Spastic Paraplegia Secondary to Spinal Metastasis in a Patient with Advanced-Stage Breast Cancer: A Case Report

Introduction

Spinal metastasis in breast cancer patients can lead to severe pain, neurological deficits, and significant morbidity, impacting quality of life and chances of survival in breast cancer patients. Case: A 48-year-old woman was referred to a neurologist because of lower extremity weakness. Due to spinal cord compression, she had paraplegia with chronic progressive mixed-type lower back pain, with radiating to the pelvis, accompanied by numbness, tingling, and burning from both feet to the subumbilical region, and impairment of defecation and urination. She had a history of breast cancer with chemotherapy and radiotherapy. Her numeric rating scale score was 7, ID pain score was 4, Karnofsky score was 40; neurological examination revealed spastic paraplegia, segmental hypoesthesia at and below the 11th spinal cord level, and urinary and bowel retention. Radiologic examination showed kyphosis with osteolytic and osteosclerotic thoracic vertebrae. Bone survey showed bone metastases in thoracic vertebral bodies 5–12, the right ilium, and the right proximal femur.