Intramedullary spinal cord metastases

Edelson, Richard N.; Deck, Michael D. F.; Posner, Jerome B.

doi:10.1212/wnl.22.12.1222

Cited by 169 publications

(77 citation statements)

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“…13,14 In the literature, lung cancer, especially small cell carcinoma, accounts for a majority of cases followed by breast cancer, melanoma, lymphoma, and renal cell carcinoma. 15,16 Colon carcinoma-related metastasis is extremely rare and only few cases have been reported, so far, in the literature.…”

Section: Discussionmentioning

confidence: 99%

“…6 In this regard, it is well known that the brain receives about one-third of the cardiac output through large vessels under high pressure, while the spinal cord receives its arterial supply from small vessels under low pressure. 10,13 The medullary arteries arise from the aorta at right angles, while the cerebral arteries are almost a direct extension of the aorta, thus favoring embolic seeding. 20 Metastasis spreading may also occur through direct extension along nerve roots, perineural sheaths and via the CSF pathways.…”

Section: Discussionmentioning

confidence: 99%

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Intramedullary spinal cord tumor presenting as the initial manifestation of metastatic colon cancer: case report and review of the literature

et al. 2007

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Study design: Case reports and review of the literature. Objective: Intramedullary spinal cord metastases (ISCMs) are rare type of central nervous system (CNS) involvement of systemic malignant tumors. Since the advent of new neuroradiological techniques, their detection have become increasingly diagnosed in recent years and, although somewhat controversial, surgical treatment has been considered a valid option. Setting: Neurosurgical Clinic, Department of Clinic Neuroscience, University of Palermo, Italy. Method: The authors describe the case of a 61-year-old woman who was admitted presenting with progressive tetraplegia. Investigations revealed an intramedullary spinal cord lesion at the cervical level. Magnetic resonance imaging of the brain did not reveal other CNS metastatic lesions. Result: Patient underwent surgical treatment. The tumor was resected and the patient's neurologic deficits slowly improved. Histological examination of the lesion showed the typical features of a colon carcinoma metastasis. Patient was referred for proper oncological treatment but, unfortunately, she died of disseminated disease within 2 months. Conclusion: Although uncommon, spinal cord metastases should be considered in the differential diagnosis of ISCM in order to rationalize the decisional-making process and improve the quality of life for these patients.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Intramedullary spinal cord tumor presenting as the initial manifestation of metastatic colon cancer: case report and review of the literature

et al. 2007

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“…Intramedullary spinal cord metastases (ISCMs) are an unusual complication of malignancies outside the central nervous system [1]. Intramedullary tumors arise within the substance of the spinal cord whereas extramedullary tumors are extrinsic to the cord [2].…”

Section: Introductionmentioning

confidence: 99%

Multiple Spinal Intradural-Intramedullary Involvement by Metastatic Carcinoma with Neuroendocrine Differentiation with Occult Primary—An Unusual Case Report and Review of Literature

Gupta¹,

Sinha²

2016

OJPathology

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Although vertebral column is recognized as the most common site for bony metastasis in patient with systemic malignancy, intramedullary metastases to the spinal cord is infrequent. Between 5% -10% of cancer patients develop spinal metastasis during the course of their diseases. Intramedullary tumors are rare, comprising 3.5% of spinal metastasis. Most metastatic spinal lesions (70%) are found at the thoracic level, 20% in lumbar region and 10% in the cervical region. We report a rare biopsy proven case of intramedullary spinal metastatic carcinoma with neuroendocrine differentiation because of its unusual presentation, involving spine at multiple noncontiguous levels, which appeared as irregular small nodules on MRI. The primary tumor was most likely from occult primary in lung. Biopsy from the spinal lesion established the diagnosis of metastatic carcinoma with neuroendocrine differentiation. Therefore, in patients with spinal metastasis, a thorough work up is advised to evaluate primary site. This would help to delineate the nature and the extent of the systemic disease. We highlighted herein the clinical presentation, radiological findings particularly MRI and role of biopsy in the diagnosis and treatment of intramedullary spinal metastasis.

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“…ISCM clinically affects only 0.1-0.4% of all cancer patients [1][2][3] . Most patients with ISCM present with rapid progressive neurological deficits and require immediate examination 1,2,[4][5][6] .…”

Section: Introductionmentioning

confidence: 99%

Intramedullary Spinal Cord and Cauda Equina Metastasis of Breast Carcinoma: Case Report

Hrabálek¹,

Kalita²,

Študentová³

et al. 2010

BIOMED PAP

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Aim. We present a case report of a female patient with metastasis of breast carcinoma to the medullary conus and cauda equina.Methods. A 48-year-old woman with a history of breast tumor, suddenly felt severe weakness and numbness of the lower extremities. MRI of the spine disclosed a mass lesion within the medullary conus, with leptomeningeal involvement of cauda equina at the spinal level L1. Laminectomy was performed and partial resection of the medullary conus tumor and especially release of nerve roots of cauda equina was achieved using microsurgical techniques.Results. Her clinical status, especially right leg weakness and sensory loss in the lower extremities have immediately improved but bladder dysfunction remained and she was unable to walk.The histological picture and immunophenotype indicates the presence of metastatic ductal adenocarcinoma of the mammary gland. Patient died 4 months after the spinal cord and cauda equina surgery.Conclusion. To our knowledge, this is the first report of successful surgical treatment of metastatic leptomeningeal infiltration of breast carcinoma.

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Intramedullary spinal cord metastases

Cited by 169 publications

References 0 publications

Intramedullary spinal cord tumor presenting as the initial manifestation of metastatic colon cancer: case report and review of the literature

Intramedullary spinal cord tumor presenting as the initial manifestation of metastatic colon cancer: case report and review of the literature

Multiple Spinal Intradural-Intramedullary Involvement by Metastatic Carcinoma with Neuroendocrine Differentiation with Occult Primary—An Unusual Case Report and Review of Literature

Intramedullary Spinal Cord and Cauda Equina Metastasis of Breast Carcinoma: Case Report

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