Solitary cerebral metastasis from transitional cell carcinoma of the urinary tract

Spinal infections originating from the gastrointestinal tract are rare. We report a patient in whom esophageal rupture during endoscopy led to spinal infection with neurological deficit. An 80-year-old Asian man with a history of recent endoscopic gastrointestinal investigation presented to our clinic with the chief complaints of upper thoracic discomfort, chest pain and mild intermittent fever. Progressive weakness and numbness in both lower extremities had developed during the previous two weeks. A thoracic spine MRI showed a space-occupying lesion with involvement of the T2 and T3 vertebral bodies including an epidural abscess. After surgical decompression, the patient gradually recovered power in his lower extremities. Early diagnosis is a key factor to avoid neurologic sequelae in the treatment of patients with spinal infection. Physicians need to be aware of this potential complication following endoscopic gastrointestinal investigation. (C) 2006 Elsevier Ltd. All rights reserved.