Magnetic Resonance Imaging in the Management of Suspected Spinal Canal Disease in Patients with Known Malignancy

Loughrey, Gareth J.; Collins, Conor D; Todd, Susan M; Brown, Nicola M.; Johnson, Richard J.

doi:10.1053/crad.2000.0547

Cited by 63 publications

(30 citation statements)

References 12 publications

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“…They also corroborated well with the findings of Brown, et al [6] who noted approximately 70% of lesions are located in the thoracic spine. Loughrey, et al [19] observed that the thoracic spine was the most frequently affected in 74% patients. Daniel Sciubba, et al [20] had reported that all segments of the vertebral column are susceptible to distant metastasis, but the thoracic spine was by far the most frequent site (70%), which was quite consistent with our findings.…”

Section: Discussionmentioning

confidence: 97%

Metastatic Spinal Cord Compression (MSCC) —The Evolving Story from Kashmir

Mir¹,

Bhat²,

Reshi³

et al. 2014

OJMN

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Aim: To know the demographics of the patients most commonly involved by metastatic cord compression in Kashmir and to find the commonest primary organ to metastasize to spine causing cord compression. Methods: A hospital-based 10-year retro-prospective study was carried out in the Department of Neurosurgery of Sher-i-Kashmir Institute of Medical Sciences, Soura from July 2002 to June 2012, which is the premier tertiary care institute of the Kashmir valley. Patients were evaluated for metastatic spinal cord compression based on a standard proforma and specialized investigations were carried out and were deemed necessary by the concerned neurosurgical unit. Results: The commonest primary malignancy to metastasize to the spinal column in our study was Non-Hodgkin's lymphoma, followed in turn by metastatic squamous cell carcinoma lung, metastatic intraductal carcinoma breast and metastatic adenocarcinoma prostate. Predominantly dorsal spine was the commonest region of spine involved by MSCC. Conclusion: Metastatic spinal cord compression is coming up in a big way. As the long-term cancer survivors increase due to multi-modality treatment protocols aimed at treating cancers and prolonging survival, there will be a proportionate increase in the number of patients who will potentially land up in metastatic spinal cord compression.

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Section: Discussionmentioning

confidence: 97%

Metastatic Spinal Cord Compression (MSCC) —The Evolving Story from Kashmir

Mir¹,

Bhat²,

Reshi³

et al. 2014

OJMN

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“…In the PubMed search, a total of 248 patients with ISCM were identified (Table I). Gadolinium-enhanced MRI shows high sensitivity and has become the gold standard in diagnosis of all spinal canal lesions [12]. PET-CT has a sensitivity of 96% in detecting spinal metastasis [13].…”

Section: Discussionmentioning

confidence: 99%

Intramedullary spinal cord metastasis of lung cancer presenting with acute urinary retention: a case report

Şen

Şahin

Arslan

2017

MMJ

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Intramedullary spinal cord metastasis is a rare entity. In this case report , we described an 82-year-old male patient with lung cancer who developed acute urinary retention during palliative radiotherapy for painful rib metastases. Left lower limb paresis occurred subsequently. Magnetic resonance imaging (MRI) scan revealed intramedullary spinal cord metastasis at the 11th-12th thoracic spine level. We decided to give steroid treatment and apply palliative radiotherapy. Spinal cord compression is generally seen due to vertebral metastases and compression fractures. Intramedullary spinal cord metastasis is a rare entity with only case reports in the literature. We aim to draw attention to this rare entity and increase awareness among physicians. IntroductionIntramedullary spinal cord metastasis (ISCM) is a rare entity seen in the course of malignant tumors. In autopsy series, the incidence is reported as 2% in patients with malignancies [1,2]. Due to the low incidence of treated cases, standard treatment methods are still to be defined. Early diagnosis of the ISCM and microsurgical operations can slightly improve the prognosis and neurological deficit, but surgical resection usually is not recommended for these patients [3]. Patients with ISCM are generally in poor performance status, and have visceral metastases. Thus, radiotherapy and steroid therapy are still the main treatment options. However, clinical benefits are limited [4]. The clinical course is rapidly progressive with permanent neurological morbidity, and poor survival [5].Intramedullary spinal cord metastasis of lung cancer presenting with acute urinary retention: a case report Akciğer kanserinde akut üriner retansiyon ile farkedilen intramedullar spinal kord metastazı: olgu sunumu

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“…It is wellknown that sensory levels do not always correlate well with the level of compression. 19,[23][24][25] In SCC, sensory abnormalities begin distally and ascend to form a distinct sensory level. 7 Additionally, lesions below the conus medullaris have been reported to cause symptoms earlier than lesions above it.…”

Section: Discussionmentioning

confidence: 99%

A case of indirect cauda equina syndrome from metastatic prostate cancer

Lefresne

Fairchild

Bistritz

et al. 2013

CUAJ

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We report the case of a patient with metastatic hormone refractory prostate cancer in whom "indirect" cauda equina syndrome developed concurrent with multilevel spinal cord compression (SCC). Three months after his first positive bone scan, a 65-yearold otherwise healthy man presented with severe back pain, bilateral lower extremity paresthesias, leg weakness and urinary retention. Magnetic resonance imaging (MRI) showed a dural-based mass causing SCC at the T9, T10 and T11 vertebrae, with a normal cauda equina. He received corticosteroids and palliative external beam radiotherapy, resulting in good pain control and gradual improvement in his neurological symptoms. He did well for 8 months, at which time his residual bilateral leg weakness abruptly worsened and he experienced numbness, paresthesias, urinary incontinence and constipation. Repeat MRI showed progression of epidural metastatic disease compressing the spinal cord or thecal sac at 7 thoracic vertebral levels. The cauda equina was also distorted and flattened without evidence of direct solid tumour impingement. We hypothesized that the etiology was increased intrathecal pressure due to disrupted cerebrospinal fluid flow resulting from multiple levels of upstream thecal sac compression. It is essential to image the entire spinal cord and cauda equina when patients with metastatic bone disease present with neurological symptoms to institute correct treatment and preserve function and mobility.Can Urol Assoc J 2009;3(4):E31-E35 pathological fracture, an intramedullary lesion or a combination of these factors.5 Both oncological emergencies require early diagnosis and treatment to prevent the development of devastating and potentially irreversible neurological complications. We present a unique case of CES secondary to increased cerebrospinal fluid (CSF) pressure as a result of multilevel upstream malignant SCC in a patient with prostate cancer.

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Magnetic Resonance Imaging in the Management of Suspected Spinal Canal Disease in Patients with Known Malignancy

Cited by 63 publications

References 12 publications

Metastatic Spinal Cord Compression (MSCC) —The Evolving Story from Kashmir

Metastatic Spinal Cord Compression (MSCC) —The Evolving Story from Kashmir

Intramedullary spinal cord metastasis of lung cancer presenting with acute urinary retention: a case report

A case of indirect cauda equina syndrome from metastatic prostate cancer

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