CASE 12: Laryngeal (nasopharyngeal) cancer with spinal metastasis

• 58-year-old male patient
• A patient undergoing active treatment for nasopharyngeal cancer and with a history of previous surgery due to thoracic vertebral metastasis presented to us with complaints of progressive back pain, numbness, and weakness in the legs.
• The patient arrived in a wheelchair because they were unable to walk.
• He had severe spinal cord compression due to tumor recurrence in the operated spine and the region above.
• Emergency surgery was planned for the patient, and after the tumor tissues causing spinal cord compression were completely removed (separation surgery), the treatment was successfully completed by performing screw fixation to the upper and lower vertebrae.
• The patient's neurological condition improved rapidly, and they were discharged walking without any problems.
• The patient, whose wound had healed, was referred to radiation oncology for radiotherapy in the second week after surgery.

BEFORE THE OPERATION: The X-ray shows a previous screw fixation procedure, and the MRI reveals tumor recurrence at both vertebral levels and severe spinal cord compression.

POST-OPERATIVE: X-ray shows that the tumorous vertebra in the lower thoracic region was removed, and the resulting space was reconstructed with a titanium cage. Tumor compression in the upper thoracic region was relieved (laminectomy), and the area was reinforced with unilateral screw fixation.