Intramedullary Spinal Cord and Cauda Equina Metastasis of Breast Carcinoma: Case Report

Abstract

Aim. We present a case report of a female patient with metastasis of breast carcinoma to the medullary conus and cauda equina.Methods. A 48-year-old woman with a history of breast tumor, suddenly felt severe weakness and numbness of the lower extremities. MRI of the spine disclosed a mass lesion within the medullary conus, with leptomeningeal involvement of cauda equina at the spinal level L1. Laminectomy was performed and partial resection of the medullary conus tumor and especially release of nerve roots of cauda equina was achieved using microsurgical techniques.Results. Her clinical status, especially right leg weakness and sensory loss in the lower extremities have immediately improved but bladder dysfunction remained and she was unable to walk.The histological picture and immunophenotype indicates the presence of metastatic ductal adenocarcinoma of the mammary gland. Patient died 4 months after the spinal cord and cauda equina surgery.Conclusion. To our knowledge, this is the first report of successful surgical treatment of metastatic leptomeningeal infiltration of breast carcinoma.

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

“…ISCM can be surgically excised since most ISCMs are well encapsulated. Although the surgery does not improve survival duration, radical removal of the intramedullary metastasis to the conus medullaris may improve quality of life [6,7]. The risks of operative morbidity remain high as this site is a transition point from the spinal cord to nerve roots, and a circumscribed mass may not be sharply demarcated.…”

Metástasis espinal dural y leptomeníngea de cáncer de mama: reporte de un caso

“…El manejo actual consiste en una combinación de quimioterapia intratecal, terapia sistémica, radioterapia y/o la mejor atención de apoyo 5 . La cirugía tiene como objetivo la descompresión del tejido neural funcional y la confirmación histológica del tumor 6 .…”

“…El pronóstico para las pacientes con metástasis en el SNC es malo 3 , con una supervivencia media de 3 a 4 meses a partir del diagnóstico 6 .…”

Spinal Intramedullary Metastasis of Breast Cancer

“…Nearly 8.5% of all central nervous system metastases are into spinal cord, but the exact incidence of breast cancer's spinal intramedullary metastasis is not known [ 4 ]. It is predicted that only 0.1–0.4% of all cancer patients have metastasis into intramedullary spinal cord (MISC) [ 5 ]. These patients have rapidly progressing neurological deficit and require immediate evaluation.…”