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Dural metastases
Florence Laigle-Donadey1, Sophie Taillibert, Karima Mokhtari
1Fédération de Neurologie Mazarin, Groupe Hospitalier Pitié-Salpêtrière, 47 boulevard de l'hôpital, 75651, Paris Cedex 13, France.
Abstract:
Dural metastases are found at autopsy in 8-9% of patients with advanced systemic cancer. They arise either by direct extension from skull metastases or by hematogeneous spread. Dural metastases are often clinically asymptomatic but they may produce progressive neurological deficits and sometimes subdural hematomas. MRI may be misleading when the metastasis simulates a meningioma or when a subdural hematoma masks the underlying tumor. Whenever possible, surgical removal is the most appropriate treatment. The prognosis is poor because of the progressive systemic cancer but prolonged survival has been reported in operated patients, when the systemic cancer was controlled.
Insights
Dural metastases, cancer spread to the dura mater, occur in advanced cancer patients. Surgical removal offers potential for prolonged survival when systemic cancer is controlled.
Area of Science:
- Neurology
- Oncology
- Neurosurgery
Background:
- Dural metastases are identified in 8-9% of autopsied advanced systemic cancer patients.
- These metastases originate from direct extension of skull tumors or hematogenous spread.
- While often asymptomatic, they can lead to progressive neurological deficits and subdural hematomas.
Purpose of the Study:
- To review the occurrence, clinical presentation, diagnostic challenges, and management of dural metastases.
Main Methods:
- Review of existing literature on dural metastases.
- Analysis of diagnostic imaging, particularly MRI, and its limitations.
- Evaluation of treatment outcomes, focusing on surgical intervention.
Main Results:
- Dural metastases can mimic meningiomas or be obscured by subdural hematomas on MRI.
- Surgical removal is the preferred treatment when feasible.
- Prognosis is generally poor due to advanced systemic cancer.
Conclusions:
- Despite poor prognosis, surgical intervention for dural metastases can lead to prolonged survival if the primary cancer is managed.
- Accurate diagnosis is crucial, despite potential imaging challenges.
- Multidisciplinary management is essential for patients with dural metastases.
