Intramedullary spinal cord metastasis in a patient with colon cancer: a case report.
BACKGROUND
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%.


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 can be made due to the lack of controlled comparative clinical trials.
Vassiliou
Vassilios
V
Department of Radiation Oncology, Bank of Cyprus Oncology Centre, Nicosia, Cyprus. vvassilios@yahoo.gr
Papamichael
Dimitrios
D
Polyviou
Petros
P
Koukouma
Alona
A
Andreopoulos
Dimitrios
D
D000230:Adenocarcinoma / Q000556:secondary* / Q000628:therapy; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002574:Cervical Vertebrae; D003110:Colonic Neoplasms / Q000473:pathology* / Q000628:therapy; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D011878:Radiotherapy; D013120:Spinal Cord Neoplasms / Q000556:secondary* / Q000628:therapy