Secondary paraparesia to vertebral metastasis as an initial manifestation of a lung carcinoma: case report and bibliographical review

Abstract

Introduction: Spinal metastases are the manifestation of a systemic neoplasm. It is evidenced that the prevalence of the metastatic tumors of the spine is high, these being 40 times more frequent than all the combined primary bone tumors. The natural history of the metastatic spine is partial or total compression of the spinal cord or nerve roots known as spinal cord compression syndrome. One third of the cases that present this syndrome are the irst manifestation of the tumor, especially in lung cancer, with a tendency to metastasize in 13%. Clinical Case: The case of a 40-year-old male patient with no history of interest is presented, who is admitted for paraparesis associated with urinary and fecal incontinence; two days after admission he underwent an MRI with gadolinium, which reported a T3-level lesion that compressed and widened the vertebra, which led to the diagnosis of spinal cord compression syndrome. A decompressive laminectomy and biopsy were performed, giving the diagnosis of metastatic carcinoma in the vertebral column of probable pulmonary origin, according to immunohistochemical study. Conclusions: Timely diagnosis and treatment is essential to reverse the natural evolution of this disease, with treatment being instituted within the irst 12 to 24 hours, thus avoiding a signiicant neurological disability.