En Bloc resection of solitary functional secreting spinal metastasis Journal Article


Authors: Goodwin, C. R.; Clarke, M. J.; Gokaslan, Z. L.; Fisher, C.; Laufer, I.; Weber, M. H.; Sciubba, D. M.
Article Title: En Bloc resection of solitary functional secreting spinal metastasis
Abstract: Study Design Literature review. Objective Functional secretory tumors metastatic to the spine can secrete hormones, growth factors, peptides, and/or molecules into the systemic circulation that cause distinct syndromes, clinically symptomatic effects, and/or additional morbidity and mortality. En bloc resection has a limited role in metastatic spine disease due to the current paradigm that systemic burden usually determines morbidity and mortality. Our objective is to review the literature for studies focused on en bloc resection of functionally active spinal metastasis as the primary indication. Methods A review of the PubMed literature was performed to identify studies focused on functional secretingmetastatic tumors to the spinal column.We identified five cases of patients undergoing en bloc resection of spinal metastases from functional secreting tumors. Results The primary histologies of these spinal metastases were pheochromocytoma, carcinoid tumor, choriocarcinoma, and a fibroblast growth factor 23-secreting phosphaturic mesenchymal tumor. Although studies of en bloc resection for these rare tumor subtypes are confined to case reports, this surgical treatment option resulted in metabolic cures and decreased clinical symptoms postoperatively for patients diagnosed with solitary functional secretory spinal metastasis. Conclusion Although the ability to formulate comprehensive conclusions is limited, case reports demonstrate that en bloc resection may be considered as a potential surgical option for the treatment of patients diagnosed with solitary functional secretory spinal metastatic tumors. Future prospective investigations into clinical outcomes should be conducted comparing intralesional resection and en bloc resection for patients diagnosed with solitary functional secretory spinal metastasis. © 2016 Georg Thieme Verlag KG Stuttgart - New York.
Keywords: cancer surgery; overall survival; review; cancer recurrence; recurrence risk; cytoreductive surgery; metastasis; progression free survival; morbidity; histology; systematic review; spine; surgery; surgical mortality; carcinoid; pheochromocytoma; choriocarcinoma; spinal cord metastasis; fibroblast growth factor 23; en bloc resection; mesenchymoma; human; priority journal; en bloc; functional secretory tumor
Journal Title: Global Spine Journal
Volume: 6
Issue: 3
ISSN: 2192-5682
Publisher: Georg Thieme Verlag  
Date Published: 2016-05-01
Start Page: 277
End Page: 283
Language: English
DOI: 10.1055/s-0035-1558654
PROVIDER: scopus
PMCID: PMC4836935
PUBMED: 27099819
DOI/URL:
Notes: Review -- Export Date: 2 August 2017 -- Source: Scopus
Altmetric
Citation Impact
BMJ Impact Analytics
MSK Authors
  1. Ilya Laufer
    146 Laufer