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Spinal Cord Metastases
Jeffrey S. Ross, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Clinical Issues

          • Diagnostic Checklist

            TERMINOLOGY

            • Synonyms

              • Intramedullary spinal cord metastatic (ISCM) disease
            • Definitions

              • Metastatic lesion from primary carcinoma in another organ (including brain)

            IMAGING

            • General Features

              • CT Findings

                • MR Findings

                  • Ultrasonographic Findings

                    • Angiographic Findings

                      • Nonvascular Interventions

                        • Nuclear Medicine Findings

                          • Imaging Recommendations

                            DIFFERENTIAL DIAGNOSIS

                              PATHOLOGY

                              • General Features

                                • Gross Pathologic & Surgical Features

                                  • Microscopic Features

                                    CLINICAL ISSUES

                                    • Presentation

                                      • Demographics

                                        • Natural History & Prognosis

                                          • Treatment

                                            DIAGNOSTIC CHECKLIST

                                            • Consider

                                              • Image Interpretation Pearls

                                                Selected References

                                                1. Rykken JB et al: Rim and flame signs: postgadolinium MRI findings specific for non-CNS intramedullary spinal cord metastases. AJNR Am J Neuroradiol. 34(4):908-15, 2013
                                                2. Sung WS et al: Intramedullary spinal cord metastases: a 20-year institutional experience with a comprehensive literature review. World Neurosurg. 79(3-4):576-84, 2013
                                                3. Birbilis TA et al: Spinal metastasis of glioblastoma multiforme: an uncommon suspect? Spine (Phila Pa 1976). 35(7):E264-9, 2010
                                                4. Graber JJ et al: Myelopathies in patients with cancer. Arch Neurol. 67(3):298-304, 2010
                                                5. Dam-Hieu P et al: Retrospective study of 19 patients with intramedullary spinal cord metastasis. Clin Neurol Neurosurg. 111(1):10-7, 2009
                                                6. Ebner FH et al: Intramedullary lesions of the conus medullaris: differential diagnosis and surgical management. Neurosurg Rev. 32(3):287-300; discussion 300-1, 2009
                                                7. Pellegrini D et al: Intramedullary spinal cord metastasis. Arch Neurol. 66(11):1422, 2009
                                                8. Shin DA et al: Stereotactic spine radiosurgery for intradural and intramedullary metastasis. Neurosurg Focus. 27(6):E10, 2009
                                                9. Donovan DJ et al: Solitary intramedullary spinal cord tumor presenting as the initial manifestation of metastatic renal cell carcinoma: case report. Spine (Phila Pa 1976). 31(14):E460-3, 2006
                                                10. Aryan HE et al: Intramedullary spinal cord metastasis of lung adenocarcinoma presenting as Brown-Sequard syndrome. Surg Neurol. 61(1):72-6, 2004
                                                11. Kaya RA et al: Intramedullary spinal cord metastasis: a rare and devastating complication of cancer--two case reports. Neurol Med Chir (Tokyo). 43(12):612-5, 2003
                                                12. Reddy P et al: Intramedullary spinal cord metastases: case report and review of literature. J La State Med Soc. 155(1):44-5, 2003
                                                13. Ogino M et al: Successful removal of solitary intramedullary spinal cord metastasis from colon cancer. Clin Neurol Neurosurg. 104(2):152-6, 2002
                                                14. Fakih M et al: Intramedullary spinal cord metastasis (ISCM) in renal cell carcinoma: a series of six cases. Ann Oncol. 12(8):1173-7, 2001
                                                15. Mortimer N et al: Intramedullary spinal cord metastasis. Lancet Oncol. 2(10):607, 2001
                                                16. Potti A et al: Intramedullary spinal cord metastases (ISCM) and non-small cell lung carcinoma (NSCLC): clinical patterns, diagnosis and therapeutic considerations. Lung Cancer. 31(2-3):319-23, 2001
                                                17. Ateaque A et al: Intramedullary spinal cord metastases from a hypernephroma 11 years following the diagnosis and treatment of the primary lesion. Br J Neurosurg. 14(5):474-6, 2000
                                                18. Mathur S et al: Late intramedullary spinal cord metastasis in a patient with lymphoblastic lymphoma: case report. J Clin Neurosci. 7(3):264-8, 2000
                                                19. Schijns OE et al: Intramedullary spinal cord metastasis as a first manifestation of a renal cell carcinoma: report of a case and review of the literature. Clin Neurol Neurosurg. 102(4):249-254, 2000
                                                20. Sutter B et al: Treatment options and time course for intramedullary spinal cord metastasis. Report of three cases and review of the literature. Neurosurg Focus. 4(5):e3, 1998
                                                21. Keung YK et al: Secondary syringomyelia due to intramedullary spinal cord metastasis. Case report and review of literature. Am J Clin Oncol. 20(6):577-9, 1997
                                                22. Connolly ES Jr et al: Intramedullary spinal cord metastasis: report of three cases and review of the literature. Surg Neurol. 46(4):329-37; discussion 337-8, 1996
                                                23. Honma Y et al: Intramedullary spinal cord and brain metastases from thyroid carcinoma detected 11 years after initial diagnosis--case report. Neurol Med Chir (Tokyo). 36(8):593-7, 1996
                                                24. Phuphanich S et al: Magnetic resonance imaging of syrinx associated with intramedullary metastases and leptomeningeal disease. J Neuroimaging. 6(2):115-7, 1996
                                                25. Schiff D et al: Intramedullary spinal cord metastases: clinical features and treatment outcome. Neurology. 47(4):906-12, 1996
                                                26. Shibamoto Y et al: Spinal metastasis from occult intracranial germinoma mimicking primary intramedullary tumour. Neuroradiology. 36(2):137-8, 1994
                                                27. Raco A et al: Intramedullary metastasis of unknown origin: a case report. Neurosurg Rev. 15(2):135-8, 1992
                                                28. Tognetti F et al: Metastases of the spinal cord from remote neoplasms. Study of five cases. Surg Neurol. 30(3):220-7, 1988
                                                29. Van Velthoven V et al: Intramedullary spread of a cerebral oligodendroglioma. Surg Neurol. 30(6):476-81, 1988
                                                30. Foster O et al: Syrinx associated with intramedullary metastasis. J Neurol Neurosurg Psychiatry. 50(8):1067-70, 1987
                                                31. Winkelman MD et al: Intramedullary spinal cord metastasis. Diagnostic and therapeutic considerations. Arch Neurol. 44(5):526-31, 1987
                                                Related Anatomy
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                                                Related Differential Diagnoses
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                                                References
                                                Tables

                                                Tables

                                                KEY FACTS

                                                • Terminology

                                                  • Imaging

                                                    • Top Differential Diagnoses

                                                      • Clinical Issues

                                                        • Diagnostic Checklist

                                                          TERMINOLOGY

                                                          • Synonyms

                                                            • Intramedullary spinal cord metastatic (ISCM) disease
                                                          • Definitions

                                                            • Metastatic lesion from primary carcinoma in another organ (including brain)

                                                          IMAGING

                                                          • General Features

                                                            • CT Findings

                                                              • MR Findings

                                                                • Ultrasonographic Findings

                                                                  • Angiographic Findings

                                                                    • Nonvascular Interventions

                                                                      • Nuclear Medicine Findings

                                                                        • Imaging Recommendations

                                                                          DIFFERENTIAL DIAGNOSIS

                                                                            PATHOLOGY

                                                                            • General Features

                                                                              • Gross Pathologic & Surgical Features

                                                                                • Microscopic Features

                                                                                  CLINICAL ISSUES

                                                                                  • Presentation

                                                                                    • Demographics

                                                                                      • Natural History & Prognosis

                                                                                        • Treatment

                                                                                          DIAGNOSTIC CHECKLIST

                                                                                          • Consider

                                                                                            • Image Interpretation Pearls

                                                                                              Selected References

                                                                                              1. Rykken JB et al: Rim and flame signs: postgadolinium MRI findings specific for non-CNS intramedullary spinal cord metastases. AJNR Am J Neuroradiol. 34(4):908-15, 2013
                                                                                              2. Sung WS et al: Intramedullary spinal cord metastases: a 20-year institutional experience with a comprehensive literature review. World Neurosurg. 79(3-4):576-84, 2013
                                                                                              3. Birbilis TA et al: Spinal metastasis of glioblastoma multiforme: an uncommon suspect? Spine (Phila Pa 1976). 35(7):E264-9, 2010
                                                                                              4. Graber JJ et al: Myelopathies in patients with cancer. Arch Neurol. 67(3):298-304, 2010
                                                                                              5. Dam-Hieu P et al: Retrospective study of 19 patients with intramedullary spinal cord metastasis. Clin Neurol Neurosurg. 111(1):10-7, 2009
                                                                                              6. Ebner FH et al: Intramedullary lesions of the conus medullaris: differential diagnosis and surgical management. Neurosurg Rev. 32(3):287-300; discussion 300-1, 2009
                                                                                              7. Pellegrini D et al: Intramedullary spinal cord metastasis. Arch Neurol. 66(11):1422, 2009
                                                                                              8. Shin DA et al: Stereotactic spine radiosurgery for intradural and intramedullary metastasis. Neurosurg Focus. 27(6):E10, 2009
                                                                                              9. Donovan DJ et al: Solitary intramedullary spinal cord tumor presenting as the initial manifestation of metastatic renal cell carcinoma: case report. Spine (Phila Pa 1976). 31(14):E460-3, 2006
                                                                                              10. Aryan HE et al: Intramedullary spinal cord metastasis of lung adenocarcinoma presenting as Brown-Sequard syndrome. Surg Neurol. 61(1):72-6, 2004
                                                                                              11. Kaya RA et al: Intramedullary spinal cord metastasis: a rare and devastating complication of cancer--two case reports. Neurol Med Chir (Tokyo). 43(12):612-5, 2003
                                                                                              12. Reddy P et al: Intramedullary spinal cord metastases: case report and review of literature. J La State Med Soc. 155(1):44-5, 2003
                                                                                              13. Ogino M et al: Successful removal of solitary intramedullary spinal cord metastasis from colon cancer. Clin Neurol Neurosurg. 104(2):152-6, 2002
                                                                                              14. Fakih M et al: Intramedullary spinal cord metastasis (ISCM) in renal cell carcinoma: a series of six cases. Ann Oncol. 12(8):1173-7, 2001
                                                                                              15. Mortimer N et al: Intramedullary spinal cord metastasis. Lancet Oncol. 2(10):607, 2001
                                                                                              16. Potti A et al: Intramedullary spinal cord metastases (ISCM) and non-small cell lung carcinoma (NSCLC): clinical patterns, diagnosis and therapeutic considerations. Lung Cancer. 31(2-3):319-23, 2001
                                                                                              17. Ateaque A et al: Intramedullary spinal cord metastases from a hypernephroma 11 years following the diagnosis and treatment of the primary lesion. Br J Neurosurg. 14(5):474-6, 2000
                                                                                              18. Mathur S et al: Late intramedullary spinal cord metastasis in a patient with lymphoblastic lymphoma: case report. J Clin Neurosci. 7(3):264-8, 2000
                                                                                              19. Schijns OE et al: Intramedullary spinal cord metastasis as a first manifestation of a renal cell carcinoma: report of a case and review of the literature. Clin Neurol Neurosurg. 102(4):249-254, 2000
                                                                                              20. Sutter B et al: Treatment options and time course for intramedullary spinal cord metastasis. Report of three cases and review of the literature. Neurosurg Focus. 4(5):e3, 1998
                                                                                              21. Keung YK et al: Secondary syringomyelia due to intramedullary spinal cord metastasis. Case report and review of literature. Am J Clin Oncol. 20(6):577-9, 1997
                                                                                              22. Connolly ES Jr et al: Intramedullary spinal cord metastasis: report of three cases and review of the literature. Surg Neurol. 46(4):329-37; discussion 337-8, 1996
                                                                                              23. Honma Y et al: Intramedullary spinal cord and brain metastases from thyroid carcinoma detected 11 years after initial diagnosis--case report. Neurol Med Chir (Tokyo). 36(8):593-7, 1996
                                                                                              24. Phuphanich S et al: Magnetic resonance imaging of syrinx associated with intramedullary metastases and leptomeningeal disease. J Neuroimaging. 6(2):115-7, 1996
                                                                                              25. Schiff D et al: Intramedullary spinal cord metastases: clinical features and treatment outcome. Neurology. 47(4):906-12, 1996
                                                                                              26. Shibamoto Y et al: Spinal metastasis from occult intracranial germinoma mimicking primary intramedullary tumour. Neuroradiology. 36(2):137-8, 1994
                                                                                              27. Raco A et al: Intramedullary metastasis of unknown origin: a case report. Neurosurg Rev. 15(2):135-8, 1992
                                                                                              28. Tognetti F et al: Metastases of the spinal cord from remote neoplasms. Study of five cases. Surg Neurol. 30(3):220-7, 1988
                                                                                              29. Van Velthoven V et al: Intramedullary spread of a cerebral oligodendroglioma. Surg Neurol. 30(6):476-81, 1988
                                                                                              30. Foster O et al: Syrinx associated with intramedullary metastasis. J Neurol Neurosurg Psychiatry. 50(8):1067-70, 1987
                                                                                              31. Winkelman MD et al: Intramedullary spinal cord metastasis. Diagnostic and therapeutic considerations. Arch Neurol. 44(5):526-31, 1987