PMC3667035_01
Preoperative MRI.. This patient had metastasis invading into the spinal canal at the T5 level.
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Metastasis of T5 had invaded into adjacent vertebrae above and below (T4 and T6) and the spinal cord was severely compressed (Figure 6).
Operative photograph after en bloc corpectomy.. En bloc corpectomy of T4-6 was performed.
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T6 was performed (Figure 7).
Frozen tumor-bearing vertebrae.
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The excised en bloc laminae and en bloc vertebral bodies of T4 to T6 were placed into liquid nitrogen for 20 minutes. Then, the frozen laminae and vertebral bodies (Figure 8) were crushed and packed into a titanium cage. The cage was placed between T3 and T7 for spinal anterior reconstruction (Figure 9).
Operative photograph before inserting a cage containing frozen autograft.
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The excised en bloc laminae and en bloc vertebral bodies of T4 to T6 were placed into liquid nitrogen for 20 minutes. Then, the frozen laminae and vertebral bodies (Figure 8) were crushed and packed into a titanium cage. The cage was placed between T3 and T7 for spinal anterior reconstruction (Figure 9).
Postoperative computed tomography of the lung (Top; immediately after TES, Bottom; 1 month after TES).. Right axillary lymph node metastasis is reduced. A circle shows reduced lymph node of right axilla.
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At one month after surgery, the axillary lymph node metastasis decreased in size without any other treatments (Figure 10).
Postoperative computed tomography of the thoracic spine (Left; frontal view, Right; lateral view) one year after TES.. Bony fusion can be seen inside the cage.
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Before TES the prognosis given by the specialists in breast cancer was 6 months to 1 year (maximum 1 year); she is still alive with disease 18 months after TES (Figure 11).