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1. Ito T, Mochida A, Saito K, Nishi K, Sasaki S, Hisada T, Morinari H, Nakahara K, Tahara M, Masuda S, Yakumaru K: [An autopsy case of pulmonary and central nervous system metastatic osteosarcoma treated with thirty-six courses of chemotherapy over four years]. Nihon Kokyuki Gakkai Zasshi; 2002 Jan;40(1):71-6
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  • [Title] [An autopsy case of pulmonary and central nervous system metastatic osteosarcoma treated with thirty-six courses of chemotherapy over four years].
  • After 4 courses of chemotherapy combined with CDDP, the mass in the left upper lobe of the lung decreased in size, and it was then resected.
  • Three months later, new metastatic lesions were detected in the thoracic area.
  • Therefore, 29 additional courses of chemotherapy were administered (36 courses in total over 4 years; including regimens combined with CDDP, carboplatin, high-dose methotrexate, ifosfamide, dacarbazine, vindesine, etoposide, vincristine, taxotere and gemcitabine).
  • In spite of the several courses of chemotherapy, brain and spinal cord metastases appeared, and the patient eventually died of cerebral hemorrhage.
  • During the four years after the first recurrence he had good quality of life as a result of the chemotherapy.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Bone Neoplasms / pathology. Brain Neoplasms / drug therapy. Deoxycytidine / analogs & derivatives. Lung Neoplasms / drug therapy. Osteosarcoma / drug therapy. Paclitaxel / analogs & derivatives. Spinal Cord Neoplasms / drug therapy. Taxoids
  • [MeSH-minor] Adult. Carboplatin / administration & dosage. Cisplatin / administration & dosage. Dacarbazine / administration & dosage. Drug Administration Schedule. Etoposide / administration & dosage. Humans. Ifosfamide / administration & dosage. Male. Methotrexate / administration & dosage. Survivors. Vincristine / administration & dosage. Vindesine / administration & dosage

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  • (PMID = 11925923.001).
  • [ISSN] 1343-3490
  • [Journal-full-title] Nihon Kokyūki Gakkai zasshi = the journal of the Japanese Respiratory Society
  • [ISO-abbreviation] Nihon Kokyuki Gakkai Zasshi
  • [Language] jpn
  • [Publication-type] Case Reports; English Abstract; Journal Article
  • [Publication-country] Japan
  • [Chemical-registry-number] 0 / Taxoids; 0W860991D6 / Deoxycytidine; 15H5577CQD / docetaxel; 5J49Q6B70F / Vincristine; 6PLQ3CP4P3 / Etoposide; 7GR28W0FJI / Dacarbazine; B76N6SBZ8R / gemcitabine; BG3F62OND5 / Carboplatin; P88XT4IS4D / Paclitaxel; Q20Q21Q62J / Cisplatin; RSA8KO39WH / Vindesine; UM20QQM95Y / Ifosfamide; YL5FZ2Y5U1 / Methotrexate
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2. Ngan RK, Yiu HH, Cheng HK, Chan JK, Sin VC, Lau WH: Central nervous system metastasis from nasopharyngeal carcinoma: a report of two patients and a review of the literature. Cancer; 2002 Jan 15;94(2):398-405
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  • [Title] Central nervous system metastasis from nasopharyngeal carcinoma: a report of two patients and a review of the literature.
  • BACKGROUND: Central nervous system (CNS) metastasis from nasopharyngeal carcinoma (NPC) is an extremely rare occurrence, although direct intracranial invasion is not infrequent in patients with NPC at a locally advanced stage.
  • METHODS: The clinical records of two such patients with NPC who were diagnosed with metastasis to the spinal cord (intradural) and to the occipital lobe, respectively, were reviewed.
  • RESULTS: Both patients had locally advanced disease at the time of presentation and were treated with neoadjuvant chemotherapy and radical radiotherapy.
  • Spread through cerebral spinal fluid was postulated for the patient with spinal cord metastasis, and hematogenous spread was postulated for the patient with brain metastasis.
  • The patient with brain metastasis died 6 months later of lung metastasis, whereas the other patient is still alive 40 months from the diagnosis of spinal metastasis.
  • CONCLUSIONS: Good symptom control and disease control can be achieved for patients with CNS metastasis after surgery with or without radiotherapy.
  • After aggressive therapy, the ultimate survival depends on control of extracranial disease.
  • [MeSH-major] Brain Neoplasms / secondary. Carcinoma, Squamous Cell / secondary. Nasopharyngeal Neoplasms / pathology. Spinal Cord Neoplasms / secondary
  • [MeSH-minor] Adult. Chemotherapy, Adjuvant. Fatal Outcome. Herpesvirus 4, Human / genetics. Herpesvirus 4, Human / metabolism. Humans. In Situ Hybridization. Male. Middle Aged. Prognosis. Radiotherapy, Adjuvant. Survival

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  • (PMID = 11905411.001).
  • [ISSN] 0008-543X
  • [Journal-full-title] Cancer
  • [ISO-abbreviation] Cancer
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article; Review
  • [Publication-country] United States
  • [Number-of-references] 22
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3. Tashima M, Ono N, Noguchi T, Ishikawa H, Kamakari K, Terada Y: [Two cases of intramedullary spinal cord metastasis of lung cancer detected with MRI]. Nihon Kokyuki Gakkai Zasshi; 2003 Apr;41(4):320-3
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  • [Title] [Two cases of intramedullary spinal cord metastasis of lung cancer detected with MRI].
  • We report two cases of intramedullary spinal cord metastasis of lung cancer detected by MRI.
  • Case 1: A 77-year-old man underwent chemotherapy and left lower lung lobectomy for squamous cell carcinoma of the lung (T2N0M0).
  • The pathological diagnosis was squamous cell carcinoma.
  • Case 2: A small cell carcinoma of lung with metastasis to bone, kidney and cerebellum (T4 N3 M1) in a 73-year-old man was diagnosed.
  • He showed a partial response to chemotherapies and to whole brain radiation (45 Gy).
  • [MeSH-major] Carcinoma, Small Cell / secondary. Carcinoma, Squamous Cell / secondary. Lung Neoplasms / pathology. Magnetic Resonance Imaging. Spinal Cord Neoplasms / secondary

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  • (PMID = 12795190.001).
  • [ISSN] 1343-3490
  • [Journal-full-title] Nihon Kokyūki Gakkai zasshi = the journal of the Japanese Respiratory Society
  • [ISO-abbreviation] Nihon Kokyuki Gakkai Zasshi
  • [Language] jpn
  • [Publication-type] Case Reports; English Abstract; Journal Article
  • [Publication-country] Japan
  • [Chemical-registry-number] K2I13DR72L / Gadolinium DTPA
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4. Wada H, Ieki R, Ota T, Iguchi M, Yuasa K, Okamura T, Karasawa K, Goto H: [Intramedullary spinal cord metastasis of lung adenocarcinoma causing Brown-Séquard Syndrome]. Nihon Kokyuki Gakkai Zasshi; 2001 Aug;39(8):590-4
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  • [Title] [Intramedullary spinal cord metastasis of lung adenocarcinoma causing Brown-Séquard Syndrome].
  • A 36-year-old woman admitted to our hospital because of numbness in the left limbs and weakness in the right arm, and was subsequently given a diagnosis of intramedullary spinal cord metastases from lung cancer.
  • Occipital craniotomy, radiation therapy and chemotherapy were performed on the lesions in the year following June 1994.
  • Compatible with her neurological manifestation, MRI demonstrated tumors in the right side of the cord at the spinal level of C3-4 and C7-Th1, both of which were of high density in T2-enhanced conditions with enhancement by gadolinium-diethylenetriamine pentaacetic acid.
  • No invasion from spinal metastasis was detected by CT, scintigraphy or MRI.
  • We therefore diagnosed her manifestation as Brown-Séquard syndrome caused by intramedullary spinal cord metastatic tumors of lung adenocarcinoma.
  • In order to avoid paraplegia and dysfunction of the bladder and bowel, radiation therapy of the cord lesions with total dose of 44 Gy was performed.
  • Her neurologic manifestation was improved, restoring her quality of life, as the tumor size estimated by MRI decreased.
  • Four months later, however, she died of lung adenocarcinoma that developed accompanied with severe peritonitis carcinomatosa and multiple metastases.
  • [MeSH-major] Adenocarcinoma / pathology. Adenocarcinoma / secondary. Brown-Sequard Syndrome / etiology. Lung Neoplasms / pathology. Spinal Cord Neoplasms / secondary
  • [MeSH-minor] Adult. Brain Neoplasms / secondary. Fatal Outcome. Female. Humans. Lymphatic Metastasis. Magnetic Resonance Imaging


5. Ishibashi Y, Tokuchi Y, Kamachi M, Harada M, Isobe H: [A case of non-small-cell lung cancer with intramedullary spinal cord metastasis diagnosed pre-mortem]. Nihon Kokyuki Gakkai Zasshi; 2000 Dec;38(12):943-6
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  • [Title] [A case of non-small-cell lung cancer with intramedullary spinal cord metastasis diagnosed pre-mortem].
  • The patient was a 54-year-old man who in May 1999 received a diagnosis of squamous cell carcinoma, T4 N2 M1, stage IV.
  • Systemic chemotherapy and stereotactic radiosurgery were performed only to result in further progression of the disease.
  • Brain MRI revealed multiple brain metastasis and whole brain irradiation was performed.
  • Later, bladder dysfunction also developed.
  • Since spinal cord MRI revealed intramedullary metastasis at Th 12 and L1 levels, we performed radiotherapy for the lumbar medullary lesion, together with systemic chemotherapy.
  • After chemoradiotherapy the tumor size decreased and the pain improved.
  • Cases of lung cancer with intramedullary metastasis are rare, especially those diagnosed before death.
  • [MeSH-major] Carcinoma, Squamous Cell / secondary. Lung Neoplasms / pathology. Spinal Cord Neoplasms / secondary
  • [MeSH-minor] Brain Neoplasms / secondary. Brain Neoplasms / therapy. Combined Modality Therapy. Humans. Magnetic Resonance Imaging. Male. Middle Aged

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  • (PMID = 11244733.001).
  • [ISSN] 1343-3490
  • [Journal-full-title] Nihon Kokyūki Gakkai zasshi = the journal of the Japanese Respiratory Society
  • [ISO-abbreviation] Nihon Kokyuki Gakkai Zasshi
  • [Language] jpn
  • [Publication-type] Case Reports; English Abstract; Journal Article
  • [Publication-country] Japan
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6. Nikolaou M, Koumpou M, Mylonakis N, Karabelis A, Pectasides D, Kosmas C: Intramedullary spinal cord metastases from atypical small cell lung cancer: a case report and literature review. Cancer Invest; 2006 Feb;24(1):46-9
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  • [Title] Intramedullary spinal cord metastases from atypical small cell lung cancer: a case report and literature review.
  • Intramedullary spinal cord metastases (ISCM) are usually the result of rapidly progressing systemic malignancy.
  • Lung cancer represents the most common solid tumor associated with the development of ISCM.
  • After a thoracoscopic biopsy she was treated with combination chemotherapy consolidated by mediastinal radiotherapy leading to complete remission.
  • Three months later, she developed a Brown-Sequard syndrome and an MRI scan revealed ISCM at the T10-T12 levels, and secondary brain lesions.
  • Despite treatment with steroids and thoracic spine/brain radiotherapy, no recovery of her motor function was seen and she died 4 months later due to progressive disease in the CNS.
  • The present case, adds to the existing list of ISCM cases reported so far for lung cancer, undermine the ominous prognosis and limited treatment options available, and an extensive literature overview and discussion of similar cases is provided.
  • [MeSH-major] Carcinoma, Small Cell / secondary. Lung Neoplasms / pathology. Spinal Cord Neoplasms / secondary

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  • (PMID = 16466992.001).
  • [ISSN] 0735-7907
  • [Journal-full-title] Cancer investigation
  • [ISO-abbreviation] Cancer Invest.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
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7. Yang WQ, Senger D, Muzik H, Shi ZQ, Johnson D, Brasher PM, Rewcastle NB, Hamilton M, Rutka J, Wolff J, Wetmore C, Curran T, Lee PW, Forsyth PA: Reovirus prolongs survival and reduces the frequency of spinal and leptomeningeal metastases from medulloblastoma. Cancer Res; 2003 Jun 15;63(12):3162-72
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  • [Title] Reovirus prolongs survival and reduces the frequency of spinal and leptomeningeal metastases from medulloblastoma.
  • Medulloblastoma (MB), the most common pediatric brain tumor, is a highly malignant disease with a 5-year survival rate of only 60%.
  • Tumor cells invade surrounding tissue and disseminate through cerebral spinal fluid, making treatment difficult.
  • Human reovirus type 3 exploits an activated Ras pathway in tumor cells to support productive infection as an oncolytic virus.
  • Here, we examined the ability of human reovirus to kill MB cells lines and surgical specimens in vitro and inhibit tumor growth/metastases in vivo.
  • Repeating this experiment with GFP-labeled Daoy cells and multiple i.t. administrations of reovirus, we again found prolonged survival and a dramatic reduction in spinal and leptomeningeal metastases (66.7% in control injections versus 0.0% in the live virus group).
  • These data suggest that this oncolytic virus may be a potentially effective novel therapy against human MB.
  • Its ability to reduce metastases to the spinal cord could allow a reduction in the dose/field of total neuroaxis cerebral-spinal radiotherapy currently used to treat/prevent cerebral spinal fluid dissemination.
  • [MeSH-major] Biological Therapy. Cerebellar Neoplasms / therapy. Mammalian orthoreovirus 3 / physiology. Medulloblastoma / secondary. Meningeal Neoplasms / secondary. Spinal Cord Neoplasms / secondary
  • [MeSH-minor] Animals. Drug Administration Schedule. Enzyme Activation. Eukaryotic Initiation Factor-2 / antagonists & inhibitors. Female. Genes, Reporter. Genes, p53. Green Fluorescent Proteins. Humans. Injections, Spinal. Luminescent Proteins / analysis. Luminescent Proteins / genetics. Mice. Mice, Nude. Neoplasm Proteins / physiology. Proto-Oncogene Proteins p21(ras) / physiology. Signal Transduction. Transcription, Genetic. Tumor Cells, Cultured. Virus Replication. Xenograft Model Antitumor Assays. eIF-2 Kinase / antagonists & inhibitors. eIF-2 Kinase / physiology

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  • (PMID = 12810644.001).
  • [ISSN] 0008-5472
  • [Journal-full-title] Cancer research
  • [ISO-abbreviation] Cancer Res.
  • [Language] eng
  • [Grant] United States / NCI NIH HHS / CA / P30 CA21765
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Eukaryotic Initiation Factor-2; 0 / Luminescent Proteins; 0 / Neoplasm Proteins; 147336-22-9 / Green Fluorescent Proteins; EC 2.7.11.1 / eIF-2 Kinase; EC 3.6.5.2 / HRAS protein, human; EC 3.6.5.2 / Proto-Oncogene Proteins p21(ras)
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8. Ota KV, Dimaras H, Héon E, Babyn PS, Yau YC, Read S, Budning A, Gallie BL, Chan HS: Toxocariasis mimicking liver, lung, and spinal cord metastases from retinoblastoma. Pediatr Infect Dis J; 2009 Mar;28(3):252-4
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  • [Title] Toxocariasis mimicking liver, lung, and spinal cord metastases from retinoblastoma.
  • A boy with bilateral retinoblastoma underwent metastatic surveillance for increased risk of systemic and central nervous system metastasis because of the extensive choroid and optic nerve invasion in his enucleated eye.
  • Two years after finishing chemotherapy, surveillance MRI showed multiple new liver, lung and spinal cord lesions.
  • High Toxocara antibody titers, eosinophilia, and elevated IgE levels supported a diagnosis of toxocariasis, rather than retinoblastoma metastasis.
  • This is the first report of early, asymptomatic spinal cord toxocariasis diagnosed incidentally through metastatic surveillance.
  • [MeSH-major] Liver Neoplasms / diagnosis. Lung Neoplasms / diagnosis. Retinal Neoplasms / pathology. Retinoblastoma / diagnosis. Spinal Cord Neoplasms / diagnosis. Toxocariasis / diagnosis
  • [MeSH-minor] Albendazole / therapeutic use. Animals. Anthelmintics / therapeutic use. Antibodies, Helminth / blood. Child, Preschool. Diagnosis, Differential. Humans. Magnetic Resonance Imaging. Male. Toxocara / immunology

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  • (PMID = 19209093.001).
  • [ISSN] 0891-3668
  • [Journal-full-title] The Pediatric infectious disease journal
  • [ISO-abbreviation] Pediatr. Infect. Dis. J.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Anthelmintics; 0 / Antibodies, Helminth; F4216019LN / Albendazole
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9. Poelen J, Bernsen HJ, Prick MJ: Metastatic medulloblastoma in an adult; treatment with temozolomide. Acta Neurol Belg; 2007 Jun;107(2):51-4
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Metastatic medulloblastoma in an adult; treatment with temozolomide.
  • Medulloblastoma is a malignant brain tumour most frequently seen in children.
  • Treatment of this tumour type usually consists of surgery followed by radiotherapy.
  • Relapses of medulloblastoma are sensitive to chemotherapy and treatment with chemotherapeutics in children has increased the survival rates.
  • A medulloblastoma at adult age is extremely rare, and there is no overall accepted treatment, especially not in the case of a relapse.
  • This female patient showed a recurrence of a medulloblastoma 7 years after the initial presentation with metastatic spread along the neuraxis and progressive neurological deterioration.
  • Treatment with temozolomide resulted in relief of clinical symptoms and stabilization of tumour growth for 8 months.
  • [MeSH-major] Antineoplastic Agents, Alkylating / therapeutic use. Cerebellar Neoplasms / drug therapy. Dacarbazine / analogs & derivatives. Medulloblastoma / drug therapy. Neoplasm Recurrence, Local / drug therapy
  • [MeSH-minor] Adult. Female. Humans. Magnetic Resonance Imaging. Spinal Cord Neoplasms / drug therapy. Spinal Cord Neoplasms / secondary

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  • (PMID = 17710841.001).
  • [ISSN] 0300-9009
  • [Journal-full-title] Acta neurologica Belgica
  • [ISO-abbreviation] Acta Neurol Belg
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Belgium
  • [Chemical-registry-number] 0 / Antineoplastic Agents, Alkylating; 7GR28W0FJI / Dacarbazine; 85622-93-1 / temozolomide
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10. Aryan HE, Farin A, Nakaji P, Imbesi SG, Abshire BB: Intramedullary spinal cord metastasis of lung adenocarcinoma presenting as Brown-Sequard syndrome. Surg Neurol; 2004 Jan;61(1):72-6
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Intramedullary spinal cord metastasis of lung adenocarcinoma presenting as Brown-Sequard syndrome.
  • BACKGROUND: It is extremely rare for cancer to present first as an intramedullary spinal cord metastasis.
  • Furthermore, because it is unlikely for spinal cord neoplasm to present acutely, an acute presentation may signify metastatic disease and should be considered in the initial differential diagnosis.
  • METHODS: 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.
  • Review of the literature reveals this case to be one of only a very few where intramedullary tumor was the first manifestation of metastatic disease.
  • RESULTS: The mainstay of treatment for intramedullary spinal metastases remains steroids, radiation, and chemotherapy, though no well-designed study compares these modalities by long-term survival and functional results.
  • This patient underwent local radiation and systemic chemotherapy following surgical resection.
  • CONCLUSIONS: This patient had no preoperative signs suggesting disease in other organs, making the diagnosis of lung adenocarcinoma metastatic to the intramedullary cord surprising, especially given the extremely rare incidence of spinal intramedullary metastatic disease.
  • However, the patient had an acute presentation, uncommon for primary neoplasm, which may be an indication of metastatic disease.
  • [MeSH-major] Adenocarcinoma / secondary. Brown-Sequard Syndrome / diagnosis. Lung Neoplasms / pathology. Spinal Cord Neoplasms / secondary
  • [MeSH-minor] Diagnosis, Differential. Humans. Magnetic Resonance Imaging. Male. Middle Aged. Neurosurgical Procedures / methods. Postoperative Period


11. Jacobs WB, Perrin RG: Evaluation and treatment of spinal metastases: an overview. Neurosurg Focus; 2001 Dec 15;11(6):e10
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  • [Title] Evaluation and treatment of spinal metastases: an overview.
  • Metastases to the spine are a common and somber manifestation of systemic neoplasia.
  • The incidence of spinal metastases continues to increase, likely a result of increasing survival times for patients with cancer.
  • Historically, surgery for spinal metastases has consisted of simple decompressive laminectomy.
  • Results obtained in retrospective case series, however, have shown that this treatment provides little benefit to the patient.
  • With the advent of better patient-related selection practices, in conjunction with new surgical techniques and improved postoperative care, the ability of surgical therapy to play an important and beneficial role in the multidisciplinary care of cancer patients with spinal disease has improved significantly.
  • Controversy remains, however, with respect to the relative merits of surgery, radiotherapy, chemotherapy, or a combination of these treatments.
  • In this topic review, the literature on spinal column and spinal cord metastases is collated to provide a description of the presentation, investigations, indications for surgical therapy, and the role of adjuvant cancer therapies for patients with spinal metastases.
  • In addition, the authors discuss the different surgical strategies available in the armamentarium of the neurosurgeon treating patients with spinal metastasis.
  • [MeSH-major] Spinal Neoplasms / secondary. Spinal Neoplasms / therapy
  • [MeSH-minor] Adrenal Cortex Hormones / therapeutic use. Case Management. Decompression, Surgical. Diagnosis, Differential. Diagnostic Imaging. Diagnostic Tests, Routine. Embolization, Therapeutic. Humans. Incidence. Internal Fixators. Laminectomy. Neurosurgical Procedures. Orthopedic Procedures. Preoperative Care. Radiotherapy / adverse effects. Radiotherapy / methods. Spinal Cord Compression / drug therapy. Spinal Cord Compression / etiology. Spinal Cord Compression / radiotherapy. Spinal Cord Compression / surgery. Treatment Outcome

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  • (PMID = 16463993.001).
  • [ISSN] 1092-0684
  • [Journal-full-title] Neurosurgical focus
  • [ISO-abbreviation] Neurosurg Focus
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Adrenal Cortex Hormones
  • [Number-of-references] 105
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12. Stebbing J, Ngan S: Breast cancer (metastatic). BMJ Clin Evid; 2010;2010
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  • [Title] Breast cancer (metastatic).
  • INTRODUCTION: Median survival from metastatic breast cancer is 12 months without treatment, but young people can survive up to 20 years with the disease, whereas in other metastatic cancers this would be considered unusual.
  • METHODS AND OUTCOMES: We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of first-line hormonal treatment?
  • What are the effects of second-line hormonal treatment in women who have not responded to tamoxifen?
  • What are the effects of first-line chemotherapy?
  • What are the effects of first-line chemotherapy in combination with a monoclonal antibody?
  • What are the effects of second-line chemotherapy?
  • What are the effects of treatments for bone metastases?
  • What are the effects of treatments for spinal cord metastases?
  • What are the effects of treatments for cerebral or choroidal metastases?
  • We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA).
  • CONCLUSIONS: In this systematic review we present information relating to the effectiveness and safety of the following interventions: first-line hormonal treatment using anti-oestrogens (tamoxifen), ovarian ablation, progestins, selective aromatase inhibitors, or combined gonadorelin analogues plus tamoxifen; second-line hormonal treatment using progestins or selective aromatase inhibitors; first-line non-taxane combination chemotherapy; first-line taxane-based combination chemotherapy; first-line high- versus low-dose standard chemotherapy; first-line chemotherapy plus monoclonal antibody (bevacizumab, trastuzumab); first-line chemotherapy plus tyrosine kinase inhibitor (lapatinib); second-line taxane-based combination chemotherapy; second-line capecitabine or semi-synthetic vinca alkaloids for anthracycline-resistant disease; second-line chemotherapy plus tyrosine kinase inhibitor (lapatinib); and treatment for bone, spinal, or choroidal metastases using bisphosphonates, intrathecal chemotherapy, radiotherapy (alone or plus corticosteroids) radiation sensitisers, or surgical resection.
  • [MeSH-major] Drug Therapy, Combination. Protein Kinase Inhibitors
  • [MeSH-minor] Administration, Oral. Breast Neoplasms / drug therapy. Humans

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  • (PMID = 21418674.001).
  • [ISSN] 1752-8526
  • [Journal-full-title] BMJ clinical evidence
  • [ISO-abbreviation] BMJ Clin Evid
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Protein Kinase Inhibitors
  • [Other-IDs] NLM/ PMC3217794
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13. Inoue T, Tanaka E, Sakuramoto M, Minakuchi M, Maeda Y, Maniwa K, Terada K, Goto S, Takeda T, Yuba Y, Kobashi Y, Noma S, Taguchi Y: [A case of intramedullary spinal cord metastasis due to small cell lung cancer]. Nihon Kokyuki Gakkai Zasshi; 2004 Dec;42(12):1014-8
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  • [Title] [A case of intramedullary spinal cord metastasis due to small cell lung cancer].
  • Systemic chemotherapy and radiotherapy were performed resulting in complete remission of the disease.
  • Specimen obtained by tumor biopsy showed pathological diagnosis of metastasis from small cell lung cancer.
  • Intramedullary metastasis of lung cancer is very rare, and early diagnosis and multidisciplinary treatment may improve quality of life.
  • [MeSH-major] Carcinoma, Small Cell / secondary. Lung Neoplasms / pathology. Spinal Cord Neoplasms / secondary
  • [MeSH-minor] Aged. Cervical Vertebrae / pathology. Combined Modality Therapy. Female. Humans. Magnetic Resonance Imaging

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  • (PMID = 15678908.001).
  • [ISSN] 1343-3490
  • [Journal-full-title] Nihon Kokyūki Gakkai zasshi = the journal of the Japanese Respiratory Society
  • [ISO-abbreviation] Nihon Kokyuki Gakkai Zasshi
  • [Language] jpn
  • [Publication-type] Case Reports; English Abstract; Journal Article
  • [Publication-country] Japan
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14. Engebraaten O, Sivam G, Juell S, Fodstad O: Systemic immunotoxin treatment inhibits formation of human breast cancer metastasis and tumor growth in nude rats. Int J Cancer; 2000 Dec 15;88(6):970-6
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  • [Title] Systemic immunotoxin treatment inhibits formation of human breast cancer metastasis and tumor growth in nude rats.
  • Adjuvant chemotherapy in breast cancer patients has had limited success, which is possibly because of lack of effect on non-proliferating cells accompanied by the emergence of drug-resistant cell clones.
  • In the MA-11 model in nude rats, a single i. v. dose of 20 microg MOC31-PE prevented development of metastasis in the spinal cord in 11/19 (58%) of the animals.
  • Similarly, 425.3-PE treatment gave 6/9 (66%) long-term survivors.
  • In rats injected intracardially or intratibially with MT-1 cells, treatment with 425.
  • 3-PE prevented metastasis in 4/10 (40%) and intratibial tumor growth in 17/18 (94%) of the rats.
  • The results demonstrate that systemic short-term treatment with non-toxic doses of the 3 ITs tested can effectively inhibit the development of experimental breast cancer metastasis and/or local tumor growth in bone.
  • The results support the development of the ITs towards clinical evaluation for possible use as short-term adjuvant therapy in patients at high risk of early relapse.
  • [MeSH-major] ADP Ribose Transferases. Antibodies, Monoclonal / therapeutic use. Bacterial Toxins. Breast Neoplasms / therapy. Exotoxins / therapeutic use. Immunotoxins / therapeutic use. Receptor, Epidermal Growth Factor / immunology. Virulence Factors
  • [MeSH-minor] Animals. Antineoplastic Agents / therapeutic use. Bone Neoplasms / prevention & control. Bone Neoplasms / secondary. Cisplatin / therapeutic use. Doxorubicin / therapeutic use. Female. Injections, Intravenous. Male. Rats. Rats, Nude. Specific Pathogen-Free Organisms. Spinal Neoplasms / prevention & control. Spinal Neoplasms / secondary. Tibia. Tumor Cells, Cultured

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  • [Copyright] Copyright 2000 Wiley-Liss, Inc.
  • (PMID = 11093823.001).
  • [ISSN] 0020-7136
  • [Journal-full-title] International journal of cancer
  • [ISO-abbreviation] Int. J. Cancer
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] UNITED STATES
  • [Chemical-registry-number] 0 / Antibodies, Monoclonal; 0 / Antineoplastic Agents; 0 / Bacterial Toxins; 0 / Exotoxins; 0 / Immunotoxins; 0 / Virulence Factors; 80168379AG / Doxorubicin; EC 2.4.2.- / ADP Ribose Transferases; EC 2.4.2.31 / toxA protein, Pseudomonas aeruginosa; EC 2.7.10.1 / Receptor, Epidermal Growth Factor; Q20Q21Q62J / Cisplatin
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15. Gabriel K, Schiff D: Metastatic spinal cord compression by solid tumors. Semin Neurol; 2004 Dec;24(4):375-83
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  • [Title] Metastatic spinal cord compression by solid tumors.
  • As the survival of cancer patients continues to improve, physicians in the 21st century face the challenge of early detection of metastatic spinal cord compression.
  • Prompt diagnosis and intervention increase the likelihood of functional recovery.
  • Because the epidural space is the most common site of spinal cord metastasis from solid tumors, this article will review the epidemiology, relevant anatomy, pathophysiology, clinical presentation, diagnostic evaluation, treatment, and prognosis for metastatic epidural spinal cord compression.
  • Special attention will be given to the various modalities available for management of metastatic epidural spinal cord compression to maintain or restore normal spinal cord function and relieve pain.
  • These treatment options will be considered according to patients' disease burden, life expectancy, and values.
  • Intramedullary metastasis will be briefly discussed.
  • [MeSH-major] Spinal Cord Compression / etiology. Spinal Cord Compression / pathology. Spinal Cord Neoplasms / complications. Spinal Cord Neoplasms / pathology
  • [MeSH-minor] Adrenal Cortex Hormones / therapeutic use. Diagnostic Imaging / methods. Drug Therapy / methods. Humans. Prognosis. Radiotherapy / methods

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  • (PMID = 15637649.001).
  • [ISSN] 0271-8235
  • [Journal-full-title] Seminars in neurology
  • [ISO-abbreviation] Semin Neurol
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Adrenal Cortex Hormones
  • [Number-of-references] 65
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16. Chiewvit P, Danchaivijitr N, Sirivitmaitrie K, Chiewvit S, Thephamongkhol K: Does magnetic resonance imaging give value-added than bone scintigraphy in the detection of vertebral metastasis? J Med Assoc Thai; 2009 Jun;92(6):818-29
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  • [Title] Does magnetic resonance imaging give value-added than bone scintigraphy in the detection of vertebral metastasis?
  • OBJECTIVE: To determine the role of Magnetic Resonance (MR) imaging for the investigation ofpatients with suspected metastasis to the spine by bone scintigraphy.
  • MATERIAL AND METHOD: Retrospectively reviewed with comparison was made between Technetium-99m Methylene Diphosphonate (99(m)Tc-MDP) bone scintigraphy and corresponding spine MR images in 48 cases of vertebral metastasis at Siriraj Hospital.
  • The MR imaging findings were studied: location (cervical or thoracic or lumbar or sacrum spine), number of lesions (solitary or multiple lesions), pattern of enhancement (homogeneous or inhomogeneous), involvement of spinal canal, compression of spinal cord, extradural extension, other incidental findings such as pulmonary metastasis, pleural effusion, lymphadenopathy The final diagnosis was confirmed clinically and followed-up for further management (radiation or surgery) or followed-up by MR imaging (1 month-16 months) and bone scintigraphy (5 months-12 months).
  • RESULTS: Forty-eight cases (80 lesions) of vertebral metastasis were identified (25 men and 23 women; mean age 61 years and range 8-84 years).
  • Primary neoplasms include breast cancer (n=11), colorectal cancer (n=7), lung cancer (n=6), prostate cancer (n=5), nasopharyngeal cancer (n=5), head and neck cancer (n=3), thyroid cancer (n=2), liver cancer (n=2), esophagus cancer (n=1), bladder cancer (n=1), retroperitoneum cancer (n=1), medulloblastoma (n=1), cervical cancer (n=1), ovarian cancer (n=1), malignant melanoma (n=1).
  • The result of bone scintigraphy and MR imaging is used to evaluate vertebral metastasis: in 44 lesions of bone scintigraphy positive for vertebral metastasis, 40/44 lesions (91%) which MR imaging reveal vertebral metastasis.
  • In 24 lesions of negative of bone scintigraphy for vertebral metastasis, the authors found that 14/24 lesions (58%) showed positive of vertebral metastasis from MR imaging.
  • MR imaging demonstrated metastatic cord compression in 16 cases.
  • Extradural extension causes spinal canal narrowing in 30 cases.
  • CONCLUSION: The authors conclude that the MR imaging is more efficient than the bone scintigraphy in detecting vertebral metastasis, especially in the cases that bone scintigraphy are equivocal or negative for vertebral metastasis in high clinical suspicion.
  • Furthermore, MR imaging is important for the further treatment planning such as radiation therapy or systemic chemotherapy.
  • Although MR imaging is useful in the detection of early metastasis that are localized completely in the bone marrow cavity routinely bone scintigraphy remains that most cost-effective method for examination of the entire skeleton.
  • [MeSH-major] Lumbar Vertebrae / pathology. Magnetic Resonance Imaging. Spinal Neoplasms / radionuclide imaging
  • [MeSH-minor] Adolescent. Adult. Aged. Aged, 80 and over. Child. Diphosphonates. Female. Humans. Male. Middle Aged. Neoplasm Metastasis / radionuclide imaging. Organotechnetium Compounds. Radionuclide Imaging. Retrospective Studies. Spinal Cord Compression. Young Adult

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  • (PMID = 19530588.001).
  • [ISSN] 0125-2208
  • [Journal-full-title] Journal of the Medical Association of Thailand = Chotmaihet thangphaet
  • [ISO-abbreviation] J Med Assoc Thai
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article
  • [Publication-country] Thailand
  • [Chemical-registry-number] 0 / Diphosphonates; 0 / Organotechnetium Compounds; 0 / technetium 99m methylene bisphosphonate
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17. Koutsis G, Spengos K, Potagas C, Dimitrakopoulos A, Sfagos K, Zakopoulos N: Intramedullary spinal cord metastases in a patient with small-cell lung cancer. Eur J Intern Med; 2006 Aug;17(5):372-4
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Intramedullary spinal cord metastases in a patient with small-cell lung cancer.
  • He had been diagnosed 10 months earlier with limited stage small-cell lung cancer, had received chemotherapy, thoracic radiotherapy, and prophylactic cranial irradiation, and was in remission on follow-up.
  • Gadolinium-enhanced MRI of the cervical and thoracic spinal cord revealed two enhancing intramedullary lesions consistent with metastases.

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  • (PMID = 16864018.001).
  • [ISSN] 0953-6205
  • [Journal-full-title] European journal of internal medicine
  • [ISO-abbreviation] Eur. J. Intern. Med.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Netherlands
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18. Hrabalek L: Intramedullary spinal cord metastases: review of the literature. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub; 2010 Jun;154(2):117-22
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Intramedullary spinal cord metastases: review of the literature.
  • AIMS: To review the epidemiology, dissemination, clinical presentation, diagnosis, treatment, survival and functional outcome of intramedullary spinal cord metastases (ISCM).
  • In only 9 cases of spinal cord metastases of breast cancer was surgical resection of ISCM done (10% of all surgically treated ISCM).
  • CONCLUSIONS: Three treatment modalities are available for ISCM: radiotherapy, chemotherapy, and surgery.
  • Patients who have no evidence of widespread organ metastases or multiple intramedullary lesions and who have a life expectancy of at least a few months with tumours of non-lymphoma histology should be considered for tumor resection.
  • In conclusion, ISCM are difficult to treat lesions, but early diagnosis, careful surgical management and maintenance therapy may substantially contribute to a satisfactory functional outcome and prolonged survival.
  • [MeSH-major] Spinal Cord Neoplasms / secondary

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  • (PMID = 20668492.001).
  • [ISSN] 1213-8118
  • [Journal-full-title] Biomedical papers of the Medical Faculty of the University Palacký, Olomouc, Czechoslovakia
  • [ISO-abbreviation] Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] Czech Republic
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19. Petridis AK, Hempelmann RG, Hugo HH, Eichmann T, Mehdorn HM: Metastatic low-grade inflammatory myofibroblastic tumor (IMT) in the central nervous system of a 29-year-old male patient. Clin Neuropathol; 2004 Jul-Aug;23(4):158-66
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  • [Title] Metastatic low-grade inflammatory myofibroblastic tumor (IMT) in the central nervous system of a 29-year-old male patient.
  • A case of myofibrosarcoma (IMT) of the brain and lung as well as the spinal cord is described.
  • Computer tomography identified a bleeding in the left frontal lobe.
  • The histological examination could not reveal an exact diagnosis.
  • In the CT of the chest a large tumor in the left lower lobe of the lung and additionally a cystic structure in the mediastinum was seen.
  • The histological examination of this tumor identified an inflammatory myofibroblastic tumor (IMT).
  • In the further clinical history the patient developed a large spinal cord metastasis of the thoracic spine.
  • The metastatic development of the tumor reported in this case is unusual.
  • The current therapy of these tumors consists of complete tumor resection and further clinical controls.
  • There is no proven role of chemotherapy and radiation therapy.
  • [MeSH-major] Central Nervous System Neoplasms / secondary. Fibrosarcoma / secondary. Lung Neoplasms / pathology. Neoplasms, Muscle Tissue / secondary
  • [MeSH-minor] Adult. Diagnosis, Differential. Hemangioma, Cavernous, Central Nervous System / pathology. Humans. Immunohistochemistry. Magnetic Resonance Imaging. Male. Tomography, X-Ray Computed

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  • (PMID = 15328880.001).
  • [ISSN] 0722-5091
  • [Journal-full-title] Clinical neuropathology
  • [ISO-abbreviation] Clin. Neuropathol.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Germany
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20. Nakadate M, Harad M, Isobe H: [Clinical features of intradural spinal cord metastases in primary lung cancer]. Nihon Kokyuki Gakkai Zasshi; 2005 Sep;43(9):541-6
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  • [Title] [Clinical features of intradural spinal cord metastases in primary lung cancer].
  • We retrospectively investigated the clinical features of 9 consecutive cases of intradural spinal cord metastasis from primary lung cancer treated at our hospital between April 1999 and March 2002.
  • During those three years, spinal cord metastasis was diagnosed in seven of 49 (14.3%) cases with small cell carcinoma and only two of 284 (0.7%) cases with non-small cell carcinoma.
  • Eight of the 9 cases had concomitant brain metastasis that preceded spinal cord metastasis and had received brain irradiation.
  • The other patient without brain metastasis had also received prophylactic cranial irradiation.
  • The interval from brain irradiation to the diagnosis of spinal cord metastasis ranged from 116 to 708 days (median 183 days).
  • Seven of the patients rapidly developed transverse myelopathy within two weeks.
  • Spinal cord metastasis was often multifocal, and in each case lumbar enlargement was commonly involved.
  • Radiation therapy with or without concurrent chemotherapy produced both neurologic improvement and a tumor response shown on MRI in 4 patients.
  • Heightened awareness of the increasing incidence and background risk factors of this unusual complication could lead to earlier diagnosis and more effective treatment for neurologic palliation.
  • [MeSH-major] Lung Neoplasms / pathology. Spinal Cord / pathology. Spinal Cord Neoplasms / radiotherapy. Spinal Cord Neoplasms / secondary
  • [MeSH-minor] Adenocarcinoma / radiotherapy. Adenocarcinoma / secondary. Carcinoma, Small Cell / radiotherapy. Carcinoma, Small Cell / secondary. Carcinoma, Squamous Cell / radiotherapy. Carcinoma, Squamous Cell / secondary. Female. Humans. Magnetic Resonance Imaging. Male. Middle Aged. Radiotherapy Dosage

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  • (PMID = 16218424.001).
  • [ISSN] 1343-3490
  • [Journal-full-title] Nihon Kokyūki Gakkai zasshi = the journal of the Japanese Respiratory Society
  • [ISO-abbreviation] Nihon Kokyuki Gakkai Zasshi
  • [Language] jpn
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] Japan
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21. Stebbing J, Slater S, Slevin M: Breast cancer (metastatic). BMJ Clin Evid; 2007;2007
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  • [Title] Breast cancer (metastatic).
  • INTRODUCTION: Median survival from metastatic breast cancer is 12 months without treatment, but young people can survive up to 20 years with the disease, whereas in other metastatic cancers this would be considered unusual.
  • METHODS AND OUTCOMES: We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of first-line hormonal treatment?
  • What are the effects of second-line hormonal treatment in women who have not responded to tamoxifen?
  • What are the effects of first-line chemotherapy?
  • What are the effects of first-line chemotherapy in combination with a monoclonal antibody?
  • What are the effects of second-line chemotherapy?
  • What are the effects of treatments for bone metastases?
  • What are the effects of treatments for spinal cord metastases?
  • What are the effects of treatments for cerebral or choroidal metastases?
  • We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA).
  • CONCLUSIONS: In this systematic review we present information relating to the effectiveness and safety of the following interventions: anthracycline-based non-taxane combination chemotherapy regimens; bisphosphonates; capecitabine or semisynthetic vinca alkaloids for anthracycline-resistant disease; chemotherapy plus monoclonal antibody (trastuzumab); classical non-taxane combination chemotherapy; combined gonadorelin analogues plus tamoxifen; hormonal treatment with antioestrogens (tamoxifen) or progestins; intrathecal chemotherapy; non-anthracycline-based regimens; non-taxane combination chemotherapy; ovarian ablation; radiation sensitisers; radiotherapy (alone, or plus appropriate analgesia, or plus high-dose corticosteroids); selective aromatase inhibitors; chemotherapy (standard, or high dose); surgical resection; tamoxifen; and taxane-based combination chemotherapy.
  • [MeSH-minor] Administration, Oral. Bone Neoplasms / drug therapy. Diphosphonates / administration & dosage. Humans. Tamoxifen / therapeutic use

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  • (PMID = 19454050.001).
  • [ISSN] 1752-8526
  • [Journal-full-title] BMJ clinical evidence
  • [ISO-abbreviation] BMJ Clin Evid
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Anthracyclines; 0 / Diphosphonates; 094ZI81Y45 / Tamoxifen
  • [Other-IDs] NLM/ PMC2943771
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22. Gale J, Mead GM, Simmonds PD: Management of spinal cord and cauda equina compression secondary to epidural metastatic disease in adults with malignant germ cell tumours. Clin Oncol (R Coll Radiol); 2002 Dec;14(6):481-90
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  • [Title] Management of spinal cord and cauda equina compression secondary to epidural metastatic disease in adults with malignant germ cell tumours.
  • AIM: To review the management and clinical outcome of 10 patients, presenting to a single centre with symptoms and signs of spinal cord or cauda equina compression secondary to epidural metastatic disease from a testicular germ cell cancer.
  • METHODS: Clinical data regarding presenting history, physical examination, staging investigations, treatment and clinical outcome were retrospectively obtained from patient records.
  • RESULTS: Eight patients exhibited neurological deficits at the time of initial presentation of germ cell cancer or as a first manifestation of relapse following dog leg irradiation.
  • Four of these cases were managed with chemotherapy alone, with excellent neurological recovery, whilst four underwent decompressive laminectomy--in three cases prior to referral and in one case after commencing chemotherapy.
  • Four required further chemotherapy (high dose in two cases).
  • Two patients presented with cord compression as a feature of disease relapse following chemotherapy, and were managed with radiotherapy alone in an attempt to achieve local disease control and limit neurological dysfunction.
  • CONCLUSION: Epidural spinal cord or cauda equina compression is a rare complication of metastatic germ cell cancer, which can be successfully managed in chemo-naive patients with good neurological outcome.
  • [MeSH-major] Bone Neoplasms / secondary. Cauda Equina / pathology. Neoplasms, Germ Cell and Embryonal / secondary. Peripheral Nervous System Neoplasms / secondary. Spinal Cord Compression / etiology. Spinal Cord Compression / therapy. Testicular Neoplasms / pathology
  • [MeSH-minor] Adolescent. Adult. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Humans. Male. Middle Aged. Neoplasm Recurrence, Local. Physical Examination. Retrospective Studies. Treatment Outcome

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  • (PMID = 12512971.001).
  • [ISSN] 0936-6555
  • [Journal-full-title] Clinical oncology (Royal College of Radiologists (Great Britain))
  • [ISO-abbreviation] Clin Oncol (R Coll Radiol)
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] England
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23. Witwer BP, Salamat MS, Resnick DK: Gliosarcoma metastatic to the cervical spinal cord: case report and review of the literature. Surg Neurol; 2000 Nov;54(5):373-8; discusiion 378-9
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  • [Title] Gliosarcoma metastatic to the cervical spinal cord: case report and review of the literature.
  • BACKGROUND: We describe a case of an intramedullary metastasis to the cervical spinal cord from a temporal gliosarcoma.
  • A MRI scan revealed the presence of an intramedullary lesion in the spinal cord behind the body of C2.
  • Despite repeated craniotomy, radiation, and chemotherapy, the patient succumbed to a rapidly progressive disease.
  • We believe this to be the first case report of an intramedullary spinal cord metastasis from a gliosarcoma.
  • [MeSH-major] Brain Neoplasms / pathology. Gliosarcoma / secondary. Spinal Cord Neoplasms / diagnosis. Spinal Cord Neoplasms / secondary. Temporal Lobe
  • [MeSH-minor] Cervical Vertebrae. Diagnosis, Differential. Disease Progression. Fatal Outcome. Humans. Magnetic Resonance Imaging. Male. Middle Aged. Paresis / etiology

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  • (PMID = 11165614.001).
  • [ISSN] 0090-3019
  • [Journal-full-title] Surgical neurology
  • [ISO-abbreviation] Surg Neurol
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article; Review
  • [Publication-country] United States
  • [Number-of-references] 25
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24. Fujimoto N, Hiraki A, Ueoka H, Kiura K, Bessho A, Takata I, Hiramatsu Y, Ikeda K, Harada M: Intramedullary spinal cord recurrence after high-dose chemotherapy and autologous peripheral blood progenitor cell transplantation for limited-disease small cell lung cancer. Lung Cancer; 2000 Nov;30(2):145-8
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  • [Title] Intramedullary spinal cord recurrence after high-dose chemotherapy and autologous peripheral blood progenitor cell transplantation for limited-disease small cell lung cancer.
  • Intramedullary spinal cord metastasis is very rare in small-cell lung cancer (SCLC), and develops in only 2% of neurological disorders associated with SCLC according to previous reports.
  • We describe here a patient with SCLC who developed intramedullary spinal cord recurrence after high-dose chemotherapy (HDCT) followed by autologous blood progenitor cell transplantation (ABPCT).
  • A 59-year-old Japanese male was referred to us for diagnosis and treatment of an abnormal shadow on a chest radiograph.
  • Magnetic resonance imaging (MRI) of the spinal cord disclosed an intramedullary tumor exhibiting an enhancement effect with Gd-DTPA at the 11-12th level of the thoracic vertebra.
  • Immediately, radiotherapy to the spinal cord metastasis was given at a dose of 30 Gy, and his neurological disorders were completely resolved.
  • At this time of reporting, he is doing well without recurrence.
  • This case indicates that intramedullary spinal cord is one of the recurrence sites implicated after HDCT and PCI in LD-SCLC.
  • [MeSH-major] Carcinoma, Small Cell / secondary. Lung Neoplasms / pathology. Neoplasms, Second Primary. Spinal Cord Neoplasms / secondary
  • [MeSH-minor] Combined Modality Therapy. Drug Therapy. Hematopoietic Stem Cell Transplantation. Humans. Male. Medulla Oblongata. Middle Aged. Transplantation, Autologous


25. Kim W, Min CK, Shim YS, Shon YM, Yang DW: Intramedullary spinal cord metastasis of acute lymphoblastic leukemia as the initial manifestation of relapse. Leuk Lymphoma; 2008 Jun;49(6):1214-6
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  • [Title] Intramedullary spinal cord metastasis of acute lymphoblastic leukemia as the initial manifestation of relapse.
  • [MeSH-major] Neoplasm Recurrence, Local / diagnosis. Precursor Cell Lymphoblastic Leukemia-Lymphoma / pathology. Spinal Cord Neoplasms / etiology
  • [MeSH-minor] Adolescent. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Humans. Male. Muscle Weakness / drug therapy. Muscle Weakness / etiology. Remission Induction

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  • (PMID = 18569642.001).
  • [ISSN] 1029-2403
  • [Journal-full-title] Leukemia & lymphoma
  • [ISO-abbreviation] Leuk. Lymphoma
  • [Language] eng
  • [Publication-type] Case Reports; Letter
  • [Publication-country] England
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26. Bakshi A, Biswas G, Deshmukh C, Prasad N, Nair R, Parikh PM: Successful complete regression of isolated intramedullary spinal cord metastases from epithelial ovarian carcinoma with chemotherapy and radiotherapy. Indian J Cancer; 2006 Jul-Sep;43(3):136-8
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  • [Title] Successful complete regression of isolated intramedullary spinal cord metastases from epithelial ovarian carcinoma with chemotherapy and radiotherapy.
  • Advances in the management of ovarian cancer by use of aggressive surgery and effective platinum-based chemotherapy have prolonged survival; this may have resulted in an alteration of the metastatic pattern of the disease and spread to unusual sites (e.g, CNS) has become more common.
  • Intramedullary spinal cord metastasis is rare.
  • We report one such case treated successfully with chemotherapy and radiotherapy with long-term survival.
  • [MeSH-major] Ovarian Neoplasms / drug therapy. Ovarian Neoplasms / radiotherapy. Spinal Cord Neoplasms / drug therapy. Spinal Cord Neoplasms / radiotherapy. Spinal Cord Neoplasms / secondary
  • [MeSH-minor] Administration, Oral. Adult. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. CA-125 Antigen / cerebrospinal fluid. Combined Modality Therapy. Cystadenocarcinoma, Serous / drug therapy. Cystadenocarcinoma, Serous / radiotherapy. Drug Administration Schedule. Etoposide / administration & dosage. Etoposide / therapeutic use. Female. Humans. Lumbar Vertebrae / radiography. Remission Induction / methods

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  • (PMID = 17065773.001).
  • [ISSN] 0019-509X
  • [Journal-full-title] Indian journal of cancer
  • [ISO-abbreviation] Indian J Cancer
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] India
  • [Chemical-registry-number] 0 / CA-125 Antigen; 6PLQ3CP4P3 / Etoposide
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27. Cormio G, Colamaria A, Di Vagno G, De Tommasi A, Loverro G, Selvaggi L: Surgical decompression and radiation therapy in epidural metastasis from cervical cancer. Eur J Obstet Gynecol Reprod Biol; 2000 Mar;89(1):59-61
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  • [Title] Surgical decompression and radiation therapy in epidural metastasis from cervical cancer.
  • Spinal cord compression by epidural metastasis is considered an exceptional complication in patients with cervical carcinoma.
  • We report three patients treated for a cervical carcinoma who developed epidural metastasis with spinal cord compression at 9, 25 and 48 months after primary treatment of the uterine malignancy.
  • All patients had poorly-differentiated adenocarcinomas with lymphovascular space invasion, and two had lymph node metastasis.
  • In two patients the spinal cord was the only site of recurrent disease, whereas the other had lung and brain metastasis at the time of epidural involvement diagnosis.
  • Surgical decompression followed by radiation therapy may result in a complete preservation of the neurologic functions in patients with spinal cord compression secondary to metastatic carcinoma of the uterine cervix.
  • Considering the propensity for disseminated disease, long term survival might be achieved only with the use of effective chemotherapy.
  • [MeSH-major] Epidural Neoplasms / secondary. Spinal Cord Compression / etiology. Spinal Cord Compression / surgery. Uterine Cervical Neoplasms
  • [MeSH-minor] Adenocarcinoma / complications. Adenocarcinoma / radiotherapy. Adenocarcinoma / secondary. Adult. Brain Neoplasms / secondary. Fatal Outcome. Female. Humans. Laminectomy. Lung Neoplasms / secondary. Lymphatic Metastasis. Middle Aged

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  • (PMID = 10733025.001).
  • [ISSN] 0301-2115
  • [Journal-full-title] European journal of obstetrics, gynecology, and reproductive biology
  • [ISO-abbreviation] Eur. J. Obstet. Gynecol. Reprod. Biol.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] IRELAND
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28. Jalali K, Chautard D, Racineux P, Pabot du Chatelard P: [Spinal cord metastasis from prostate cancer]. Prog Urol; 2004 Sep;14(4):554-7; discussion 557
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  • [Title] [Spinal cord metastasis from prostate cancer].
  • [Transliterated title] Métastase dans la moelle épinière d'un cancer de la prostate.
  • The majority of spinal cord lesions observed in prostate cancer are related to extradural compression.
  • The authors report a case of probable carcinomatous myelitis secondary to prostate cancer in a 50-year-old man, 9 months after the initial diagnosis of advanced metastatic prostate cancer.
  • Despite endocrine therapy initiated immediately after diagnosis, the patient rapidly developed leg pain due to vertebral osteolysis.
  • He developed flaccid paraplegia despite radiotherapy of the lumbar spine combined with corticosteroid therapy and chemotherapy.
  • Spinal cord magnetic resonance imaging (MRI) showed typical features of very probable carcinomatous myelitis in the cervicothoracic zone.
  • Regardless of the primary cancer, intramedullary spinal cord metastases have a very poor prognosis.
  • [MeSH-major] Adenocarcinoma / secondary. Prostatic Neoplasms / pathology. Spinal Neoplasms / secondary

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  • (PMID = 15776912.001).
  • [ISSN] 1166-7087
  • [Journal-full-title] Progrès en urologie : journal de l'Association française d'urologie et de la Société française d'urologie
  • [ISO-abbreviation] Prog. Urol.
  • [Language] fre
  • [Publication-type] Case Reports; English Abstract; Journal Article
  • [Publication-country] France
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29. Kodama M, Kawaguchi H, Komoto Y, Takemura M: Coexistent intramedullary spinal cord and choroidal metastases in ovarian cancer. J Obstet Gynaecol Res; 2010 Feb;36(1):199-203
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Coexistent intramedullary spinal cord and choroidal metastases in ovarian cancer.
  • Involvement of intramedullary spinal cord and the choroid by ovarian cancer is rare, and coexistence of metastases at these sites is extremely rare and has never been reported.
  • This condition rapidly progresses to a neurological emergency; however, an efficient standard treatment method is not available for this rare condition.
  • She presented with blindness and other neurologic complaints during the course of treatment for a recurrence at 50 months after the primary surgical treatment for the tumor.
  • Magnetic resonance imaging (MRI) revealed intramedullary spinal cord metastasis and choroidal metastasis, coexisting with multiple brain metastases and intra-abdominal lesions.
  • Neurological emergency was prevented by administering whole-brain irradiation therapy followed by systemic chemotherapy.
  • Early diagnosis and multidisciplinary treatment, including radiotherapy and chemotherapy, may offer good palliation for such unusual metastases of ovarian cancer.
  • [MeSH-major] Brain Neoplasms / secondary. Choroid Neoplasms / secondary. Cystadenocarcinoma, Serous / secondary. Neoplasm Recurrence, Local. Ovarian Neoplasms / pathology. Spinal Cord Neoplasms / secondary
  • [MeSH-minor] Abdominal Neoplasms / secondary. Abdominal Neoplasms / therapy. Aged, 80 and over. Combined Modality Therapy. Female. Humans. Hysterectomy. Ovariectomy

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  • (PMID = 20178552.001).
  • [ISSN] 1447-0756
  • [Journal-full-title] The journal of obstetrics and gynaecology research
  • [ISO-abbreviation] J. Obstet. Gynaecol. Res.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Australia
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30. Aida Y, Igarashi A, Inoue S, Abe S, Shibata Y, Kubota I: [A case of lung adenocarcinoma exhibiting Garcin syndrome]. Nihon Kokyuki Gakkai Zasshi; 2010 Jan;48(1):66-9
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  • We report a rare case of lung adenocarcinoma exhibiting Garcin syndrome due to skull base metastasis.
  • A diagnosis of lung adenocarcinoma and intraperitoneal lymph node metastases was given to a 50-year-old man after pathological examination of a superclavicular lymph node biopsy.
  • After systemic chemotherapy with cisplatin plus docetaxel, he had left hearing loss and vertigo.
  • Since auditory nerve damage might occur due to cisplatin, the chemotherapy regimen was changed.
  • However, facial paralysis occurred and his auditory nerve disorder progressed to deafness.
  • He was diagnosed with Garcin syndrome due to the skull base and spinal cord metastases by brain and spine MRI, and cytological examination of the spinal fluid.
  • After intrathecal administration of methotrexate and cranial irradiation, the progression of facial paralysis and auditory nerve disorder were halted.
  • [MeSH-minor] Humans. Male. Middle Aged. Skull Base Neoplasms / secondary. Spinal Cord Neoplasms / secondary

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  • (PMID = 20163025.001).
  • [ISSN] 1343-3490
  • [Journal-full-title] Nihon Kokyūki Gakkai zasshi = the journal of the Japanese Respiratory Society
  • [ISO-abbreviation] Nihon Kokyuki Gakkai Zasshi
  • [Language] jpn
  • [Publication-type] Case Reports; English Abstract; Journal Article
  • [Publication-country] Japan
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31. Nguyen NC, Sayed MM, Taalab K, Osman MM: Spinal cord metastases from lung cancer: detection with F-18 FDG PET/CT. Clin Nucl Med; 2008 May;33(5):356-8
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Spinal cord metastases from lung cancer: detection with F-18 FDG PET/CT.
  • Preoperative F-18 FDG PET/CT study in this 57-year-old woman showed an FDG avid lesion in the left upper lung without evidence of lymphadenopathy or distant metastasis.
  • She underwent a left upper lobectomy in June 2005 revealing moderately poorly differentiated adenocarcinoma (pT3N0M0) and subsequent chemotherapy completed December 2005.
  • Nine months later, a left parietal lobe metastatic lesion was surgically resected.
  • A true whole body FDG PET/CT study in November 2006 for restaging demonstrated new FDG avid spinal cord foci, which were highly suspicious for spinal cord metastases; these lesions were confirmed by MRI.
  • Clinically, the patient recently developed back pain without evidence of neurologic deficits.
  • [MeSH-major] Carcinoma, Non-Small-Cell Lung / diagnosis. Carcinoma, Non-Small-Cell Lung / secondary. Fluorodeoxyglucose F18. Lung Neoplasms / diagnosis. Spinal Cord Neoplasms / diagnosis. Spinal Cord Neoplasms / secondary
  • [MeSH-minor] Female. Humans. Lumbar Vertebrae / radiography. Lumbar Vertebrae / radionuclide imaging. Positron-Emission Tomography / methods. Radiopharmaceuticals. Thoracic Vertebrae / radiography. Thoracic Vertebrae / radionuclide imaging. Tomography, X-Ray Computed / methods

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  • (PMID = 18431157.001).
  • [ISSN] 0363-9762
  • [Journal-full-title] Clinical nuclear medicine
  • [ISO-abbreviation] Clin Nucl Med
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Radiopharmaceuticals; 0Z5B2CJX4D / Fluorodeoxyglucose F18
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32. Cormio G, Di Vagno G, Di Fazio F, Loverro G, Selvaggi L: Intramedullary spinal cord metastasis from ovarian carcinoma. Gynecol Oncol; 2001 Jun;81(3):506-8
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Intramedullary spinal cord metastasis from ovarian carcinoma.
  • BACKGROUND: Intramedullary spinal cord involvement by ovarian carcinoma is extremely rare.
  • CASE: A patient with stage IV serous cystadenocarcinoma of the ovary presented with neurologic complaints 16 months after primary treatment.
  • Magnetic resonance imaging demonstrated a metastatic lesion in the intramedullary area of the spinal cord.
  • No other site of metastatic disease was observed.
  • Following chemotherapy she was given radiotherapy on the spinal cord, but died 10 months later for disseminated abdominal disease, without neurologic symptoms.
  • CONCLUSION: Spinal cord involvement is unusual in ovarian carcinoma; multidisciplinary treatment, including chemotherapy and radiotherapy, may offer good palliation of the symptomatology.
  • [MeSH-major] Cystadenocarcinoma, Serous / secondary. Ovarian Neoplasms / pathology. Spinal Cord Neoplasms / secondary
  • [MeSH-minor] Antineoplastic Agents / therapeutic use. Carboplatin / therapeutic use. Female. Humans. Middle Aged

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  • [Copyright] Copyright 2001 Academic Press.
  • (PMID = 11371147.001).
  • [ISSN] 0090-8258
  • [Journal-full-title] Gynecologic oncology
  • [ISO-abbreviation] Gynecol. Oncol.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents; BG3F62OND5 / Carboplatin
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33. Kaal EC, Vecht CJ: CNS complications of breast cancer: current and emerging treatment options. CNS Drugs; 2007;21(7):559-79
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] CNS complications of breast cancer: current and emerging treatment options.
  • The choice of appropriate therapy for brain metastases also depends on prognostic factors, including the age of the patient, the Karnofsky performance score, the number of brain metastases and the presence of systemic disease.
  • Surgery followed by whole brain radiation therapy (WBRT) is generally restricted to ambulant patients with a single brain metastasis without active extracranial disease.
  • Although breast carcinoma is sensitive to chemotherapy, the role of chemotherapy in the treatment of brain metastases is still unclear.
  • Objective responses after cyclophosphamide-based therapies were reported in studies performed in the 1980s.
  • A randomised study in patients with leptomeningeal disease secondary to breast cancer has revealed that intrathecal chemotherapy is associated with substantially more adverse effects than non-intrathecal treatment, without a clear benefit in terms of response or survival.
  • Intramedullary metastasis is rare but often presents with a rapidly progressive myelopathy.
  • Epidural spinal cord metastasis occurs in approximately 4% of patients and can lead to paraplegia.
  • [MeSH-major] Brain Neoplasms / secondary. Brain Neoplasms / therapy. Breast Neoplasms / pathology
  • [MeSH-minor] Antineoplastic Agents / therapeutic use. Clinical Trials as Topic. Female. Humans. Incidence. Meningeal Neoplasms / diagnosis. Meningeal Neoplasms / secondary. Meningeal Neoplasms / therapy. Risk Factors. Spinal Cord Neoplasms / diagnosis. Spinal Cord Neoplasms / secondary. Spinal Cord Neoplasms / therapy


34. Kato A, Katayama H, Hamada H, Nagao T, Kadowaki T, Ito R, Irifune K, Higaki J: [A case of small cell lung cancer with intramedullary spinal cord metastasis]. Nihon Ronen Igakkai Zasshi; 2005 Sep;42(5):567-70
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  • [Title] [A case of small cell lung cancer with intramedullary spinal cord metastasis].
  • A magnetic resonance imaging revealed an enhanced mass in the intramedullary spinal cord at the level of Th10-L1.
  • Metastatic spinal tumor was diagnosed by clinical and radiological examinations.
  • This is a rare case of small cell lung cancer with intramedullary spinal cord metastasis which caused various neurological symptoms.
  • [MeSH-major] Carcinoma, Small Cell / secondary. Lung Neoplasms / pathology. Spinal Cord / pathology. Spinal Cord Neoplasms / secondary

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  • (PMID = 16248423.001).
  • [ISSN] 0300-9173
  • [Journal-full-title] Nihon Ronen Igakkai zasshi. Japanese journal of geriatrics
  • [ISO-abbreviation] Nihon Ronen Igakkai Zasshi
  • [Language] jpn
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] Japan
  • [Chemical-registry-number] K2I13DR72L / Gadolinium DTPA
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