Metastatic Pancreatic Endocrine Tumor Presenting as Thoracic Spinal Cord Compression

Study Design. A case report. Objective. The authors present a rare case of metastatic nonfunctioning neuroendocrine tumor of the pancreas presenting as thoracic spinal cord compression. Summary of Background Data. Pancreatic endocrine tumors (PETs) are a slow-growing subset of pancreatic tumors. They can be classified as either functioning or nonfunctioning. To our knowledge, this is the second reported case of a PET presenting as spinal cord compression. Methods. The clinical course, radiologic features, pathology, and outcome of the metastasis of PET are reported. Results. A 59-year-old woman presenting with a 2-week history of midthoracic back pain and early signs of myelopathy. A computed tomography scan and magnetic resonance imaging revealed multiple mildly enhancing lesions within T5, T7, T8, and L1 vertebral bodies with ventral epidural and bilateral T8-T9 neuroforaminal soft tissue extension causing severe spinal canal stenosis. A computed tomography-guided biopsy was in conclusive, and we performed a T7-T9 laminectomy with T8 bilateral transpedicular decompression and T6 to T10 pedicle screw fixation and posterolateral fusion with subtotal resection of the tumor. Pathology was consistent with low-grade neuroendocrine tumor. The patient recovered well, and an octreotide scan ultimately revealed an area of abnormal uptake within the body of the pancreas. Conclusion. We have reported a rare case of a metastatic PET presenting as spinal cord compression.