Cervical spine involvement in metastatic colorectal carcinoma

Preliminary experience of titanium mesh cages for pathological fracture of middle and lower cervical vertebrae

“…Neoplasms of the cervical spine occur less frequently than neoplasms of the thoracic-lumbar spine. [1][2][3] External radiation therapy and steroid administration are used in traditional management of cervical spinal metastases. Surgery is indicated only if the response to these modalities is poor.…”

Cervical Spine Metastasis as a Primary Manifestation of Occult Colorectal Carcinoma: Case Report

“…This difference might relate to differences in anatomical position and venous drainage, because rectal tumors lie adjacent to the paravertebral venous plexus [6,7]. In the series reported by Geh and Glynne-Jones [4], 54% of bone metastases originated from primary colorectal cancer tumors without involving the lymph nodes [3]. This supports the notion that osseous metastases are blood-borne and probably travel via the venous circulation.…”

“…Only 4% of patients have metastases in the cervical vertebrae [3]. Geh and Glynne-Jones [4] reported that 28% of their patients who had metastatic disease in the liver at the initial presentation subsequently developed symptoms of metastatic disease, and that 71% of these patients showed evidence of metastases at other sites. These patients had poor survival -a median of 5 months [4] -indicating that they were diagnosed relatively late in the natural history of the disease process.…”

“…Even when plain radiography is negative, bone scanning reveals abnormality at the sites of metastases in 57% of patients [9]. Cervical spine metastasis from colorectal carcinoma is thought to be underreported [4]. For patients complaining of neck pain or symptoms of cervical root irritation or spinal cord compression, a lower threshold for investigating by MRI should be considered.…”

“…This presumption may give another perspective about the presentation of colorectal cancer. Patients with cervical spine metastasis from colorectal carcinoma are expected to have poor survival [3], similar to that of patients with other types of bone metastases, of a median of 5 months [4]. The prognostic features and outcomes for spinal cord metastasis are similar to those for other primary sites.…”