Intramedullary spinal cord metastasis

Abstract

A retrospective autopsy study of 627 patients with systemic cancer disclosed 153 patients with metastasis to the central nervous system (CNS) and 13 patients with intramedullary spinal cord metastasis (ISM). Thus, the frequency of ISM was 8.5% of cases of metastasis to the CNS and 2.1% of all cases of cancer. Bronchogenic carcinoma accounted for 11 cases of ISM, and breast carcinoma and melanoma for the other two. There were two distinct patterns of spinal cord involvement, indicating spread of tumor to the cord by two different routes. In nine of the 13 ISM patients a metastasis was found deep within the spinal cord, unassociated with leptomeningeal carcinomatosis; this most likely resulted from hematogenous spread of tumor from a pulmonary source. In the other four patients there was focal or multifocal direct extension of leptomeningeal metastatic tumor across the pia into the parenchyma of the cord. Only four of the 13 patients had a clinical myelopathy; in three of these four this was the presenting feature of an occult lung cancer.

Intramedullary spinal cord and leptomeningeal metastases from intracranial low-grade oligodendroglioma

“…1 Intramedullary metastases are less commonly diagnosed in about 2% of systemic cancers at autopsy. 2 Most leptomeningeal metastases from primary brain tumors are from malignant high grade tumors such as glioblastoma, anaplastic glioma and medulloblastoma. For malignant astrocytic gliomas, dissemination through the cerebrospinal fluid has been described at 10–21% at autopsy.…”

“…Postulated pathways into the spinal cord parenchyma include dissemination through the perivascular spaces or central canal, and direct invasion of leptomeningeal metastases across the pia 2, 7 . The latter is probably the most common as intramedullary and leptomeningeal metastases are found together in up to 27% of cases 9 .…”

Symptomatic spinal cord metastasis from cerebral oligodendroglioma

“…Because most cases occurred after surgery of the brain tumor, surgical manipulation may play a role. In exceptional intramedullary metastases, spread through the central canal [20] or, more likely, through the perivascular Virchow-Robin spaces of the spinal cord [21] has been suggested.…”

Intramedullary Spinal Cord Metastasis of Bladder Carcinoma: A Case Report

“…Incidence is reported as 1-3.4 % in the literature [1][2][3][4]. The most common primary site is lung accounting for 50-64%, followed by breast carcinoma (15%) [1,8,10,11].…”

“…One to 3.4 percent of spinal cord lesions are metastatic [1][2][3][4]. Most of the intramedullary metastases occur primarily from lung cancer while the others originate from breast cancer, malign melanoma, ovarian tumour, Hodgkin's disease, colorectal carcinoma, thyroid carcinoma and renal cell carcinoma [1,3,[5][6][7][8][9][10][11].…”