OJO  Vol.3 No.1 , March 2013
Isolated Metastatic Barrett’s Adenocarcinoma of the Thoracic Epidural Space Causing Paraplegia

Barrett’s adenocarcinoma is an esophageal cancer arising from Barrett’s esophagus. In this report, a metastatic epidural tumor from Barrett’s adenocarcinoma with paraplegia that required surgical treatment is documented. A 50-year-old man who had had a resection of the distal esophagus due to Barrett’s adenocarcinoma six month before presented with progressive weakness and numbness in lower limbs with urinary disturbance. Magnetic resonance imaging of the thoracic region revealed compression of the spinal cord at the T3-4 level by a dorsally located epidural mass. No signal changes were detected in vertebrae. Since the paraplegia and urinary disturbance were rapidly progressing, laminectomy and tumor resection was performed. Postoperatively, neurological function improved immediately and there was no recurrence of spinal region. This is the first report on an isolated metastatic Barrett’s adenocarcinoma of the thoracic epidural space.

Cite this paper
T. Banno, T. Ohishi, D. Suzuki, K. Yamamoto, H. Ushirozako, S. Kobayashi and Y. Matsuyama, "Isolated Metastatic Barrett’s Adenocarcinoma of the Thoracic Epidural Space Causing Paraplegia," Open Journal of Orthopedics, Vol. 3 No. 1, 2013, pp. 1-3. doi: 10.4236/ojo.2013.31001.
[1]   T. Lerut, W. Coosemans, D. Van Raemdonck, B. Dillemans, P. De Leyn, J. M. Marnette and K. Geboes, “ Surgical Treatment of Barrett’s Carcinoma,” The Journal of Thoracic Cardiovascular Surgery, Vol. 107, No. 4, 1994, pp. 1059-1065.

[2]   M. Hongo and T. Shoji, “Epidemiology of Reflux Disease and CLE in East Asia,” Journal of Gastroenterology, Vol. 38, No. 15, 2003, pp. 25-30.

[3]   B. C. Morson and J. R. Belcher, “Adenocarcinoma of Oesophagus and Ectopic Gastric Mucosa,” British Journal of Cancer, Vol. 6, No. 2, 1953, pp. 127-130. doi:10.1038/bjc.1952.14

[4]   O. V. Batson, “The Function of the Vertebral Veins and Their Role in the Spread of Metastases,” Annals of Surgery, Vol. 112, No. 1, 1940, pp. 138-149. doi:10.1097/00000658-194007000-00016

[5]   F. Hvid-Jensen, L. Pedersen, A. M. Drewes, H. T. SØrensen and P. Funch-Jensen, “Incidence of Adenocarcinoma among Patients with Barrett’s Esophagus,” New England Journal of Medicine, Vol. 365, No. 15, 2011, pp. 13751383. doi:10.1056/NEJMoa1103042

[6]   L. Murray, P. Watson, B. Johnston, J. Sloan, I. M. Mainie and A. Gavin, “Risk of Adenocarcinoma in Barrett’s Oesophagus,” BMJ, Vol. 327, No. 7414, 2003, pp. 534-535. doi:10.1136/bmj.327.7414.534

[7]   M. Solaymani-Dodaran, R. F. Logan, J. West, T. Card and C. Coupland, “Risk of Oesophagus Cancer in Barrett’s Oesophagus and Gastro-Oesophageal Reflex,” Scandinavian Journal of Gastroenterology, Vol. 39, No. 7, 2004, pp. 680-685. doi:10.1080/00365520410004802

[8]   S. S. Devesa, W. J. Blot and J. F. Fraumeni, “Changing Patterns in the Incidence of Esophageal and Gastric Carcinoma in the United States,” Cancer, Vol. 83, No. 10, 1998, pp. 2049-2053. doi:10.1002/(SICI)1097-0142(19981115)83:10<2049::AID-CNCR1>3.0.CO;2-2

[9]   M. Mut, D. Schiff and M. E. Shafferey, “Metastatic to Nerveous System: Spinal Epidural and Intramedullsry Metastasis,” Journal of Neu-ro-Oncology, Vol. 75, No. 1, 2005, pp. 43-56. doi:10.1007/s11060-004-8097-2

[10]   J. Brice and W. Mckissock, “Surgical Treatment of Malignant Extradural Spinal Tumors,” British Medical Journal, Vol. 1, No. 5446, 1965, pp. 1339-1342. doi:10.1136/bmj.1.5446.1341

[11]   H. O. Chade, “Metastatic Tumors of the Spine and Spinal cord,” Handbook of Clinical Neurology, Vol. 20, No. 2, 1976, pp. 415-433.

[12]   R. L. Wright, “Malignant Tumors in the Spinal Extradural Space: Results of Surgical Treatment,” Annals of Surgery, Vol. 157, No. 2, 1963, pp. 227-231.

[13]   M. Rodoriguez and R. P. Dinapoli, “Spinal Cord Compression with Special Reference to Metastatic Epidural Tumors,” Mayo Clinic Proceedings, Vol. 55, No. 7, 1980, pp. 442-448.

[14]   K. Shibasaki, C. G. Harper and G. M. Bedbrock, “Vertebral Metastases and Spinal Cord Compression,” Paraplegia, Vol. 21, No. 1, 1983, pp. 47-61.