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Published on: August 9, 2024
Needle-tract seeding after percutaneous vertebroplasty: a case report
Chang-Hyun Lee1, Joon Woo Lee, Seung-Jae Hyun
1From *the Department of Neurosurgery, Konyang University Hospital, Konyang University College of Medicine, Daejeon Departments of †Radiology; and ‡Neurosurgery, Spine Center, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Republic of Korea.
Needle-tract seeding (NTS) of lung adenocarcinoma can occur after vertebroplasty (VP), a rare complication. This case highlights the importance of considering NTS in patients with pathological fractures undergoing VP.
Area of Science:
- Oncology
- Neurosurgery
- Radiology
Background:
- Needle-tract seeding (NTS) is a known complication following invasive procedures like biopsies.
- NTS after injections, such as vertebroplasty (VP), is exceptionally rare.
- Lung adenocarcinoma can metastasize to the thoracic spine, causing pathological fractures.
Observation:
- A 61-year-old female with a history of lung adenocarcinoma presented with a painful back mass and lower extremity weakness.
- The patient had previously undergone percutaneous VP for a metastatic pathological fracture of T4-T6.
- Imaging revealed a subcutaneous mass extending to the thoracic spine, involving the T5 pedicle and epidural space.
Findings:
- Surgical removal of the mass confirmed metastatic adenocarcinoma of the lung.
- Histological analysis confirmed needle-tract seeding from the primary lung cancer.
- The patient's back pain and neurological deficits improved following surgical intervention and spinal reconstruction.
Implications:
- This case underscores that needle-tract seeding is a potential complication even after vertebroplasty in patients with metastatic cancer.
- Clinicians should maintain a high index of suspicion for NTS in patients presenting with new masses or neurological deterioration after VP.
- Difficulties during polymethyl methacrylate injection in VP might warrant further investigation for potential tumor involvement.
