Intramedullary spinal cord metastasis : an under-diagnosed entity

Area of Science:

• Neurology
• Oncology
• Neurosurgery

Background:

• Intramedullary spinal cord metastatic tumors are rare but increasingly diagnosed.
• Improved imaging and aggressive primary cancer management contribute to higher detection rates.
• Late diagnosis historically led to palliative care, but intensive protocols offer better immediate outcomes.

Purpose of the Study:

• To report on two cases where spinal cord lesions were the primary manifestation of malignancy.
• To evaluate the outcomes of surgical excision for these rare tumors.

Main Methods:

• Case report of two patients with intramedullary spinal cord tumors.
• Surgical total excision of the spinal cord lesions.
• Post-operative adjuvant therapy including radiation and chemotherapy in one case.

Main Results:

• One patient experienced significant neurological improvement post-surgery, survived seven months with adjuvant therapy, but eventually succumbed to brain metastases.
• The second patient showed no immediate neurological improvement and was lost to follow-up.

Conclusions:

• Surgical excision can lead to neurological improvement in select cases of intramedullary spinal cord metastases.
• Despite surgical intervention, advanced metastatic disease significantly impacts long-term survival.
• Multidisciplinary treatment approaches are crucial for managing these complex cases.