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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 inconclusive, 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.