Spinal cord compression as the initial presentation of colorectal cancer: case report and review of the literature

Spinal cord compression as the initial presentation of colorectal cancer: case report and review of the literature

Magdalena Maria Gilg, Gerhard Bratschitsch, Ulrike Wiesspeiner, Roman Radl, Andreas Leithner, Cord Langner




Background: Malignant spinal cord compression (MSCC) is most frequently seen in patients with breast, prostate and lung cancer. 5% to 25% of MSCC cases occur as the initial presentation of malignancy.

Case report: We report the case of a 43-year-old male patient with sudden onset incomplete paraplegia. Imaging revealed spinal cord compression at the level TH 3/4 and TH 8. Emergency decompressive surgery with tumour biopsy was performed. Two days after surgery, the patient developed large bowel obstruction, and a sigmoid tumour was identified as underlying cause. The sigmoid tumour was diagnosed as colorectal adenocarcinoma, and histological examination of the spinal tumour confirmed metastatic disease.

Conclusion: MSCC may be the initial presentation in patients with neoplastic disease, and also tumours that only very rarely metastasize to the skeletal system have to be included in differential diagnosis. Obtaining biopsy material during surgery is crucial to establish a definitive diagnosis.


Malignant spinal cord compression; colorectal cancer; metastasis; histology

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