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A rare occurrence of a metastatic urothelial carcinoma to the thoracic vertebra: A case report

Urothelial carcinoma (UC) is a common urinary tract malignancy that predominantly affect the urinary bladder with a low recurrence rate after surgical removal. It usually metastasizes to the lungs, regional lymph nodes, and liver. However, it rarely spread to the thoracic spine and bones, especially...

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Main Authors: Soe, May Zaw, Bong, Chin Pei, Shankaran Thevarajah, Teah, Kai Ming, Yeap, Boon Tat
Format: Article
Language:English
English
Published: Elsevier Ltd 2022
Subjects:
RC31-1245 Internal medicine
Online Access:https://eprints.ums.edu.my/id/eprint/32744/2/A%20rare%20occurrence%20of%20a%20metastatic%20urothelial%20carcinoma%20to%20the%20thoracic%20vertebra%2C%20ABSTRACT.pdf
https://eprints.ums.edu.my/id/eprint/32744/1/A%20rare%20occurrence%20of%20a%20metastatic%20urothelial%20carcinoma%20to%20the%20thoracic%20vertebra%2C%20A%20case%20report.pdf
https://eprints.ums.edu.my/id/eprint/32744/
https://www.sciencedirect.com/science/article/pii/S2049080122000577
https://doi.org/10.1016/j.amsu.2022.103297
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spelling my.ums.eprints.327442022-06-09T03:43:40Z https://eprints.ums.edu.my/id/eprint/32744/ A rare occurrence of a metastatic urothelial carcinoma to the thoracic vertebra: A case report Soe, May Zaw Bong, Chin Pei Shankaran Thevarajah Teah, Kai Ming Yeap, Boon Tat RC31-1245 Internal medicine Urothelial carcinoma (UC) is a common urinary tract malignancy that predominantly affect the urinary bladder with a low recurrence rate after surgical removal. It usually metastasizes to the lungs, regional lymph nodes, and liver. However, it rarely spread to the thoracic spine and bones, especially in the Asian populations. A 50-years-old Asian man, with a one-year history of surgically resected UC, presented to us with a complaint of worsening upper back pain for three months. Magnetic resonance imaging (MRI) showed a destructed second thoracic (T2) vertebra with lytic lesion. A thoracic vertebrectomy was performed and histopathological examination (HPE) showed high-grade infiltrating metastatic malignant UC. Postoperatively, he was well and did not have any back pain. He was followed up under combined spine and oncology clinic regularly and was planned for chemoradiotherapy. UC commonly metastasizes to the lungs, liver, and lymph nodes. In young Asians, thoracic spinal metastases are rare. Urgent palliative spinal surgery is indicated to prevent further deterioration of function. Intraoperative usage of targeted controlled infusion (TCI) of remifentanil and propofol as maintenance of anaesthesia are gold standard in assisting spine surgeons who are guided by neuromuscular monitoring. Spinal metastasis to the thoracic vertebra is rare among young Asian men. Patients presented with acute neurological deficits and back pain are indicated for spinal surgery. Multidisciplinary approach is needed for management of patients with spinal metastasis. Targeted controlled infusion (TCI) of remifentanil and propofol are gold standard for maintenance of anaesthesia for spine surgeries which are guided by somatosensory, and motor evoked potential monitoring. Elsevier Ltd 2022-01-25 Article PeerReviewed text en https://eprints.ums.edu.my/id/eprint/32744/2/A%20rare%20occurrence%20of%20a%20metastatic%20urothelial%20carcinoma%20to%20the%20thoracic%20vertebra%2C%20ABSTRACT.pdf text en https://eprints.ums.edu.my/id/eprint/32744/1/A%20rare%20occurrence%20of%20a%20metastatic%20urothelial%20carcinoma%20to%20the%20thoracic%20vertebra%2C%20A%20case%20report.pdf Soe, May Zaw and Bong, Chin Pei and Shankaran Thevarajah and Teah, Kai Ming and Yeap, Boon Tat (2022) A rare occurrence of a metastatic urothelial carcinoma to the thoracic vertebra: A case report. Annals of Medicine and Surgery, 7. ISSN 2049-0801 https://www.sciencedirect.com/science/article/pii/S2049080122000577 https://doi.org/10.1016/j.amsu.2022.103297
institution Universiti Malaysia Sabah
building UMS Library
collection Institutional Repository
continent Asia
country Malaysia
content_provider Universiti Malaysia Sabah
content_source UMS Institutional Repository
url_provider http://eprints.ums.edu.my/
language English
English
topic RC31-1245 Internal medicine
spellingShingle RC31-1245 Internal medicine
Soe, May Zaw
Bong, Chin Pei
Shankaran Thevarajah
Teah, Kai Ming
Yeap, Boon Tat
A rare occurrence of a metastatic urothelial carcinoma to the thoracic vertebra: A case report
description Urothelial carcinoma (UC) is a common urinary tract malignancy that predominantly affect the urinary bladder with a low recurrence rate after surgical removal. It usually metastasizes to the lungs, regional lymph nodes, and liver. However, it rarely spread to the thoracic spine and bones, especially in the Asian populations. A 50-years-old Asian man, with a one-year history of surgically resected UC, presented to us with a complaint of worsening upper back pain for three months. Magnetic resonance imaging (MRI) showed a destructed second thoracic (T2) vertebra with lytic lesion. A thoracic vertebrectomy was performed and histopathological examination (HPE) showed high-grade infiltrating metastatic malignant UC. Postoperatively, he was well and did not have any back pain. He was followed up under combined spine and oncology clinic regularly and was planned for chemoradiotherapy. UC commonly metastasizes to the lungs, liver, and lymph nodes. In young Asians, thoracic spinal metastases are rare. Urgent palliative spinal surgery is indicated to prevent further deterioration of function. Intraoperative usage of targeted controlled infusion (TCI) of remifentanil and propofol as maintenance of anaesthesia are gold standard in assisting spine surgeons who are guided by neuromuscular monitoring. Spinal metastasis to the thoracic vertebra is rare among young Asian men. Patients presented with acute neurological deficits and back pain are indicated for spinal surgery. Multidisciplinary approach is needed for management of patients with spinal metastasis. Targeted controlled infusion (TCI) of remifentanil and propofol are gold standard for maintenance of anaesthesia for spine surgeries which are guided by somatosensory, and motor evoked potential monitoring.
format Article
author Soe, May Zaw
Bong, Chin Pei
Shankaran Thevarajah
Teah, Kai Ming
Yeap, Boon Tat
author_facet Soe, May Zaw
Bong, Chin Pei
Shankaran Thevarajah
Teah, Kai Ming
Yeap, Boon Tat
author_sort Soe, May Zaw
title A rare occurrence of a metastatic urothelial carcinoma to the thoracic vertebra: A case report
title_short A rare occurrence of a metastatic urothelial carcinoma to the thoracic vertebra: A case report
title_full A rare occurrence of a metastatic urothelial carcinoma to the thoracic vertebra: A case report
title_fullStr A rare occurrence of a metastatic urothelial carcinoma to the thoracic vertebra: A case report
title_full_unstemmed A rare occurrence of a metastatic urothelial carcinoma to the thoracic vertebra: A case report
title_sort rare occurrence of a metastatic urothelial carcinoma to the thoracic vertebra: a case report
publisher Elsevier Ltd
publishDate 2022
url https://eprints.ums.edu.my/id/eprint/32744/2/A%20rare%20occurrence%20of%20a%20metastatic%20urothelial%20carcinoma%20to%20the%20thoracic%20vertebra%2C%20ABSTRACT.pdf
https://eprints.ums.edu.my/id/eprint/32744/1/A%20rare%20occurrence%20of%20a%20metastatic%20urothelial%20carcinoma%20to%20the%20thoracic%20vertebra%2C%20A%20case%20report.pdf
https://eprints.ums.edu.my/id/eprint/32744/
https://www.sciencedirect.com/science/article/pii/S2049080122000577
https://doi.org/10.1016/j.amsu.2022.103297
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score 13.211869

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