INTRODUCTION: Intramedullary spinal cord metastasis (ISCM) is both a rare and devastating event, since it is clinically evident in 0.1-0.9% of cancer patients and the mortality rate at 3-4 months is 80%. MATERIALS AND METHODS: We present the case of a woman with colon cancer who developed ISCM while on chemotherapy for metastatic disease. The patient presented with paralysis of both legs, weakness in the upper arms, and urinary retention. RESULTS: The diagnosis of ISCM at the level of C6-C7 was made with magnetic resonance imaging of the whole spine. Due to the fact that the patient had an established lower limb paralysis and a poor overall clinical status, external beam radiotherapy (RT) was administered, achieving stabilization of symptoms. CONCLUSIONS: ISCM should be diagnosed and managed as early as possible, since this may result in improvement of neurological deficits. RT is the treatment of choice in most cases, with surgery reserved for selected patients. Recent published data suggest that surgery may result in an improved survival. However, no firm recommendations can be made due to the lack of controlled comparative clinical trials.
INTRODUCTION: Intramedullary spinal cord metastasis (ISCM) is both a rare and devastating event, since it is clinically evident in 0.1-0.9% of cancerpatients and the mortality rate at 3-4 months is 80%. MATERIALS AND METHODS: We present the case of a woman with colon cancer who developed ISCM while on chemotherapy for metastatic disease. The patient presented with paralysis of both legs, weakness in the upper arms, and urinary retention. RESULTS: The diagnosis of ISCM at the level of C6-C7 was made with magnetic resonance imaging of the whole spine. Due to the fact that the patient had an established lower limb paralysis and a poor overall clinical status, external beam radiotherapy (RT) was administered, achieving stabilization of symptoms. CONCLUSIONS: ISCM should be diagnosed and managed as early as possible, since this may result in improvement of neurological deficits. RT is the treatment of choice in most cases, with surgery reserved for selected patients. Recent published data suggest that surgery may result in an improved survival. However, no firm recommendations can be made due to the lack of controlled comparative clinical trials.
Authors: Oscar Persson; Alexander Fletcher-Sandersjöö; Gustav Burström; Erik Edström; Adrian Elmi-Terander Journal: Front Neurol Date: 2019-07-26 Impact factor: 4.003