Intradural and extradural spinal metastases

Schick, Uta; Marquardt, Gerhard; Lorenz, Rüdiger

doi:10.1007/pl00011959

Cited by 81 publications

(55 citation statements)

References 14 publications

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“…IDEMs are very rare and appear from extended systemic cancer (2,(6)(7)(8). It has been reported 5% of cases of metastatic disease to the spine occur in intradural extramedullary region (4,7,9).…”

Section: Discussionmentioning

confidence: 99%

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Lumbar Intradural Metastasis from Large Cell Neuroendocrine Carcinoma of the Lung

Karataş¹,

Zeydoglu²,

Alacacıoğlu³

et al. 2013

Acta Oncol Tur.

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ÖZETSpinal metastaz malignitelerde sık görülen bir bulgu olmasına rağmen intradural ekstrameduller metastazı (IDEM) çok nadirdir. Biz 55 yaşında erkek hastada lomber omurgada intradural metastaz ile presente olan akciğerin büyük hücreli nöroendokrin karsinom olgusunu sunuyoruz. Anahtar Kelimeler: Tümör; Intradural metastaz; Akciğer kanseri ABSTRACT Although spinal metastasis is a common finding in malignancies, however intradural extramedullary metastasis (IDEM) is very rare. We report a 55-year-old man, known case of a large cell neuroendocrine carcinoma of the lung with IDEM in lumbar spine.

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Section: Discussionmentioning

confidence: 99%

“…Carcinoid tumours are neuroendocrine cell originated malignant tumours (3). Usually, intradural carcinoma metastasis occur with past cure systemic cancer and indicate a short survival time (4)(5)(6)(7). The optimal treatment is still controversial, with choices including steroids, radiation, chemotherapy and surgery (4,7).…”

Section: Introductionmentioning

confidence: 99%

Lumbar Intradural Metastasis from Large Cell Neuroendocrine Carcinoma of the Lung

Karataş¹,

Zeydoglu²,

Alacacıoğlu³

et al. 2013

Acta Oncol Tur.

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“…As most spinal metastases (more than 98%) occur in an extradural location, anatomical classification of the extradural location is very important (8). Anatomical (Fig.…”

Section: Anatomical Classificationsmentioning

confidence: 99%

Interpretation of MR Imaging of Spinal Metastasis: Focus on the Understanding of Its Pathophysiology and the Next Step toward a Further Clinical Approach Using MRI Findings

Lee

2016

Investig Magn Reson Imaging

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The spine is the most common location for skeletal metastases, and the incidence of spinal metastasis shows an increasing tendency. Because metastatic spinal tumors progress from an anterior element to a posterior element resulting in continuing destruction of the pedicles, epidural extension and involvement of neural structures of the metastatic tumor are eventually visible. Therefore, it is clinically significant for radiologists to understand the pathophysiology of spinal metastasis and to assess the involvement of neural structures and the disintegration of spinal instability related to the pathophysiology. As MRI is also the best imaging modality for diagnosing spinal metastasis, radiologists should accurately assess spinal metastasis and provide practical information to physicians. Therefore, we will describe some analysis points focusing on the understanding of pathophysiology of spinal metastasis and the next step toward a more extensive clinical approach using MR imaging.

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“…Spinal cord compression is expected in up to 20% of the patients with SM. Approximately 95% of the patients with SM will demonstrate epidural metastases, mainly affecting the vertebral body and the pedicle regions, whereas 5% will present with intradural and less than 1% with intramedullary metastases 5,6 . Symptomatic spinal cord compression occurs more frequently in the thoracic spine, followed by cervical and then lumbar.…”

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confidence: 99%

An update in the management of spinal metastases

Joaquim

Powers

Laufer

et al. 2015

Arq. Neuro-Psiquiatr.

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Advances in cancer treatment over the past decade, such biologics and immunotherapy are improving patient outcomes and consequently life expectancy. The most common sites for metastases in the general population with cancer are the liver and lungs, followed by bone. Considering bone metastases, the majority will affect the spine 1 . Some studies estimate that up to 40% of all patients with cancer will have spinal metastases (SM) during the course of their disease 2,3 . The most frequent histologic types of cancer that give rise to bone metastases are breast, prostate and lung cancer 4 . Most of the spinal metastases are diagnosed following the diagnosis of the primary cancer. However, in about 10% of the patients, SM is the first manifestation of an unknown primary tumor 1 . Spinal cord compression is expected in up to 20% of the patients with SM. Approximately 95% of the patients with SM will demonstrate epidural metastases, mainly affecting the vertebral body and the pedicle regions, whereas 5% will present with intradural and less than 1% with intramedullary metastases 5,6 . Symptomatic spinal cord compression occurs more frequently in the thoracic spine, followed by cervical and then lumbar. The greater incidence of SM in the thoracic spine is attributed to the higher number of vertebrae and small canal diameter AbstrActThe best clinical treatment for spinal metastases requires an integrated approach with input from an interdisciplinary cancer team. The principle goals of treatment are maintenance or improvement in neurologic function and ambulation, spinal stability, durable tumor control, and pain relief. The past decade has witnessed an explosion of new technologies that have impacted our ability to reach these goals, such as separation surgery and minimally invasive spinal procedures. The biggest advance, however, has been the evolution of stereotactic radiosurgery that has demonstrated durable tumor control both when delivered as definitive therapy and as a postoperative adjuvant even for tumors considered markedly resistant to conventional external beam radiation. In this paper, we perform an update on the management of spinal metastases demonstrating the integration of these new technologies into a decision framework NOMS that assesses four basic aspects of a patient's spine disease: Neurologic, Oncologic, Mechanical Instability and Systemic disease.Keywords: spinal metastases, bone metastases, diagnosis, management, treatment, NOMS.resumo O tratamento dos pacientes com metástases na coluna requer uma abordagem multidisciplinar por equipe especializada em oncologia. Os objetivos básicos do tratamento são a manutenção/ melhora da função neurológica com preservação da deambulação, manutenção da estabilidade da coluna, controle tumoral e alívio da dor. A última década testemunhou uma explosão de novas tecnologias que auxiliaram a atingir os objetivos terapêuticos, como a cirurgia de separação e procedimentos minimamente cirúrgicos minimamente invasivos. Contudo, o maior avanço terapêutico constitui-se d...

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Intradural and extradural spinal metastases

Cited by 81 publications

References 14 publications

Lumbar Intradural Metastasis from Large Cell Neuroendocrine Carcinoma of the Lung

Lumbar Intradural Metastasis from Large Cell Neuroendocrine Carcinoma of the Lung

Interpretation of MR Imaging of Spinal Metastasis: Focus on the Understanding of Its Pathophysiology and the Next Step toward a Further Clinical Approach Using MRI Findings

An update in the management of spinal metastases

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