Paraplegia in a Patient With Tongue Cancer Caused by Metastatic Rib Tumor Extension Through an Intervertebral Foramen: A Case Report.

Among patients being treated for cancer, almost all malignant spinal cord compression (MSCC) occurs in those with vertebral bone metastases. MSCC without vertebral bone metastasis is extremely rare; however, we report herein a case of rapid paraplegia caused by metastatic rib tumor progression through the intervertebral foramen in a patient with tongue cancer. A 37-year-old man was diagnosed with squamous cell carcinoma of the tongue (T2N0M0). The patient underwent a partial glossectomy, followed by neck dissection for cervical metastasis and anticancer drug therapy for lung and third rib metastases. The rib metastasis progressed, subsequently extending through the intervertebral foramen, in the absence of vertebral bone metastasis. At the time of detection, symptoms of MSCC were not observed. However, eight days after the diagnosis of tumor extension through the intervertebral foramen, slight paraplegia appeared, followed by complete paraplegia on day 10. Despite radiotherapy and glucocorticoid therapy, the paraplegia did not improve, and the patient died 90 days after the diagnosis of MSCC.