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Intramedullary spinal cord metastases

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Summary

Seven autopsy cases of intramedullary metastases, four in the cervical spinal cord, are reported and the literature reviewed. Whereas lung and breast cancer, malignant melanomas and lymphomas are reported as the most common primary tumors, the present series included three cases of breast carcinoma and two cases each of colon and oat cell carcinoma of the lung. Neither the clinical symptoms nor the neurological signs distinguished intramedullary metastases from the more common extradural deposits, but radiological evidence of vertebral metastases and myelographic stop were present in only one case each, and CSF cytology was negative. Intramedullary deposits in this series were neither associated with extradural tumor nor with spread into the subarachnoid space, while cerebral metastases were present in four cases. This favors hematogenous dissemination rather than direct trans-dural or perineural spread of these lesions.

Zusammenfassung

Es wird über 7 Autopsiefälle von intramedullären Metastasen, davon 4 im Halsmark, berichtet und ein Überblick des Schrifttums gegeben. Während Bronchus- und Mammakarzinome, maligne Melanome und Lymphome die häufigsten Primärgeschwülste darstellen sollen, lagen in dieser Serie 3 Mammakarzinome und je 2 Kolon- und Haferzellkarzinome des Bronchus vor. Weder der klinische Verlauf noch die neurologische Symptomatik gestatten eine eindeutige Abgrenzung gegenüber den häufigeren extraduralen Metastasen, doch lagen röntgenologisch faßbare Wirbelmetastasen und positive Myelographie nur je einmal vor; die Liquorzytologie war negativ. Intramedulläre Metastasen unserer Serie waren weder mit extraduralen Absiedelungen noch mit Befall des Subarachnoidalraumes, in 4 Fällen aber mit Hirnmetastasen verbunden. Das spricht eher für ihre hämatogene Entstehung als ein direktes transdurales oder perineurales Einwachsen des Tumors.

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Authors and Affiliations

  1. Ludwig Boltzmann-Institute of Clinical Neurobiology, Lainz-Hospital, Wolkersbergenstr. 1, A-1130, Wien, Austria

    K. Jellinger, P. Kothbauer, E. Sunder-Plassmann & R. Weiss

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  1. K. Jellinger
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  2. P. Kothbauer
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  3. E. Sunder-Plassmann
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  4. R. Weiss
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Jellinger, K., Kothbauer, P., Sunder-Plassmann, E. et al. Intramedullary spinal cord metastases. J. Neurol. 220, 31–41 (1979). https://doi.org/10.1007/BF00313146

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