Intramedullary Spinal Cord Metastasis in a Patient with Colon Cancer: A Case Report
- PDF / 100,887 Bytes
- 3 Pages / 595.276 x 790.866 pts Page_size
- 6 Downloads / 176 Views
BRIEF COMMUNICATION
Intramedullary Spinal Cord Metastasis in a Patient with Colon Cancer: A Case Report Vassilios Vassiliou & Dimitrios Papamichael & Petros Polyviou & Alona Koukouma & Dimitrios Andreopoulos
Published online: 14 September 2010 # Springer Science+Business Media, LLC 2010
Abstract Introduction Intramedullary spinal cord metastasis (ISCM) is both a rare and devastating event, since it is clinically evident in 0.1–0.9% of cancer patients and the mortality rate at 3–4 months is 80%. Materials and Methods We present the case of a woman with colon cancer who developed ISCM while on chemotherapy for metastatic disease. The patient presented with paralysis of both legs, weakness in the upper arms, and urinary retention. Results The diagnosis of ISCM at the level of C6–C7 was made with magnetic resonance imaging of the whole spine. Due to the fact that the patient had an established lower limb paralysis and a poor overall clinical status, external beam radiotherapy (RT) was administered, achieving stabilization of symptoms. Conclusions ISCM should be diagnosed and managed as early as possible, since this may result in improvement of neurological deficits. RT is the treatment of choice in most cases, with surgery reserved for selected patients. Recent published data suggest that surgery may result in an improved survival. However, no firm recommendations V. Vassiliou (*) : D. Andreopoulos Department of Radiation Oncology, Bank of Cyprus Oncology Centre, Nicosia, Cyprus e-mail: [email protected] D. Papamichael : A. Koukouma Department of Medical Oncology, Bank of Cyprus Oncology Centre, Nicosia, Cyprus P. Polyviou : D. Andreopoulos Department of Radiology, Bank of Cyprus Oncology Centre, Nicosia, Cyprus
can be made due to the lack of controlled comparative clinical trials. Keywords Colon cancer . Spinal cord . Metastasis . Radiotherapy . Surgery
Introduction We herein present a rare case of a 71-year-old woman with a caecal adenocarcinoma who developed intramedullary spinal cord metastasis (ISCM). The incidence, radiological and clinical characteristics, treatment options, and survival of ISCM patients are discussed.
Case The patient was first evaluated at our center in May 2007 following a right hemicolectomy due to a caecal adenocarcinoma (pT2N0, R0, GII). The tumor was considered to be of low risk for recurrence, and following a discussion with the patient, no adjuvant treatment was administered. In June 2009, a computed tomographic (CT) scan revealed asymptomatic pulmonary and liver metastases associated with a carcinoembryonic antigen (CEA) rise, and the patient received combination chemotherapy using XELOX in a 21-day cycle (capecitabine, 1,000 mg per m2 twice daily on days 1–14 and oxaliplatin; 130 mg per m2 administered on day 1). A re-assessment with CT scan and serum CEA levels in September 2009 indicated response to therapy and a decision to go on with further chemotherapy was taken. In November 2009, the patient visited the emergency department of our center with a 5-day history of neck pain,
Data Loading...
