neurologic function. Here, we report the case of a 45-year-old man who presented with leg weakness and voiding difficulty, and was found to have ISCM from pNET. Surgical treatment prevented further neurological deterioration. This is the first case report of ISCM from pNET.

Keywords: Intramedullary; Spinal cord neoplasm; Metastasis; Neuroendocrine tumor; Pancreas

Core tip: We report the first case of intramedullary spinal cord metastasis (ISCM) from a pancreatic neuroendocrine tumor. Despite its rarity, ISCM is a significant clinical condition that can cause critical neurologic issues. We suggest that taking an immediate surgical approach can increase the chances of restoring neurologic deficits and improving quality of life in cases of pancreatic neuroendocrine tumor with ISCM. Our report includes a review of previous studies of surgical and non-surgical approaches to ISCM.