1
|
Ben Kridis W, Nefzi I, Souissi B, Ben Mahfoudh K, Dammak M, Daoud J, Khanfir A. Intramedullary spinal cord metastasis from breast cancer: an ambiguous entity. BMJ Support Palliat Care 2024:spcare-2024-004910. [PMID: 38697779 DOI: 10.1136/spcare-2024-004910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2024] [Accepted: 04/17/2024] [Indexed: 05/05/2024]
Abstract
Intramedullary spinal cord metastasis (IMSC) from solid tumors is rare. In this report, we describe the case of a patient treated at our center for breast cancer with intramedullary spinal cord metastases without bone and brain metastases or meningitis. Management of the disease remains challenging even with recent advances in the treatment of metastatic breast cancer. Treatment options include surgery, radiotherapy and chemotherapy. The prognosis of these patients still very poor.
Collapse
Affiliation(s)
- Wala Ben Kridis
- Medical Oncology, Habib Bourguiba Hospital university of Sfax, Sfax, Tunisia
| | - Issaad Nefzi
- Medical Oncology, Habib Bourguiba Hospital university of Sfax, Sfax, Tunisia
| | | | | | | | - Jamel Daoud
- Radiotherapy, Habib Bourguiba Hospital, Sfax, Tunisia
| | - Afef Khanfir
- Medical Oncology, Habib Bourguiba Hospital university of Sfax, Sfax, Tunisia
| |
Collapse
|
2
|
Iwasaki M, Naito K, Endo T, Hijikata Y, Mizuno M, Hoshimaru M, Hida K, Takami T. Impact of surgical treatment for intramedullary spinal cord metastasis on neurological function and survival: A multicenter retrospective study by the Neurospinal Society of Japan. J Clin Neurosci 2023; 117:27-31. [PMID: 37740999 DOI: 10.1016/j.jocn.2023.09.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 08/31/2023] [Accepted: 09/16/2023] [Indexed: 09/25/2023]
Abstract
BACKGROUND This retrospective multicenter study aimed to analyze the characteristics and surgical outcomes of intramedullary spinal cord metastasis (ISCM) and to discuss the controversy regarding its surgical indications. METHODS This study included 29 ISCM patients who underwent surgery between 2009 and 2020. Biopsy cases were excluded from analysis. For functional and neurological functional assessments, Karnofsky Performance Status (KPS, %) and modified McCormick Scale (MMS, 5-grade scale) scores were determined before and after surgery. Patients were divided into two groups: a mild-to-moderate disability group with preoperative MMS grades 1 to 3, and a severe disability group with preoperative MMS grades 4 to 5. RESULTS The mean preoperative KPS was 45.9, and the mean duration from symptom onset to surgical intervention was 1 month. The ISCM was located in the cervical spine in 10 cases and the thoracic spine in 19 cases. The access route (myelotomy) for ISCM removal was via the posterior median sulcus in 9 cases and via the posterior lateral sulcus in 11 cases, while others were not recorded. The degree of removal was gross total resection in 20 patients (69%), subtotal resection in 0 patients, and partial removal in 9 patients (31%). No significant complications related to the surgical procedures were recorded. Postoperative adjuvant therapy included radiotherapy in 17 patients (58.6%) and chemotherapy or molecular targeted therapy in 13 patients (44.8%). Pathological findings of ISCM showed that colorectal cancer was the most common in 9 cases, followed by lung cancer in 7, renal cell carcinoma in 5, and breast cancer in 2. Twenty-one of the 29 patients (72.4%) were confirmed to have survived 6 months after surgery: 8 of the 10 patients (80%) in the mild-to-moderate disability group and 13 of the 19 patients (68.4%) in the severe disability group. At 6 months after surgery, 3 of the 8 patients (38%) in the mild-to-moderate group were able to maintain or improve their function. Eleven of the 13 patients (85%) in the severe disability group maintained their function despite being severely disabled. CONCLUSIONS This study suggests that surgical treatment can maintain or improve neurological function in a limited number of patients with ISCM, although it had minimal impact on improving the survival rate after surgery.
Collapse
Affiliation(s)
- Motoyuki Iwasaki
- Department of Neurosurgery, Hokkaido University, Sapporo, Japan.
| | - Kentaro Naito
- Department of Neurosurgery, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan
| | - Toshiki Endo
- Division of Neurosurgery, Tohoku Medical and Pharmaceutical University, Sendai, Japan
| | | | - Masaki Mizuno
- Department of Minimum-Invasive Neurospinal Surgery, Mie University, Mie, Japan
| | | | - Kazutoshi Hida
- Department of Neurosurgery, Sapporo Azabu Neurosurgical Hospital, Sapporo, Japan
| | - Toshihiro Takami
- Department of Neurosurgery, Osaka Medical and Pharmaceutical University, Osaka, Japan
| |
Collapse
|
3
|
Calotă ND, Oprea C, Iliescu MG, Ciota AE, Obadă B, Gidu DV, Gheorghe E, Oltean A, Ionescu EV. Multiple Bone Metastatic Invasion with Clinical Implications due to Ductal Mammary Carcinoma – Case report and Short Literature Review. BALNEO AND PRM RESEARCH JOURNAL 2023. [DOI: 10.12680/balneo.2023.544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/07/2023] Open
Abstract
Multidisciplinary approach of clinical cases in rehabilitations units can be very complex and divers. Method: We present a case of a woman 30 years old, whose oncological histo-ry begins 9 years ago, when the diagnosis of invasive ductal mammary infiltrating ca-nelular carcinoma grade I was made and treated by tumorectomy (lumpectomy). The pa-tient refused oncological treatment at that time and resorted to alternative medicine dur-ing a period of 7 years: diet without sugar and animal products; regular vitamin B17 treatments; almond kernel cure; high-dose intravenous vitamin C treatment for; intrave-nous ozone therapy; apitherapy with bee venom; oral administration of cannabis oil dur-ing the past four years until now; physical therapy. Results: The evolution is marked by the appearance of multiple bone metastatic lesions. The most worst clinical consequence was a hyperalgesic cervicobrachial neuralgia, due to multiple C6-T3 lytic lesions diag-nosed 2 years ago and C7 compression (close to spinal cord injury), situation which had as medical approach two surgeries interventions, radiotherapy and chemotherapy. Con-clusions: The rehabilitation program was adapted to every stage of clinical evolution and was marked by many complications. All the steps were made for functional improvement and for increase the quality of life.
Collapse
Affiliation(s)
- Nicoleta Daniela Calotă
- Department of Kinetotherapy, Faculty of Physical Education and Sport, „Ovidius” University of Constanța, 1 Cpt. Aviator Alexandru Șerbănescu street, 900470, Constanța, România
| | - Carmen Oprea
- Department of Rehabilitation, Faculty of Medicine, „Ovidius” University of Constanța, 1 Uni-versity Alley, Campus – Corp B, 900470, Constanța, România
| | - Madalina Gabriela Iliescu
- Department of Rehabilitation, Faculty of Medicine, „Ovidius” University of Constanța, 1 Uni-versity Alley, Campus – Corp B, 900470, Constanța, România
| | - Alexandra Ecaterina Ciota
- Department of Rehabilitation, Faculty of Medicine, „Ovidius” University of Constanța, 1 Uni-versity Alley, Campus – Corp B, 900470, Constanța, România
| | - Bogdan Obadă
- Department of Orthopedics, Faculty of Medicine, „Ovidius” University of Constanța, 1 Univer-sity Al-ley, Campus – Corp B, 900470, Constanța, România
| | - Diana Victoria Gidu
- Department of Kinetotherapy, Faculty of Physical Education and Sport, „Ovidius” University of Constanța, 1 Cpt. Aviator Alexandru Șerbănescu street, 900470, Constanța, România
| | - Emma Gheorghe
- Department of Histology, Faculty of Medicine, „Ovidius” University of Constanța, 1 University Alley, Campus – Corp B, 900470, Constanța, România
| | - Antoanela Oltean
- Department of Kinetotherapy, Faculty of Physical Education and Sport, „Ovidius” University of Constanța, 1 Cpt. Aviator Alexandru Șerbănescu street, 900470, Constanța, România
| | - Elena Valentina Ionescu
- Department of Rehabilitation, Faculty of Medicine, „Ovidius” University of Constanța, 1 Uni-versity Alley, Campus – Corp B, 900470, Constanța, România
| |
Collapse
|