UNKNOWN PRIMARY TUMOR SITES IN SPINAL METASTASIS

Candido, Priscila Barile Marchi; Pinheiro, Rômulo Pedroza; Peria, Fernanda Maris; Toledo, Vinicius Nogueira; Costa, Herton Rodrigo Tavares; Defino, Helton Luiz Aparecido

doi:10.1590/S1808-185120212001243891

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Original Article, Tumor and Medical Oncologu • Coluna/Columna 20 (1) • Jan-Mar 2021 • https://doi.org/10.1590/S1808-185120212001243891 copy

UNKNOWN PRIMARY TUMOR SITES IN SPINAL METASTASIS

METÁSTASE VERTEBRAL EM TUMOR PRIMÁRIO DE LOCALIZAÇÃO DESCONHECIDA

METÁSTASIS VERTEBRAL EN TUMOR PRIMARIO DE LOCALIZACIÓN DESCONOCIDA

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective:

The goal of the study was to report the prevalence of spinal metastasis with unknown primary tumor, clinical features, treatment results and patient survival.

Methods:

A retrospective evaluation of 103 patients with spinal metastasis and epidural compression, who underwent surgical treatment between March 2009 and August 2015. The prevalence of metastatic spinal tumor with unknown primary tumor was evaluated, as well clinical features, survival and treatment results.

Results:

Of 103 patients with spinal metastasis and epidural compression, seven patients (6.8%) with unknown primary tumor site were identified; five (71.4%) male and two (28.6%) female, with ages ranging from 37 to 67 years (50.7 years). The metastasis was located in the thoracic spine in six of the patients (85.7%) and in the cervical spine in one (14.3%). The mean survival time was 44.8 days.

Conclusion:

Spinal metastasis with unknown primary tumor was found in 6.8% of patients. The prognosis and outcomes were poor, and patients had poor survival rates. Level of evidence III; Experimental study.

Keywords:
Neoplasm Metastasis; Spine; Unknown Primary Neoplasms

Primary tumor	Sex		Total n (%)
	Male	Female
	n (%)	n (%)
Adrenal	1 (1,59)	0 (0,00)	1 (0,97)
Bladder	2 (3.17)	0 (0.00)	2 (1.94)
Oral cavity	3 (4.76)	1 (2.50)	4 (3.88)
Cervix	0 (0.00)	2 (5.00)	2 (1.94)
Colon	2 (3.17)	1 (2.50)	3 (2.91)
Esophagus	1 (1.59)	0 (0.00)	1 (0.97)
Small intestine	1 (1.59)	0 (0.00)	1 (0.97)
Breast	0 (0.00)	27 (67.50)	27 (26.21)
Choroid plexus melanoma	1 (1.59)	0 (0.00)	1 (0.97)
Nasopharynx	1 (1.59)	0 (0.00)	1 (0.97)
Oropharynx	1 (1.59)	0 (0.00)	1 (0.97)
Prostate	23 (36.51)	0 (0.00)	23 (22.33)
Lung	4 (6.35)	1 (2.50)	5 (4.85)
Rectum	3 (4.76)	2 (5.00)	5 (4.85)
Kidney	3 (4.76)	0 (0.00)	3 (2.91)
Sarcoma	7 (11.11)	1 (2.50)	8 (7.77)
Maxillary sinus	1 (1.59)	0 (0.00)	1 (0.97)
Unknown primary	5 (7.94)	2 (5.00)	7 (6.80)
Testicle	2 (3.17)	0 (0.00)	2 (1.94)
Thyroid	2 (3.17)	2 (5.00)	4 (3.88)
Gallbladder	0 (0.00)	1 (2.50)	1 (0.97)
Total	63 (100.00)	40 (100.00)	103 (100.00)

Age	Sex	Localization	Lesion	Visceral metast.	Frankel pre	Frankel post	Pain improvement	Tomita score	Tokuhashi	Survival (days)
37	M	Thoracic	Multiple	Liver	A	B	Yes	8	4	30
55	M	Thoracic	Multiple	Liver	E	E	No	8	6	22
53	M	Thoracic	Single	None	B	B	Yes	8	5	34
49	F	Cervical	Single	Liver	E	E	Yes	8	6	78
43	M	Thoracic	Multiple	Lung	C	C	Yes	10	3	33
51	F	Thoracic	Multiple	Liver	E	E	No	4	6	71
67	M	Thoracic	Single	None	B	C	No	3	11	46

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[1] Correspondence: Rômulo Pedroza Pinheiro. Department of Orthopedics and Anesthesiology, and Doctoral Student, Ribeirão Preto Medical School, University of São Paulo. Av. Bandeirantes, 3900, Monte Alegre, Ribeirão Preto, SP, Brazil. 14049900. romulopedroza@gmail.com