Spinal Cord Compression Resulting from Intradural Carcinoma

Feiring, Emanuel H.; Hubbard, John H.

doi:10.3171/jns.1965.23.6.0635

Cited by 18 publications

(6 citation statements)

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“… 11 While the incidence of neurinoma reaches 0.3–0.5/100,000 persons per year, 8 LM of solid tumors are rare and most of them occur in advanced BC. 3,4,6,9,12−14 Still, LM represents an important neurologic complication of systemic BC 3,13 with an estimated frequency of 3–43%, based on clinical research and autopsies. 2,11,15 However, only 0.8–3.9% are symptomatic.…”

Section: Discussionmentioning

confidence: 99%

“… 8 The clinical presentation of LM depends on the location and growth-pattern, often resulting in general symptoms such as nausea and head-aches due to interruption of the CSF flow and, later signs of myelopathy due to compression of the spinal cord. 7,9 On the other hand, neurinomas usually affect single nerve roots with typical clinical symptoms in the associated dermatomes and peripheral nerves. 10 …”

Section: Introductionmentioning

confidence: 99%

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Atypical presentation of a cervical breast-cancer metastasis mimicking a dumbbell-shaped neurinoma

Boese

Lechler

Bredow

et al. 2014

International Journal of Surgery Case Reports

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INTRODUCTIONSpinal metastases are frequently encountered in patients with breast cancer. Because of recent improvements in oncologic therapies a growing incidence of symptomatic leptomeningeal metastases (LM) should be expected. The differential diagnosis of LM comprises a wide range of conditions, including neurinoma. The radiologic discrimination between metastases and neurinomas is primarily based on distinct neuroimaging features, particularly number, size and growth pattern.PRESENTATION OF CASEWe report the first case of a solitary leptomeningeal metastasis of a cervical nerve-root, which mimicked a benign dumbbell-shaped neurinoma, using neuroimaging and visualized intraoperatively. The tumor was successfully treated with surgery followed by adjuvant radiochemotherapy (RCT).DISCUSSIONWhile the patient history directs towards a metastasis, the localization, growth pattern and MRI signal were concordant with a cervical neurinoma. The current literature is not conclusive concerning the optimal choice of treatment; the therapy is strictly palliative and indications for surgery remain individual decisions. However, due to recent improvements in survival of patients with LM require reconsideration of established strategies.CONCLUSIONThe present case report and the reviewed literature point towards a growing clinical relevance of symptomatic LM in cancer patients and their possible atypical presentations and locations.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Atypical presentation of a cervical breast-cancer metastasis mimicking a dumbbell-shaped neurinoma

Boese

Lechler

Bredow

et al. 2014

International Journal of Surgery Case Reports

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“…Metastatic intradural extramedullary tumors, however, have been reported rarely in the English literature 1,3,6,9,11,13,16,19,22,23 and occur in only 0.9% to 2.1% of autopsied cancer patients. 5 They are most commonly located in the cervical cord (45% of cases), followed by the thoracic cord (35%) and the lumbar region (8%).…”

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confidence: 94%

Unusual Metastasis to the Cauda Equina From Renal Cell Carcinoma

Takada

Doita

Nishida

et al. 2003

Spine

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The majority of cauda equina tumors are primary tumors, and metastases are very rare. Intradural spinal metastasis pain is a characteristic cramping pain provoked by light percussion on the lumbar spine, becoming severe when sleeping in the flexion or sitting position. Magnetic resonance imaging is a useful tool for detecting intraspinal metastasis when the patient is complaining of a unique pain. A recapping T-saw laminoplasty to preserve posterior elements with tumor removal is feasible for relieving pain and demonstrating the pathology.

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“…Lung cancer was 24 cases [4,5,9,15,22,31,51,55,56,59,63,67, present case]. Breast cancer was 18 cases [4,5,7,8,11,13,14,16,22,24,41,57,61]. Renal cell cancer (including Wilm's tumor and Grawitz tumor) was 15 cases [25,27,35,38,43,[45][46][47]49,52,54,58,[64][65][66].…”

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confidence: 99%

“…The average life expectancy was 8.6 months and 84.6% patients died within one year. There were a total of 70 cases of which 55 were improved [5,6,8,10,11,13,14,[16][17][18]20,[23][24][25][28][29][30][31][32][33]35,[37][38][39][40][41][44][45][46][47][48][49]52,[54][55][56][57][58][59][61][62][63][64][65][66][67][68][69], eight remained unchanged [8,21,26,…”

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confidence: 99%

Intradural-Extramedullary Metastatic Tumor from Lung Cancer-A Case Report and Review

Sasaji¹

2017

MOJCR

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A 62-year-old male presented with a thoracic intradural-extramedullary metastasis from lung cancer. He complained of walking difficulty and bilateral lower leg numbness. He had a past history of lung adenocarcinoma three years prior. Thoracic spine magnetic resonance imaging showed that the tumor occupied the right subarachnoid space and spinal nerve roots had shifted to the left side at Th12. He was diagnosed with cauda equina syndrome by an intradural-extramedullary tumor. Surgery was performed (Th12 laminectomy) and we opened the dura mater and arachnoid membrane. The tumor was in the right side and was removed. After the operation, his neurological condition soon improved and he could walk with a cane. By four moths postoperatively, a metastatic brain tumor occurred and he had to use a wheel chair. He died one year after surgery. Immunohistochemical staining was positive for thyroid transcription factor-1 in both the lung adenocarcinoma and intraduralextramedullary tumor. We diagnosed a metastatic tumor. Including the present case, 102 cases of a metastatic intradural-extramedullary tumor have been reported and, thus, the condition may not be rare. In more than twenty years there have only been two case studies, which recommended both operative and non-operative methods. We reviewed the validity of an operation base on the prognosis and surgical results of previous reports. The average life expectancy was 8.6 months. The functional improvement rate was 78%. We recommend an operation for an intradural-extramedullary metastatic tumor because it improves the quality of a patients' short life. Keywords: IntroductionMetastases are by far the most common skeletal tumors seen by orthopedists, and the spine is the most common site of skeletal involvement [1]. A spinal epidural metastasis is the most common neoplastic myelopathy [2]. In a total of 1215 cases of primary lung cancer in an autopsy study, 20 (1.65%) revealed intradural parenchymal involvement [3]. Among 200 patients treated for symptomatic spinal metastases, a localized intradural extramedullary tumor was discovered in 10 cases [4]. Among 136 patients who underwent surgery for spinal metastases, an intradural extramedullary tumor was observed in two cases (1.5%) [5]. To our knowledge, Rogers et al. [6] were the first to report on an intradural-extramedurally metastatic tumor in 1958 since then, 101 cases have been reported in 66 articles . Including our case, the total number of reported cases is now 102. Many authors have described an intradural-extramedullary metastasis as a rare metastatic condition, however, we do not consider it to be rare given the number of reported cases.Two types of treatment have been reported for an intraduralextramedullary tumor, the recommended operative and nonoperative methods [4,18,31,38,45,63]. In two case studies, Perrin et al.[4] recommended a non-operative method and Chow et al.[30] recommended an operation. Both reports had a small number of cases (n=10). There have been no reviews of many cases that were n...

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Spinal Cord Compression Resulting from Intradural Carcinoma

Cited by 18 publications

References 5 publications

Atypical presentation of a cervical breast-cancer metastasis mimicking a dumbbell-shaped neurinoma

Atypical presentation of a cervical breast-cancer metastasis mimicking a dumbbell-shaped neurinoma

Unusual Metastasis to the Cauda Equina From Renal Cell Carcinoma

Intradural-Extramedullary Metastatic Tumor from Lung Cancer-A Case Report and Review

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