Anaplastic oligodendroglioma presenting with drop metastases in the cauda equina

Natale, Massimo; Spennato, Pietro; Savarese, Luciano; Bocchetti, Antonio; Esposito, Salvatore; Barbato, R

doi:10.1016/j.clineuro.2004.09.013

Cited by 17 publications

(21 citation statements)

References 18 publications

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“…It is slightly longer for low-grade oligodendrogliomas (30 months) than for anaplastic tumors (21 months). In the case reported by Natale et al [16], the symptoms of cauda equina involvement were the first clinical manifestations of the intracranial anaplastic oligodendroglioma. In our case, the spinal symptoms first occurred on progression from low-grade to anaplastic oligodendroglioma with no brain symptoms.…”

Section: Discussionmentioning

confidence: 95%

“…Radiotherapy to the spinal axis has been performed in several reported cases [12,[16][17][18], including ours, with a dose of 45 Gy. The results of the radiation therapy are difficult to define, due to the short survival.…”

Section: Discussionmentioning

confidence: 99%

“…However, metastatic involvement of the spinal cord and nerve roots has been reported mainly as microscopic findings; on the other hand, macroscopic and symptomatic spinal metastases are very rare, with only 16 reported cases (Table 1) [6][7][8][9][10][11][12][13][14][15][16][17][18].…”

Section: Discussionmentioning

confidence: 99%

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Symptomatic spinal cord metastasis from cerebral oligodendroglioma

Elefante

Peca

De³

et al. 2011

Neurol Sci

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Spinal subarachnoid spread is not uncommon in brain oligodendrogliomas; on the other hand, symptomatic involvement of the spinal cord and cauda is very rare, with only 16 reported cases. We report the case of a 41-year-old man who underwent resection of a low-grade frontal oligodendroglioma 4 years previously. He was again observed because of bilateral sciatic pain followed by left leg paresis. A spine MRI showed an intramedullary T12-L1 tumor with root enhancement. At operation, an intramedullary anaplastic oligodendroglioma with left exophytic component was found and partially resected. Two weeks later, a large left frontoparietal anaplastic oligodendroglioma was diagnosed and completely resected. The patient was neurologically stable for 8 months and died 1 year after the spinal surgery because of diffuse brain and spinal leptomeningeal spread. The review of the reported cases shows that spinal symptomatic metastases can occur in both low-grade and anaplastic oligodendrogliomas, even many years after surgery of the primary tumor; however, they exceptionally occur as first clinical manifestation or as anaplastic progression. The spinal seeding represents a negative event leading to a short survival.

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Section: Discussionmentioning

confidence: 95%

Section: Discussionmentioning

confidence: 99%

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Symptomatic spinal cord metastasis from cerebral oligodendroglioma

Elefante

Peca

De³

et al. 2011

Neurol Sci

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“…The CSF seeding pathway has been mentioned in one study of meningioma with metastasis that used CSF sampling to detect meningioma metastasis [11] and two studies of drop metastases from anaplastic oligoendroglioma [12,13]. As in the above cases, CSF cytology should be helpful in cases like the one described herein for differential diagnosis preoperatively.…”

Section: Resultsmentioning

confidence: 99%

Drop Metastasis Seeding the Intramedullary Conus Medullaris in a Patient with Breast Cancer and Brain Metastasis

Chiang¹

2013

J Gen Pract

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Breast cancer metastasis to the conus medullaris is very rare. We report a case of intra-axial conus medullaris metastasis from breast adenocarcinoma in a 39-year-old woman. Two years after the diagnosis of brain metastasis was biopsy-proven, she developed progressive lower limb weakness with urinary incontinence for one month. MRI revealed a contrast-enhancing intramedullary lesion at the conus medullaris. Laminectomy and removal of the tumor were performed for decompression and for preserving function. Postoperative histopathological examinations confirmed the metastatic nature of the lesion. We discuss the possibility of drop metastasis traveling from the brain to the conus medullaris via cerebrospinal fluid (CSF) in the central canal. Since intramedullary spinal cord metastasis can lead to rapid progressive neurological deficits and poor outcome, early diagnosis and decompression could preserve the quality of life. We suggest that CSF cytology could be helpful for the diagnosis of intraspinal metastasis in patients with brain metastasis. Jou rn a l o f Ge ner a l P r a c tic e Drop Metastasis Seeding the Intramedullary Conus Medullaris in a Patient

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“…Deciduous tumor cells travel through and then disseminate into the CSF when parenchymal tumors break through the leptomeninges or ependyma. The average interval between diagnosis of the primary brain tumor and diagnosis of CSF dissemination ranged from 5 to 14 months [9]. In two series, 33%-75% of patients with LM had synchronous intraparenchymal brain metastases [10,11].…”

Section: Discussionmentioning

confidence: 99%

Leptomeningeal metastasis from central nervous system tumors: A study of classification and stage in the spinal canal of 58 patients

Zhang

et al. 2012

Chin. Sci. Bull.

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Leptomeningeal metastasis (LM) is caused by the spread of malignant tumor cells into the subarachnoid space. However, classification and staging of LM in the spinal canal is rare in the literature. The authors reviewed the records of 58 Chinese patients with LM for clinical features, neuroimaging, and treatments. Gadolinium-enhanced magnetic resonance imaging (MRI) of brain and spinal cord were performed in all patients. Removal of intracranial tumors was performed in all patients and diagnoses were confirmed by histology. The study group consisted of 58 patients, with 29 cases presenting with intraspinal symptoms. Of the 58, 8 patients underwent intraspinal tumor removal, 8 received radiotherapy alone, 9 received chemotherapy alone, and 34 patients received combined radiochemotherapy. We classified LM into 3 types: type L or leptomeninges LM, is subdivided into 2 subtypes (subtype LI and LII (a,b)), type N or nerve root LM is subdivided into 2 subtypes (subtype NI and NII (a,b)), and type M or mixed-type LM. We also divided LM into stages of I-IV according to the symptoms and the volume of the tumor based on spinal axial MRI. Type LI LM often occurs in patients with intracranial and intraspinal tumors found simultaneously. Patients who receive surgery for intracranial tumors may present with type N LM. Surgery is suitable for patients with NI LM and LIIb LM in stages III-IV, presenting with severe spinal symptoms. The prognosis is better for type N LM than type L LM.

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Anaplastic oligodendroglioma presenting with drop metastases in the cauda equina

Cited by 17 publications

References 18 publications

Symptomatic spinal cord metastasis from cerebral oligodendroglioma

Symptomatic spinal cord metastasis from cerebral oligodendroglioma

Drop Metastasis Seeding the Intramedullary Conus Medullaris in a Patient with Breast Cancer and Brain Metastasis

Leptomeningeal metastasis from central nervous system tumors: A study of classification and stage in the spinal canal of 58 patients

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