Surgical treatment of a patient with lung cancer metastasized to the spine with EGFR mutation: A case report

INTRODUCTION: The prognosis of patients with lung cancer metastasis to the spine is not very promising and a palliative approach is often suggested by scales such as the Tomita score. The choice of surgery for these patients is questionable based on the aggressiveness of the disease. However, certain patient characteristics can be sought out to determine if surgery is indicated. PRESENTATION OF CASE: Here, we present a case of a 59 year old male which consulted for back pain, numbness of the upper left thigh, and weakness corresponding to an L2 lesion. It was later discovered that he was suffering from non small cell lung cancer (adenocarcinoma) with a single metastasis to the spine at the level of L2. The patient also presented an EGFR mutation. Thus, the patient presented two good prognosis characteristics: adenocarcinoma and an EGFR mutation. DISCUSSION: An aggressive treatment was chosen. This included an EGFR inhibitor, surgical treatment, and radiotherapy thereafter. The patient had no complications due to surgery and to date, the patient has survived over 12 months and is free of any symptoms. This case demonstrates that surgical intervention can be considered for certain patients with lung cancer metastasized to the spine. CONCLUSION: This case demonstrates that surgical intervention can be considered for certain patients with lung cancer metastasized to the spine. We hope spine surgeons in general will start verifying the EGFR mutation status of adenocarcinoma lung cancer patients to determine if surgery is indicated. (C) 2012 Surgical Associates Ltd. Published by Elsevier Ltd.