Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2010, 154(2):117-122 | DOI: 10.5507/bp.2010.018

INTRAMEDULLARY SPINAL CORD METASTASES: REVIEW OF THE LITERATURE

Lumir Hrabalek

Department of Neurosurgery, Palacky University and University Hospital Olomouc

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.

Keywords: Intramedullary, Spinal cord, Metastasis, Breast cancer, Surgery, Leptomeningeal disease

Received: November 2, 2009; Accepted: May 17, 2010; Published: June 1, 2010  Show citation