Spinal cord metastasis in small cell carcinoma of the lung

Holoye, Paul Y.; Libnoch, Joseph A.; Cox, James D.; Kun, Larry E.; Byhardt, Roger W.; Almagro, Urias A.; McClelland, Steve; Chintapali, Kedar

doi:10.1016/0360-3016(84)90053-1

Cited by 20 publications

(15 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Studies on the efficacy of chemotherapy are limited but show no effect on survival. 25 To date, surgery for ISCM should considered in selected ISCM patients, especially those presenting with previously undiagnosed or limited primary tumors, since it may improve the length and quality of survival. 26,27 In these cases, radiotherapy and chemotherapy should follow the surgical treatment in order to maximize the treatment result.…”

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

View full text Add to dashboard Cite

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.

show abstract

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

View full text Add to dashboard Cite

show abstract

“…Thus, clinicians should perform brain and spinal cord MRI when they observe neurological deficits during the clinical course of lung cancer. improve survival (5,6), and radiotherapy may contribute to improving survival (3,7,8). We performed multimodal local therapies because our patient had a good performance status and local recurrence with the risk of brain stem compression.…”

Section: Discussionmentioning

confidence: 99%

A case of long-term survival after multimodal local treatments of intramedullary spinal cord metastasis of squamous cell lung cancer

et al. 2016

View full text Add to dashboard Cite

Intramedullary spinal cord metastasis of non-small cell lung cancer is rare, and it has a short prognosis. We report a 53-year-old man diagnosed with cT4N0M0, stage IIIA squamous cell lung cancer.Ten months after left pneumonectomy (pT4N0M0), an intramedullary spinal cord tumor developed at the axis level. The intramedullary spinal cord tumor was resected, and he was diagnosed with metastatic squamous cell lung cancer. Radiotherapies and another tumor resection were conducted, as he had a good performance status and the discrete lesion was associated with the risk of brain stem compression.Multimodal local treatments for intramedullary spinal cord metastasis caused the tumor to shrink, and he lived for 25 months after the spinal metastasis occurred. After 25 months from the metastatic diagnosis, he died of respiratory arrest due to brain stem compression. Keywords DiscussionThe present patient's clinical course suggests two important clinical issues. First, metastatic squamous cell lung cancer of the intramedullary spinal cord can be detected in patients with a good performance status. However, it can be overlooked because of the following reasons. Intramedullary spinal cord metastasis of lung cancer is rare with an incidence rate of 1.65% and that of squamous cell lung cancer is especially rare at 0.16% on autopsy (1). The prognosis of intramedullary spinal cord metastasis of non-small cell lung cancer is short at approximately 5 months (2) and 23.5 months at the longest (3). Lastly, the neurologic symptoms are often confused with brain metastasis, meningitis carcinomatosa, or the side effects of chemotherapy (4). Thus, clinicians should perform brain and spinal cord MRI when they observe neurological deficits during the clinical course of lung cancer. improve survival (5,6), and radiotherapy may contribute to improving survival (3,7,8). We performed multimodal local therapies because our patient had a good performance status and local recurrence with the risk of brain stem compression. Therefore, surgery, radiotherapy, or a combination of both should be performed whenever feasible. Chemotherapy may be effective for intramedullary spinal cord metastases of small cell lung cancer (9), and tyrosine kinase inhibitors (TKI) may be effective against metastases originating from TKI-sensitive adenocarcinoma (10,11). Chemotherapy can be poorly effective for intramedullary metastases with low drug permeability due to the blood-spinal cord barrier (12). In our case, chemotherapies were ineffective even after surgeries that were supposed to break the blood-spinal cord barrier. Treatment of intramedullary metastases may be related to drug permeability and the nature of the chemoresistance of squamous cell lung cancer. Yet, despite the neurological complication, surgical and radiological treatment reduced the tumor size and improved the patient's survival. ConclusionsThis is a rare case of squamous cell lung cancer metastasizing to the intramedullary spinal cord, and our patient survived longer with multimodal l...

show abstract

“…The gold standard remains radiotherapy, with or without steroids to reduce edema 1,2,4,23,35,36 . There are some reports of long-lasting remission after irradiation, but these are limited to patients in whom a very early diagnosis was made and/or who had highly radiosensitive tumors such as small-cell carcinoma or lymphoma 4,23,[35][36][37][38] . Treatment with steroids offered no additional survival benefit when combined with radiation therapy 4 .…”

Section: Treatmentmentioning

confidence: 99%

“…Studies on the efficacy of chemotherapy are limited but failed to show any survival advantage 36 . Holoye et al 36 have described tumor ablation (lung small-cell carcinoma of the lung) with cyclophosphamide, methotrexate, and lomustine, but neurological deficits and survival remained unchanged.…”

Section: Treatmentmentioning

confidence: 99%

“…Holoye et al 36 have described tumor ablation (lung small-cell carcinoma of the lung) with cyclophosphamide, methotrexate, and lomustine, but neurological deficits and survival remained unchanged. Weissman and Grossmann recommended treatment with both intrathecal chemotherapy and radiotherapy in patients with ISCM or meningeal small-cell carcinomatosis 39 .…”

Section: Treatmentmentioning

confidence: 99%

See 1 more Smart Citation

Intramedullary Spinal Cord Metastases: Review of the Literature

Hrabálek¹

2010

BIOMED PAP

View full text Add to dashboard Cite

Aims. To review the epidemiology, dissemination, clinical presentation, diagnosis, treatment, survival and functional outcome of intramedullary spinal cord metastases (ISCM).Methods. Literature review of all surgically treated cases of ISCM and all described cases of ISCM of breast carcinoma.Results. 42 references to 87 surgically treated cases of ISCM were found, 13 references to 27 cases with diagnosed and treated ISCM of breast carcinoma. In only 9 cases of spinal cord metastases of breast cancer was surgical resection of ISCM done (10% of all surgically treated ISCM).Conclusions. Three treatment modalities are available for ISCM: radiotherapy, chemotherapy, and surgery. The gold standard remains radiotherapy.Microsurgical resection of a focal intramedullary mass appears to be feasible and should be considered in selected cases. Patients who have no evidence of widespread organ metastases or multiple intramedullary lesions and who have a life expectancy of at least a few months with tumours of non-lymphoma histology should be considered for tumor resection.In conclusion, ISCM are difficult to treat lesions, but early diagnosis, careful surgical management and maintenance therapy may substantially contribute to a satisfactory functional outcome and prolonged survival.

show abstract

Spinal cord metastasis in small cell carcinoma of the lung

Cited by 20 publications

References 12 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

A case of long-term survival after multimodal local treatments of intramedullary spinal cord metastasis of squamous cell lung cancer

Intramedullary Spinal Cord Metastases: Review of the Literature

Contact Info

Product

Resources

About