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Spinal metastasis of parotid acinic cell carcinoma followed by intradural extramedullary recurrence: illustrative case

BACKGROUND: The diagnosis and management of acinic cell carcinoma (ACC) is often challenging given its similarity to benign tumors, high incidences of late recurrence and distant metastasis, and tendency to be resistant to systemic chemotherapy. A primary parotid ACC resulting in an intradural extra...

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Autores principales: Yuan, Po Hsiang (Shawn), Grassner, Lukas, Fisher, Charles, Dea, Nicolas
Formato: Online Artículo Texto
Lenguaje:English
Publicado: American Association of Neurological Surgeons 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9281461/
https://www.ncbi.nlm.nih.gov/pubmed/35855290
http://dx.doi.org/10.3171/CASE21591
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author Yuan, Po Hsiang (Shawn)
Grassner, Lukas
Fisher, Charles
Dea, Nicolas
author_facet Yuan, Po Hsiang (Shawn)
Grassner, Lukas
Fisher, Charles
Dea, Nicolas
author_sort Yuan, Po Hsiang (Shawn)
collection PubMed
description BACKGROUND: The diagnosis and management of acinic cell carcinoma (ACC) is often challenging given its similarity to benign tumors, high incidences of late recurrence and distant metastasis, and tendency to be resistant to systemic chemotherapy. A primary parotid ACC resulting in an intradural extramedullary mass has not been reported. OBSERVATIONS: The authors describe such a case that presented as a progressive cervical myelopathy 29 years after initial diagnosis. The tumor, located at the C2–C3 level, infiltrated the dura and contained both extradural and intradural components. This occurred 18 months after the incomplete resection of an extradural metastasis at the same location. LESSONS: Although intracranial and extradural metastases of various primary malignancies are well reported, secondary spinal intradural malignancies are rare. As a result, there are no established guidelines for the surgical management of intradural extramedullary metastases and prognosis may be difficult to establish. In this case, treatment options were limited because systemic therapy options had been exhausted and repeated radiation to the area was not recommended. We report on this case to highlight the clinical course of a rare local recurrence after spinal metastasis leading to an intradural extramedullary tumor and to show that surgical intervention can lead to improvement of neurological symptoms.
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spelling pubmed-92814612022-07-18 Spinal metastasis of parotid acinic cell carcinoma followed by intradural extramedullary recurrence: illustrative case Yuan, Po Hsiang (Shawn) Grassner, Lukas Fisher, Charles Dea, Nicolas J Neurosurg Case Lessons Case Lesson BACKGROUND: The diagnosis and management of acinic cell carcinoma (ACC) is often challenging given its similarity to benign tumors, high incidences of late recurrence and distant metastasis, and tendency to be resistant to systemic chemotherapy. A primary parotid ACC resulting in an intradural extramedullary mass has not been reported. OBSERVATIONS: The authors describe such a case that presented as a progressive cervical myelopathy 29 years after initial diagnosis. The tumor, located at the C2–C3 level, infiltrated the dura and contained both extradural and intradural components. This occurred 18 months after the incomplete resection of an extradural metastasis at the same location. LESSONS: Although intracranial and extradural metastases of various primary malignancies are well reported, secondary spinal intradural malignancies are rare. As a result, there are no established guidelines for the surgical management of intradural extramedullary metastases and prognosis may be difficult to establish. In this case, treatment options were limited because systemic therapy options had been exhausted and repeated radiation to the area was not recommended. We report on this case to highlight the clinical course of a rare local recurrence after spinal metastasis leading to an intradural extramedullary tumor and to show that surgical intervention can lead to improvement of neurological symptoms. American Association of Neurological Surgeons 2021-12-20 /pmc/articles/PMC9281461/ /pubmed/35855290 http://dx.doi.org/10.3171/CASE21591 Text en © 2021 The authors https://creativecommons.org/licenses/by-nc-nd/4.0/CC BY-NC-ND 4.0 (http://creativecommons.org/licenses/by-nc-nd/4.0/ (https://creativecommons.org/licenses/by-nc-nd/4.0/) ).
spellingShingle Case Lesson
Yuan, Po Hsiang (Shawn)
Grassner, Lukas
Fisher, Charles
Dea, Nicolas
Spinal metastasis of parotid acinic cell carcinoma followed by intradural extramedullary recurrence: illustrative case
title Spinal metastasis of parotid acinic cell carcinoma followed by intradural extramedullary recurrence: illustrative case
title_full Spinal metastasis of parotid acinic cell carcinoma followed by intradural extramedullary recurrence: illustrative case
title_fullStr Spinal metastasis of parotid acinic cell carcinoma followed by intradural extramedullary recurrence: illustrative case
title_full_unstemmed Spinal metastasis of parotid acinic cell carcinoma followed by intradural extramedullary recurrence: illustrative case
title_short Spinal metastasis of parotid acinic cell carcinoma followed by intradural extramedullary recurrence: illustrative case
title_sort spinal metastasis of parotid acinic cell carcinoma followed by intradural extramedullary recurrence: illustrative case
topic Case Lesson
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9281461/
https://www.ncbi.nlm.nih.gov/pubmed/35855290
http://dx.doi.org/10.3171/CASE21591
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