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Washington University Experience | NEOPLASMS (METASTASES) | Microscopic | 66A0 Case 6 History
Case 66 History ---- The patient was a 51 year old man who presents with a 3.0 x 3.1 cm spiculated mass in the right medial lung apex as well as innumerable metastases throughout both lungs. There is a confluent soft tissue mass in the right hilum consistent with metastatic adenopathy. There are pleural metastases involving the right medial diaphragm, and a 2.6 x 2.3 cm osseous metastasis involving the right lamina, pedicle, and transverse process as well as the posterior vertebral body at T3 in the spine. The mass extends into the right lateral and anterior aspect of the spinal canal causing severe spinal canal stenosis. The patient has multiple, additional metastases involving the ribs and spine. Finally, there is a 6 mm lytic lesion involving the left T8 vertebral body and a 2.4 x 1.6 mm osseus metastasis involving the spinous process and bilateral lamina at T8, causing mild mass effect on the posterior dural sac. Operative procedure: Posterior thoracic laminectomy at T8 for resection of epidural tumor and decompression of spinal cord, posterior thoracic laminectomy at T3, T3 vertebrectomy, anterior thoracic arthrodesis from T2 to T4, and posterior instrumented fusion from T2 to T4.
