case_images: PMC8557050_01
case_images: Low-dose lung CT demonstrated multiple right lung tumors (arrow).
case_images: CRINM2021-2232769.001.jpg
case_images: PMC8557050_01_CRINM2021-2232769.001.jpg
case_images: fig1
case_images: The patient is a 62-year-old male who has right lung cancer with multiple metastasis, cT4N2M1c, stage 4B (Figure 1), after radiotherapy and chemotherapy.
case_images: The patient presented spinal tumor at the T2 level with cord compression. (a) T2-weighted, (b) T1-weighted with a contrast sagittal view, and (c) T1-weighted with a contrast axial view.
case_images: CRINM2021-2232769.002.jpg
case_images: PMC8557050_01_CRINM2021-2232769.002.jpg
case_images: fig2
case_images: T2 vertebral body (Figure 2). The patient's symptoms were related to pathologic fracture which was caused by the T2 vertebral body and T2 left-side pedicle tumor invasion. Therefore, radiculopathy and bone pain were chief symptoms instead of myelopathy.
case_images: Intraoperative picture revealed the good decompression of the spinal cord.
case_images: CRINM2021-2232769.003.jpg
case_images: PMC8557050_01_CRINM2021-2232769.003.jpg
case_images: fig3
case_images: Unfortunately, after 2 hours of surgery, just as we had removed the laminae to get well decompression (Figure 3), put all of pedicle screws, and prepared to fix the pedicle screws, sudden-onset blood pressure drop from 110/80 to 75/50 occurred and heart rate elevated to 120 bpm.
case_images: Postop immediate CT revealed all screws had good position: (a) sagittal view, (b) T1 level screws, (c) T3 screws, and (d) T4 screws.
case_images: CRINM2021-2232769.004.jpg
case_images: PMC8557050_01_CRINM2021-2232769.004.jpg
case_images: fig4
case_images: In our urgent condition, an immediate CT scan was performed instead to evaluate the condition, which showed all pedicle screws well positioned (Figure 4).
case_images: Postop immediate CT showed right apical lung pneumothorax (star) and consolidation at the right lung, leading to the radiologist's suspicion of tumor or collapsed lung (triangle): (a) sagittal view; (b) lung window.
case_images: CRINM2021-2232769.005.jpg
case_images: PMC8557050_01_CRINM2021-2232769.005.jpg
case_images: fig5
case_images: The radiologist opined that there was no obvious compressive lesion around the spinal cord such as a hematoma or abscess between C1 and T9 but found right upper lung pneumothorax with obvious bullae (Figure 5).