Intramedullary thoracic cord metastasis managed effectively without surgery

Vindlacheruvu, Raghu; McEvoy, Andrew W.; Kitchen, ND

doi:10.1016/s0936-6555(05)80070-6

Cited by 17 publications

(6 citation statements)

References 6 publications

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“…Nevertheless, many ISCM are smaller than the typical spatial resolution of FDG-PET scan. Radiotherapy at different total dose/fractionation schedules (30-40 Gy) and high-dose corticosteroids have been previously reported in SCLC and NSCLC as an effective palliative treatment in terms of improvement of neurological deficits [12][13][14][15].…”

Section: Discussionmentioning

confidence: 99%

Clinical outcome in patients with intramedullary spinal cord metastases from lung cancer

et al. 2007

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Intramedullary spinal cord metastases (ISCM) are uncommon and present with rapidly progressing neurological deficits. The objective of this study was to determine the rate, duration of neurological response and survival after radiation therapy. We have retrospectively reviewed the clinical outcome of six cases with a diagnosis of ISCM from primary lung cancer, non-small cell (NSCLC) (n=3) and small cell (SCLC) (n=3). Total radiation dose ranged from 27 Gy/5 fr to 40 Gy/20 fr. Ambulation was preserved in 3 patients and partially recovered in one. Five out of the six patients (83%) showed improvement in neurological signs/symptoms with a mean duration of 17.2 days (max: 40 days; min: 6 days). Median survival time was 5 months (confidence interval (CI) 95%: 0-12) for NSCLC and 5 months (CI 95%: 4-6) for SCLC. Although radiation response rate is high, the interval free of neurological progression is very short. A therapeutic approach should be considered for each individual.

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Section: Discussionmentioning

confidence: 99%

Clinical outcome in patients with intramedullary spinal cord metastases from lung cancer

et al. 2007

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“…12,20) Treatment modalities for intramedullary spinal cord metastasis vary from dexamethasone and radiotherapy to retain the ambulatory status of patients, to microsurgical resection or both. 3,5,8,11,27,28) Neurological recovery may not occur, especially if the initial defect is severe, whatever treatment modalities are performed. 14,29) Our Case 2 with renal carcinoma metastasis had incomplete neurological deficit at admittance showed good recovery and became ambulant.…”

Section: Discussionmentioning

confidence: 99%

Intramedullary Spinal Cord Metastasis: A Rare and Devastating Complication of Cancer -Two Case Reports-

Kaya¹,

Dalkılıç²,

Özer

et al. 2003

Neurol. Med. Chir.(Tokyo)

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Two cases of very rare intramedullary spinal cord metastasis from colon carcinoma and renal carcinoma were treated primarily by microsurgical excision. A 44-year-old female presented with colon carcinoma metastasis manifesting as complete neurological deficit. She had undergone colon resection 2 years previously for colon carcinoma. The tumor was excised by microsurgery with megadose steroid therapy but she remained paraplegic. A 43-year-old man presented with renal carcinoma metastasis manifesting as incomplete neurological deficits. He had undergone nephrectomy one year previously for renal carcinoma. The tumor was removed by microsurgery. He made a remarkable neurological recovery and became ambulatory after physical therapy.

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“…Steroid therapy was recommended only temporarily [3]. Vindlacheruvu et al [14] presented a case history of bronchial metastases and effective management by radiotherapy and steroids without operation. Findlay et al [6] support surgical removal in selected patients as technically feasible beside radiation and corticosteroids.…”

Section: Surgery and Therapymentioning

confidence: 99%

“…When intradural spinal metastases do occur, they are often in the setting of rapidly progressive neurological deficit, disseminated primary tumour, and very limited life expectancy [3][4]6]. Recommended treatment has been radiation and corticosteroids, especially for intramedullary metastases, and surgery played only a small role [12,14]. Only a few larger series report about surgical treatment of single cases of intradural metastases [3-4, 6, 9-13].…”

Section: Introductionmentioning

confidence: 99%

Intradural and extradural spinal metastases

2001

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Intradural spinal metastases are uncommon. The outcome of surgical treatment of intra- and extramedullary intradural metastases is considered to be poor, with rapid clinical deterioration. The question of optimal treatment remains controversial. We present an overview of the clinical outcome and surgical treatment of 220 spinal metastases carried out in our centre from 1980 to 1999, with particular emphasis on 11 intradural metastases. Clinical history, signs, surgical approach, outcome, and radiological reports were obtained by review of patient charts. Secondary spinal tumours most often originated from carcinomas of the breast, lung, kidney, gastrointestinal tract, and prostate. In 12% of cases, no primary tumour could be found. Drop metastases of intracranial pathology appeared in 3%. Intradural metastases were seen in 11 patients and formed a very heterogeneous group with predominance of melanoma, lymphoma, and medulloblastoma. Functional recovery and survival time were worse in intradural metastases than in extradural metastases, and the patients were younger. Treatment of metastases is designed to relieve pain and preserve or restore neurological function palliatively. Intradural metastases are a devastating condition with usually fatal outcome. Selected patients who undergo aggressive surgical treatment may have substantially increased survival.

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Intramedullary thoracic cord metastasis managed effectively without surgery

Cited by 17 publications

References 6 publications

Clinical outcome in patients with intramedullary spinal cord metastases from lung cancer

Clinical outcome in patients with intramedullary spinal cord metastases from lung cancer

Intramedullary Spinal Cord Metastasis: A Rare and Devastating Complication of Cancer -Two Case Reports-

Intradural and extradural spinal metastases

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