En Bloc resection of solitary functional secreting spinal metastasis

C. Rory Goodwin, Michelle J. Clarke, Ziya L. Gokaslan, Charles Fisher, Ilya Laufer, Michael H. Weber, Daniel M. Sciubba

Research output: Contribution to journalReview article

2 Citations (Scopus)

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.

Original languageEnglish (US)
Pages (from-to)277-283
Number of pages7
JournalGlobal Spine Journal
Volume6
Issue number3
DOIs
StatePublished - Jul 1 2016

Fingerprint

Neoplasm Metastasis
Neoplasms
Spine
Morbidity
Choriocarcinoma
Mortality
Carcinoid Tumor
Pheochromocytoma
PubMed
Intercellular Signaling Peptides and Proteins
Histology
Hormones
Peptides
Therapeutics

Keywords

  • carcinoid
  • choriocarcinoma
  • en bloc
  • Functional secretory tumor
  • metastasis
  • pheochromocytoma
  • spine
  • surgery

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine
  • Clinical Neurology

Cite this

Goodwin, C. R., Clarke, M. J., Gokaslan, Z. L., Fisher, C., Laufer, I., Weber, M. H., & Sciubba, D. M. (2016). En Bloc resection of solitary functional secreting spinal metastasis. Global Spine Journal, 6(3), 277-283. https://doi.org/10.1055/s-0035-1558654

En Bloc resection of solitary functional secreting spinal metastasis. / Goodwin, C. Rory; Clarke, Michelle J.; Gokaslan, Ziya L.; Fisher, Charles; Laufer, Ilya; Weber, Michael H.; Sciubba, Daniel M.

In: Global Spine Journal, Vol. 6, No. 3, 01.07.2016, p. 277-283.

Research output: Contribution to journalReview article

Goodwin, CR, Clarke, MJ, Gokaslan, ZL, Fisher, C, Laufer, I, Weber, MH & Sciubba, DM 2016, 'En Bloc resection of solitary functional secreting spinal metastasis', Global Spine Journal, vol. 6, no. 3, pp. 277-283. https://doi.org/10.1055/s-0035-1558654
Goodwin CR, Clarke MJ, Gokaslan ZL, Fisher C, Laufer I, Weber MH et al. En Bloc resection of solitary functional secreting spinal metastasis. Global Spine Journal. 2016 Jul 1;6(3):277-283. https://doi.org/10.1055/s-0035-1558654
Goodwin, C. Rory ; Clarke, Michelle J. ; Gokaslan, Ziya L. ; Fisher, Charles ; Laufer, Ilya ; Weber, Michael H. ; Sciubba, Daniel M. / En Bloc resection of solitary functional secreting spinal metastasis. In: Global Spine Journal. 2016 ; Vol. 6, No. 3. pp. 277-283.
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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.",
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AB - 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.

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