Delayed Epidural Mucin Collection after Surgery for Spinal Metastatic Pancreatic Adenocarcinoma.
10.14245/kjs.2017.14.1.11
- Author:
Dong Ha KIM
1
;
Dong Hwan KIM
;
Hwan Soo KIM
;
Kyoung Hyup NAM
;
Byung Kwan CHOI
;
In Ho HAN
Author Information
1. Department of Neurosurgery, Medical Research Institute, Pusan National University Hospital, Busan, Korea. farlateral@hanmail.net
- Publication Type:Case Report
- Keywords:
Spinal neoplasm;
Neoplasm metastasis;
Mucins;
Adenocarcinoma
- MeSH:
Adenocarcinoma*;
Aged;
Back Pain;
Drug Therapy;
Electrons;
Epidural Space;
Follow-Up Studies;
Gait;
Gelatin;
Humans;
Laminectomy;
Magnetic Resonance Imaging;
Mucins*;
Neoplasm Metastasis;
Neurologic Manifestations;
Pancreas;
Pancreatectomy;
Pancreatic Neoplasms;
Pedicle Screws;
Radiotherapy;
Spinal Cord;
Spinal Neoplasms;
Thorax;
Wounds and Injuries
- From:Korean Journal of Spine
2017;14(1):11-13
- CountryRepublic of Korea
- Language:English
-
Abstract:
A rare case of delayed large epidural mucin collection causing neurologic deficit after surgery for metastatic pancreatic cancer is reported. A 65-year-old man presented with intractable upper-thoracic back pain radiating to the chest and gait disturbance. He had a history of subtotal pancreatectomy due to intraductal papillary mucinous neoplasm (IPMN) of the pancreas and concurrent chemotherapy. Eight months after pancreatectomy, multiple thoracic spinal metastasis was diagnosed with routine up positron emission tomography-computed tomography. Radiotherapy for spinal metastasis and subsequent chemotherapy was carried out. Sixteen months after pancreatectomy, gait disturbance occurred and follow-up thoracic magnetic resonance imaging (MRI) showed aggravation of metastasis at T2 and T4 compressing the spinal cord. We performed a decompressive laminectomy with subtotal resection of the tumor masses and pedicle screw fixation at C7–T6. Neurologic status improved after the operation. Histopathologic examinations revealed the tumor as metastatic mucin producing adenocarcinoma. Three months after surgery, motor weakness and pain was reappeared. MRI showed large amount of epidural fluid collection. We performed wound revision and there was large amount of gelatinous fluid at the epidural space. We suggest that postoperative mucin collection and wound problems should be considered after surgery for mucin producing metastatic pancreatic tumor.
