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Unusual presentation of cervical spine metastases to the ENT surgeon

Published online by Cambridge University Press:  07 December 2012

P Baruah ,
C J Randall  and
A Burgess
P Baruah*
Affiliation:
Department of Otolaryngology, Southampton General Hospital, UK
C J Randall
Affiliation:
Department of Otolaryngology, Southampton General Hospital, UK
A Burgess
Affiliation:
Department of Otolaryngology, Southampton General Hospital, UK
*
Address for correspondence: Dr P Baruah, Department of Otolaryngology, Southampton General Hospital, Tremona Rd, Southampton SO16 6YD, UK E-mail: baruahparamita@rediffmail.com
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Abstract

Objective:

Cervical spine metastases account for 10 per cent of all spinal metastases. We report three cases of cervical spine metastases whose unusual primary presentation was with ENT-related symptoms.

Methods:

The three patients reported herein did not have a confirmed diagnosis of malignancy at presentation. The first patient presented with stridor, the second presented with dysphagia and the third presented with dysphonia. All patients complained of significant neck pain that preceded and was concomitant to the other symptoms. Clinical suspicion of cervical spine involvement led to radiological investigation with computed tomography, which showed metastatic lesions in the craniovertebral junction and cervical spine region. Histological confirmation of malignancy was obtained for two of the three patients. The condition proved uniformly fatal in the weeks following diagnosis. A review of the literature on this condition was conducted using PubMed and Medline databases.

Conclusion:

Cervical spine pathology may present initially to the ENT surgeon. A high degree of suspicion of cervical spine involvement should be maintained in elderly patients with persistent or progressive neck pain, with or without other ENT symptoms. Adequate radiological imaging will usually confirm the diagnosis.

Keywords

Neoplasm MetastasisStridorDysphagiaCervical Vertebrae
Type
Clinical Records
Information
The Journal of Laryngology & Otology , Volume 127 , Issue 1 , January 2013 , pp. 92 - 95
Copyright
Copyright © JLO (1984) Limited 2012

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