title: Upper cervical intramedullary spinal metastasis of ovarian carcinoma: a case report and review of the literature.
abstract: BACKGROUND
  Currently there is no generalized approach to treating patients with intra-medullary spinal metastasis. High cervical spinal cord lesions can be particularly challenging cases, and may even be considered inoperable by some.
  
  
  METHODS
  We present what is, to the best of our knowledge, the first reported case of ovarian carcinoma (managed primarily with surgery) in a 65-year-old Caucasian woman metastasizing to the upper cervical spinal cord; we also review the relevant literature and discuss management strategies.
  
  
  CONCLUSIONS
  Due to improving systemic cancer therapies, patients with cancer now often survive longer and are more likely to develop central nervous system metastases. Therefore, neurosurgical oncologists are often challenged with difficult decisions about how to surgically manage these patients. We recommend individualized multidisciplinary management based on patient functional status, the need for definitive diagnosis for possible additional adjuvant therapies, and consideration of extent of systemic disease impacting on desirable quality and length of survival.
authors.affiliation: Department of Neurological Surgery, School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA. j.kuo@neurosurgery.wisc.edu.
authors.forename: Amrendra S
authors.initials: AS
authors.lastname: Miranpuri
authors.forename: Sharad
authors.initials: S
authors.lastname: Rajpal
authors.forename: M Shahriar
authors.initials: MS
authors.lastname: Salamat
authors.forename: John S
authors.initials: JS
authors.lastname: Kuo