Presentation
The authors present a case of a 59-year-old man presenting with Brown-Sequard syndrome and in whom metastatic lung adenocarcinoma to the spinal cord was subsequently discovered. [ncbi.nlm.nih.gov]
Entire Body System
- Collapse
Spinal bracing may be supportive and reduce pain and risk of collapse. However, spinal bracing may not prevent further collapse and spinal cord damage, and may be uncomfortable. [cochrane.org]
Radicular pain may develop due to nerve root compression by the tumour or secondary to vertebral collapse. [bjgp.org]
Radiotherapy to metastatic deposits in the spine can achieve pain relief but this effect may take up to 6 weeks to be achieved. 2 There is also a risk of vertebral body collapse at the treated level. 3 The post-radiotherapy vertebral body collapse causes [interventionaloncology360.com]
Tumors around the spinal bones (vertebrae) can cause pain and, on occasion, collapse of the vertebrae. [lifebridgehealth.org]
Haematogenous spread with bony metastasis to the vertebral spine causes collapse and compression, accounting for over 85% of MSCC. 4 5 However, local tumour extension into the spinal cord and deposition of tumour cells directly within the spinal cord [bmj.com]
- Swelling
The characteristic myelographic appearance of fusiform swelling of the cord was seen in one third of the patients, but the myelogram was normal in 42%. [ncbi.nlm.nih.gov]
That's because cancer doesn't like to be radiated — it can swell a little before it starts to shrink. The swelling can put extra pressure on sensitive nerves. [breastcancer.org]
This high-intensity lesion might be caused by edematous swelling of the spinal cord. [nature.com]
Steroids may be used to decrease swelling. Pain medications and anti-seizure medications may be used to control headaches and seizures. Radiation therapy may be very effective in reducing symptoms for some people. [verywell.com]
These help reduce swelling and pressure on the nerves. Tell the doctor if you are diabetic or have had problems with steroids before. If you have MSCC, the doctor will talk with you about the best treatment options for you. [macmillan.org.uk]
- Localized Pain
Pain is the most common symptom and usually the first symptom that patients notice. Pain is most often felt at the site of the metastasis, which is referred to as localized pain. [mcancer.org]
On physical examination, patients with ESCC often demonstrate localized pain to percussion over the involved vertebral bodies. 13, 17 Most commonly, the tender areas are in the thoracic region; in contrast, the pain of degenerative spinal disease is more [aafp.org]
Patients with severe pain or a localized tumor burden within the vertebral bodies should be considered for RFA. Pain Relief The pain related to metastatic deposits to the spine is thought to arise from two different mechanisms. [interventionaloncology360.com]
- Anemia
The treatment generally reduces pain, but it can make you more prone to infection, anemia, and bleeding problems. Liver pain is caused by the tumor growing inside the liver and stretching the surface of the liver. [breastcancer.org]
Koizumi M, Suzuki T, Takahashi S, Ogata E: A transient splenic accumulation of Tc-99m HMDP caused by megaloblastic anemia. Clin. Nucl. Med. 25:1024-1027, 2000. [jfcr.or.jp]
- Lower Extremity Pain
Case report This 59-year-old woman presented with a 2-month history of low back pain and right lower extremity pain. [nature.com]
Gastrointestinal
- Fecal Incontinence
He presented with new-onset saddle anesthesia and fecal incontinence. Magnetic resonance imaging demonstrated a spindle-shaped intramedullary lesion of the conus medullaris. [jmedicalcasereports.biomedcentral.com]
He denies back pain or urinary or fecal incontinence. Regarding pain management, he had been recently treated at one of the pain clinics in the hospital and has continued on opioid medication at another institution. [mdedge.com]
Musculoskeletal
- Back Pain
She received abdominal ovariectomy for the ovarian adenocarcinoma 4 years before she suffered from back pain and showed neurological symptoms. The thoracic intramedullary lesion was confirmed by preoperative magnetic resonance imaging. [ncbi.nlm.nih.gov]
Symptoms/Exam Findings Back Pain Radiculopathy Sensory loss Motor loss Bowel/Bladder incontinence Hyper/hyporeflexia Increased back pain with increase in vagal tone by valsalva, cough, etc. [lasvegasemr.com]
He denies back pain or urinary or fecal incontinence. Regarding pain management, he had been recently treated at one of the pain clinics in the hospital and has continued on opioid medication at another institution. [mdedge.com]
- Low Back Pain
back pain, it is the most common systemic disease affecting the spine.17 An important clinical inquiry is to determine whether back pain in an established cancer patient can be ruled out without extensive imaging. [mdedge.com]
Lipani treats many other spinal conditions such as spinal stenosis, herniated discs, degenerative disc disease, low back pain, neck pain, spinal tumors, spinal cancer and more. Dr. [princetonneurologicalsurgery.com]
Case report This 59-year-old woman presented with a 2-month history of low back pain and right lower extremity pain. [nature.com]
back pain over the past 6 months. [orthobullets.com]
CASE REPORT A 54-year-old male presented with bilateral low back pain, tingling, numbness, and weakness in both the lower limbs, and incontinence of the bowel and bladder of 2-months duration [ Figure 1 ]. [surgicalneurologyint.com]
- Spine Pain
A month later, the patient a rebel cervical spine pain and a heaviness of the upper limbs, in front of which a cerebro-cervical magnetic resonance imaging (MRI) was requested objectifying a right hypopharyngeal process, suspicious right internal jugular [panafrican-med-journal.com]
Neurologic
- Dysesthesia
A 37-year-old man with a history of metastatic renal cell carcinoma treated with systemic agents, an autologous stem cell transplant, and local palliative radiotherapy with a 2-month history of vague right foot numbness and right leg dysesthesias was [ncbi.nlm.nih.gov]
Her exam is normal except for slight sensory dysesthesia, hyperreflexic patellar tendons, and mild gait instability which she reports has been worsening. [orthobullets.com]
- Hyperreflexia
Pyramidal signs such as hyperreflexia, spasticity, Babinski sign, and clonus can be found. 18 Lesions at the level of the conus medullaris (L1-L2) usually result in flaccid paresis and early sphincter involvement, while lesions below this level (cauda [healio.com]
Urogenital
- Urinary Incontinence
On admission, she had difficulty with her gait and with urinary retention and had episodes of overflow urinary incontinence. Her midthoracic pain was incapacitating despite a transdermal fentanyl patch and oral rescue opioids. [jamaevidence.mhmedical.com]
Neurol India 2013;61:444-6 Sir, A 74-year-old man presented with a 2-week history of decreased sensation and weakness of bilateral lower extremities along with urinary incontinence. [neurologyindia.com]
Workup
[…] night pain may be mechanical pain due to bone destruction or tumorigenic pain which often occurs at night metastatic hypercalcemia Physical exam neurologic deficits caused by compression of the spinal cord with metastatic disease to the spine Evaluation Workup [orthobullets.com]
Treatment
Median survival ranged from 3.8 to 11.6 months after treatment in patients who were deceased at time of publication. Treatments included corticosteroids, chemotherapy, various radiotherapies, and surgical resection. [ncbi.nlm.nih.gov]
Prognosis
Abstract Intramedullary spinal cord metastases are uncommon in Hodgkin's disease and have a poor prognosis. [ncbi.nlm.nih.gov]
Etiology
Numb chin syndrome in cancer patients: etiology, response to treatment, and prognostic significance. Neurology. 1992;42:1181–4. Copyright © 1999 by the American Academy of Family Physicians. This content is owned by the AAFP. [aafp.org]
Although PTC is the most common histological type of thyroid malignancy with an increasing incidence in many countries, its involvement as an etiology for IMSCM is rare. [surgicalneurologyint.com]
Despite more common etiologies of squamous cell carcinoma, this case report highlights the importance of being mindful of rare diseases. Statement of Ethics The authors have no ethical conflicts to disclose. [karger.com]
Epidemiology
The epidemiology, pathogenesis, clinical presentation, diagnostic considerations, and therapeutic options are discussed. [ncbi.nlm.nih.gov]
Generally speaking, any cancer patient who presents with new or worsening back pain—even in the absence of neurological deficits—merits evaluation for spinal cord compression.6 Nevertheless, individual risk assessment is warranted.7 Epidemiology In the [mdedge.com]
The worldwide epidemiology of prostate cancer: Perspectives from autopsy studies. Can J Urol 2008;15:3866-71. [ PUBMED ] 5. Lieberson RE, Veeravagu A, Eckermann JM, Doty JR, Jiang B, Andrews R, et al. [neurologyindia.com]
PubMed | Google Scholar National Cancer Institute Surveillance Epidemiology and End Results, SEER Stat Fact Sheet: Larynx cancer http://seer.cancer.gov/statfacts/html/laryn.html. Accessed on 27 December 2016. [panafrican-med-journal.com]
There is a need for improving awareness among all clinicians so as to make prompt diagnosis and referral of MSCC a reality. 2 EPIDEMIOLOGY AND AETIOLOGY Bone is the third most common site of metastases after the liver and the lung. [bjgp.org]
Pathophysiology
The first classifies the wide variety of disorders that can cause neurologic symptoms the patient with cancer, discusses the pathophysiology of nervous system metastases, the pathophysiology and treatment of brain edema and the approach to supportive [books.google.com]
Give steroids Pathophysiology Spinal Cord tumors can arise via a number of different sources including both intramedullary and extramedullary tumors. Primary tumors include neuron cell tumors, glial cell tumors, and meningeal tumors. [lasvegasemr.com]
Multiple spinal epidural metastases were noted in 31% of those who underwent complete imaging of the spine.12 Pathophysiology Most cases of MSCC are epidural in origin, arising from the vertebral column in 85% of patients.8 Epidural spread is caused mainly [mdedge.com]
Pathophysiology Spread from primary tumors is mainly by the arterial route. Retrograde spread through the Batson plexus during Valsalva maneuver is postulated. Direct invasion through the intervertebral foramina can also occur. [emedicine.medscape.com]
Skeletal complications of Gaucher disease: pathophysiology, evaluation, and treatment. Semin Hematol 1995; 32(3 suppl 1):20–27 Google Scholar Patten RM, Shuman WP, Teefey S. [link.springer.com]
Prevention
Surgical treatment prevented further neurological deterioration. This is the first case report of ISCM from pNET. [ncbi.nlm.nih.gov]
It both reduces the pain for 90% of patients, and can prevent spinal cord compression, fractures, and recurrences. [brainmetsbc.org]
Objectives: To investigate the correct positioning and examine the effects of spinal bracing to relieve pain or to prevent further vertebral collapse in patients with MSCC. [cochrane.org]
This will not only treat the patient’s symptoms but prevent further bony destruction of the vertebrae, avoid open surgery, prevent neurologic dysfunction and preserve quality of life. [princetonneurologicalsurgery.com]
The physician who promptly recognizes neurologic symptoms occurring in a patient with cancer and makes an early diagnosis may prevent the symptoms from becoming permanently disabling or sometimes lethal. [books.google.com]