Case reportFractionated radiosurgical management of intramedullary spinal cord metastasis: A case report and review of the literature
Section snippets
Objective and importance
Renal cell cancer has a propensity to metastasize to the central nervous system. Intramedullary spinal cord metastasis (ISCM) comprises up to 8.5% of all central nervous system metastasis and as such can cause great morbidity with motor deficits, pain, paresthesias, bowel and bladder dysfunction, and paralysis as the outcome of this entity [2], [3]. ISCM heralds a grave prognosis with a median survival following diagnosis of 3.9 months [6]. Surgical management is often of limited value because
Case report
The patient, a 50-year-old man with a history significant for seizures and hypertension, initially presented with headaches and dizziness in February 2006. He was seen and evaluated at a local Emergency Department. The diagnostic evaluation included an MRI of the brain. This study revealed a right-sided temporal lobe lesion. He underwent craniotomy and the pathology revealed a clear cell neoplasm. The staging work-up included an abdominal CT that revealed a right-sided renal mass and
Discussion
Intramedullary spinal cord metastases are an uncommon presentation of CNS metastatic disease that is associated with great morbidity and loss of function. Secondary to its location, surgical management is of limited value because of difficulty in achieving a complete resection. Furthermore, because of the poor prognosis of patients with ISCM, an invasive surgical procedure has the potential to further impair the patients’ quality of life without much hope for durable palliation. External beam
References (15)
- et al.
Intramedullary spinal cord metastasis (ISCM) in renal cell carcinoma: a series of six cases
Ann Oncol
(2001) - et al.
Retrospective study of 19 patients with intramedullary spinal cord metastasis
Clinical Neurol Neurosurg
(2009) - et al.
Update of human spinal cord reirradiation tolerance based on additional data from 38 patients
Int J Radiat Oncol Biol Phys
(2006) - et al.
Intramedullary spinal cord metastases. A clinicopathological study of 13 cases
J Neurosurg
(1985) - et al.
Intramedullary spinal cord metastases: a clinical and pathological study of nine cases
Q J Med
(1986) - et al.
Intramedullary spinal cord metastases: a single-institution experience
J Neurooncol
(2007) - et al.
Palliative radiotherapy for brain metastases in renal carcinoma
Cancer
(1988)
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Intramedullary spinal cord metastases: Report of three cases and review of the literature
2021, Cancer/RadiotherapieCitation Excerpt :Stereotactic radiosurgery (SRS) is promising. Parikh and Heron [19] documented CyberKnife SRS (15 Gy in three fractions) contributed to a 26-month OS and nearly fully functional recovery in an ISCM patient of renal cell carcinoma. A retrospective research of nine patients with 11 ISCM conducted by Veeravagu et al. [20] noted that CyberKnife SRS delivered 14–27 Gy (median 21 Gy) in 1–5 fractions (median = 3 fractions) was safe and effective.
Intramedullary Spinal Metastatic Renal Cell Carcinoma: Systematic Review of Disease Presentation, Treatment, and Prognosis with Case Illustration
2020, World NeurosurgeryCitation Excerpt :There were 72 publications that did not match our search criteria, and 14 duplicates that were removed. Studies included in the final analysis totaled 23 articles (Table 1).4-26 Our search identified 31 patients with intramedullary RCC metastasis to the intramedullary spinal cord: 81% were men, 47% were cervical, 41% were thoracic, and 9% were lumbar.
Intramedullary spinal cord metastasis from thyroid carcinoma: Case report and a systematic pooled analysis of the literature
2018, Journal of Clinical NeuroscienceCitation Excerpt :A Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) search style was adhered to (Fig. 8) [6]. Our literature search identified 145 published manuscripts regarding ISCM (Fig. 8) [1–5,7–146]. Including the current study, this represented 124 case reports and 22 case series, which described a total of 432 cases of ISCM (Table 1).
Intramedullary spinal deposits: Overview and perspective
2013, World NeurosurgeryCyberKnife stereotactic radiosurgery for the treatment of intramedullary spinal cord metastases
2012, Journal of Clinical NeuroscienceCitation Excerpt :The use of SRS has been described only recently for the treatment of SCIM, and the literature remains scarce. Previous studies include a case report26 and a small series that discussed both intramedullary and extramedullary tumors.5 In this study, we retrospectively reviewed our experience treating 11 SCIM in nine patients with SRS at Stanford University Hospital and Clinics (Stanford, CA, USA).
CyberKnife Radiosurgery for Spinal Neoplasms
2012, Schmidek and Sweet Operative Neurosurgical Techniques: Indications, Methods, and Results: Sixth Edition