Multiple Thoracic Metastasis Misrecognized as a Complication after Epidural Block : A case report

Choi, Yong Woo; Chung, Mee Young; Kim, Chang Jae; Chea, Jun Seuk; Lee, Byung Ho; Lee, Hyo Jung

Case Report

Spinal Pain

Anesthesia and Pain Medicine 2007;2(3):113-116.
Published online July 31, 2007.

Multiple Thoracic Metastasis Misrecognized as a Complication after Epidural Block : A case report

Yong Woo Choi, Mee Young Chung, Chang Jae Kim, Jun Seuk Chea, Byung Ho Lee, Hyo Jung Lee

Department of Anesthesiology and Pain Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea. chjs1202@catholic.ac.kr

Abstract

We report here on a case of a patient who developed paraplegia after thoracic epidural block that was done for the management of postherpetic neuralgia, and the patient was later diagnosed with spine metastasis from prostate cancer. This patient developed paraplegia of both lower extremities 2 weeks after the epidural block. We took X-ray and performed MRI of the thoracic spine for the differential diagnosis of paraplegia associated with herpes zoster, complications of epidural block or other diseases. The diagnosis of the paraplegia was spinal cord compression at T8, and this was caused by metastatic tumor that originated from prostate cancer. When we encounter paraplegia after epidural block, we should also consider other diseases as well as the complications of epidural block like direct neural damage, abscess and hematoma. Especially when there is the possibility of cancer, early detection, an accurate diagnosis and timely treatment can provide the best chance to ameliorate further medical consequences and optimize the quality of life.

Key Words: metastasis, paraplegia, prostate, cancer, thoracic, epidural, block