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Images in Neurology
March 2010

Spinal Epidural Metastasis

Author Affiliations

Author Affiliations: Departments of Neurosurgery (Drs Walcott and Curry) and Orthopaedic Surgery (Dr Jaglowski), Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.

Arch Neurol. 2010;67(3):358-359. doi:10.1001/archneurol.2010.7

A 74-year-old woman with a history of total thyroidectomy and 5 subsequent neck dissections for papillary thyroid carcinoma presented to the emergency department with pneumonia and back pain. She had computed tomography that revealed a large epidural mass involving the T5 vertebral body and left pedicle with significant displacement of the thoracic spinal cord (Figure 1). She did not have any neurological deficits. Fine-needle aspiration biopsy was performed and confirmed the presence of metastatic papillary thyroid carcinoma. She had resection of the T5 vertebral body, T4-T6 laminectomies, T4-T6 anterior interbody fusion, and T3-T7 instrumented posterolateral spinal fusion (Figure 2). Postoperatively, the patient was neurologically intact. She later had radiation therapy. Routine examination 3 and 6 months following surgery demonstrated normal neurological function.

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