SPINAL METASTASES AS A FIRST PRESENTATION OF MALIGNANT ASTROCYTOMA

A 46-year-old man presented with low dorsal pain and paresthesia. Comp uted tomography showed an osteolytic lesion involving most of the vert ebral body and the left pedicle of the 12th thoracic vertebra (T12). C ontrast-enhanced magnetic resonance imaging (MRI) of the spine showed an enhancing soft-tissue mass that involved the T11 and T12 vertebral bodies, as well as that of the first lumbar vertebra; the mass caused cord compression. Another lesion was identified at T9. The findings of percutaneous needle aspiration biopsy of the lesion mere consistent w ith metastatic astrocytoma, a diagnosis confirmed at surgery, MRI of t he brain showed an asymptomatic lesion of the left temporal lobe; hist ologic confirmation of malignant astrocytoma was obtained by stereotac tic biopsy. This report shows that metastatic bone disease secondary t o malignant astrocytoma may manifest itself before the primary lesion becomes symptomatic. This presentation of astrocytoma was unusual beca use there were no symptoms of the intracranial tumour and because meta static disease to the bones is less common than to the chest and the l ymph nodes.