Publication

Abstract : Reason We report a series of 4 cases of intramedullary spinal cord metastasis (IMSCM) from breast cancer. It is a rare diagnosis, but increasingly detected now as the use of magnetic resonance imaging for evaluation of spinal metastases has become more common. Methods Cases who presented with clinico-radiological features suggestive of an intramedullary spinal cord metastasis have been reported here. Most patients presented with pain and neurological deficit. Palliative radiotherapy with doses ranging from 12 Gy/2#/weekly once to 30 Gy/10#/2 weeks daily were given to these patients along with corticosteroids. All patients received systemic chemotherapy either prior or subsequent to development of IMSCM. Results Three cases were Her 2 + and one was triple negative breast cancer. Mean age of the patients was 53.3 years. One had cervical cord metastasis and the rest had thoracic cord metastasis. Three patients had prior or concurrent brain metastasis. Two patients were still alive with 9 and 12 months follow up. Three patients were non ambulatory at diagnosis, one was ambulatory with assistance. Symptomatic improvement in pain or numbness was present in all cases. But there was no significant change in motor power leading to change in status of ambulation. Conclusion IMSCM from breast cancer presents with rapid onset neurological deficit and results in poor survival. There seems association of IMSCM with negative hormonal receptor and positive Her2.Early diagnosis using MRI and institution of palliative radiotherapy is likely to give symptomatic benefit in pain and numbness.