Development of pulmonary endovascular metastases following vertebroplasty: case report

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A 69-year-old man developed pulmonary metastases following vertebroplasties for pathological fractures of vertebrae T12–L4. The fractures developed due to spinal metastases from castrate-resistant prostate cancer. A CT scan performed 1 month prior indicated no evidence of pulmonary malignancy. However, CT scans performed 2 months after the vertebroplasties demonstrated intravascular pulmonary metastases distributed similarly to embolized polymethylmethacrylate. Vertebroplasty is a well-established procedure for symptomatic management of vertebral compression fractures. However, studies have demonstrated an increase in circulating tumor cells following vertebroplasties, theoretically increasing the risk of distant metastases. In this case, the chronicity and radiological findings suggest that the pulmonary intravascular metastases may have resulted from the vertebroplasties.

ABBREVIATIONS CTC = circulating tumor cell; MIP = maximum intensity projection; PMMA = polymethylmethacrylate; PSA = prostate-specific antigen.
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Contributor Notes

Correspondence John Kavanagh: University Health Network, Toronto, ON, Canada. john.kavanagh@uhn.ca.INCLUDE WHEN CITING Published online November 29, 2019; DOI: 10.3171/2019.9.SPINE19915.Disclosures The authors report no conflict of interest concerning the materials or methods used in this study or the findings specified in this paper.
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