Summary
Seven autopsy cases of intramedullary metastases, four in the cervical spinal cord, are reported and the literature reviewed. Whereas lung and breast cancer, malignant melanomas and lymphomas are reported as the most common primary tumors, the present series included three cases of breast carcinoma and two cases each of colon and oat cell carcinoma of the lung. Neither the clinical symptoms nor the neurological signs distinguished intramedullary metastases from the more common extradural deposits, but radiological evidence of vertebral metastases and myelographic stop were present in only one case each, and CSF cytology was negative. Intramedullary deposits in this series were neither associated with extradural tumor nor with spread into the subarachnoid space, while cerebral metastases were present in four cases. This favors hematogenous dissemination rather than direct trans-dural or perineural spread of these lesions.
Zusammenfassung
Es wird über 7 Autopsiefälle von intramedullären Metastasen, davon 4 im Halsmark, berichtet und ein Überblick des Schrifttums gegeben. Während Bronchus- und Mammakarzinome, maligne Melanome und Lymphome die häufigsten Primärgeschwülste darstellen sollen, lagen in dieser Serie 3 Mammakarzinome und je 2 Kolon- und Haferzellkarzinome des Bronchus vor. Weder der klinische Verlauf noch die neurologische Symptomatik gestatten eine eindeutige Abgrenzung gegenüber den häufigeren extraduralen Metastasen, doch lagen röntgenologisch faßbare Wirbelmetastasen und positive Myelographie nur je einmal vor; die Liquorzytologie war negativ. Intramedulläre Metastasen unserer Serie waren weder mit extraduralen Absiedelungen noch mit Befall des Subarachnoidalraumes, in 4 Fällen aber mit Hirnmetastasen verbunden. Das spricht eher für ihre hämatogene Entstehung als ein direktes transdurales oder perineurales Einwachsen des Tumors.
Article PDF
Similar content being viewed by others
Avoid common mistakes on your manuscript.
References
Amyot, R., Laurin, P. E.: Contribution à lètude de la paraplégie des cancers. Presse méd. 47, 978–980 (1939)
Barron, K. D., Hirano, A., Araki, S., Terry, R. D.: Experiences with metastatic neoplasms involving the spinal cord. Neurology (Minneap.) 9, 91–106 (1959)
Batson, V. O.: The role of the vertebral veins in metastatic processes. Ann. int. Med. 16, 38–45 (1942)
Bouchard, J.: Spinal cord tumors and other lesions. In: Textbook of radiotherapy, G. H. Flechter, eds., pp. 294–296. Philadelphia: Lea & Febinger 1966
Bunn, P. A., Jr., Schein, P. S., Banks, P. M., De Vita, V. T., Jr.: Central nervous system complications in patients with diffuse histiocytic and undifferentiated lymphoma/leukemia revisited. Blood 47, 3–10 (1976)
Burger, P. C., Vogel, F. S.: Surgical pathology of the nervous system and its coverings, p. 530. New York-London-Sidney-Toronto: Wiley 1976
Cashion, E. L., Young, J. M.: Intramedullary spinal metastasis. Sth. med. J. 66, 1296–1297 (1973)
Chade, H. O.: Metastatic tumors of the spine and spinal cord. In: Handbook of clinical neurology, P. J. Vinken, G. W. Bruyn, eds., Vol. 20, pp. 415–433. Amsterdam: North Holland 1976
Chason, J. L., Walker, F. B., Landers, J. W.: Metastatic carcinoma in the central nervous system and dorsal root ganglia. A prospective autopsy study. Cancer 16, 781–787 (1963)
Constans, J.-P., Schlienger, M., Roujeau, J., Peretmere, C., Askienazy, S.: A propos d'une série de 134 cas de métastases intra-rachidiennes de l'adulte avec complications neurologiques. Sem. Hôp. Paris 48, 3611–3622 (1973)
Edelson, R. N., Deck, M. D. F., Posner, J. B.: Intramedullary spinal cord metastases. Neurology (Minneap.) 22, 1222–1231 (1972)
Elsberg, C. A.: Surgical diseases of the spinal cord, membranes and nerve roots; symptoms, diagnosis and treatment, pp. 365–404. New York: Hoeber 1941
Gilbert, R. W., Kim, J.-H., Posner, J. B.: Epidural spinal cord compression from metastatic tumor: diagnosis and treatment. Ann. Neurol. 3, 40–51 (1978)
Griffin, J. W., Thompson, R. W., Mitchinson, J. M., Kiewief, J., Welland, F. H.: Lymphomatous leptomeningitis. Amer. J. Med. 51, 200–208 (1971)
Guidetti, B., Fortuna, A.: Differential diagnosis of intramedullary and extramedullary tumors. In: Handbook of clinical neurology, P. J. Vinken, G. W. Bruyn, eds., Vol. 19, pp. 51–75. Amsterdam: North Holland 1975
Haymaker, W.: Bing's local diagnosis in neurological diseases, 15th ed., p. 92. St. Louis: Mosby 1969
Ishijima, Y.: Intramedullary spinal cord metastases from stomach cancer. Brain Nerve (Tokyo) 25, 63–68 (1973)
Jänisch, W., Güthert, H., Schreiber, D.: Pathologie der Tumoren des Zentralnervensystems. Jena: VEB Fischer 1976
Jellinger, K.: Traumatic vascular disease of the spinal cord. In: Handbook of clinical neurology, P. J. Vinken, G. W. Bruyn, eds., Vol. 12, pp. 556–630. Amsterdam: North Holland 1972
Jellinger, K.: Unpublished data
Jellinger, K., Radaszkiewicz, T.: Involvement of the central nervous system in malignant lymphomas. Virchows Arch. Abt. A. Path. Anat. Histol. 370, 345–362 (1976)
Kawakami, Y., Mair, G. W. P.: Haemoatomyelia due to secondary renal carcinoma. Acta neuropath. (Berl.) 26, 85–92 (1973)
Kepes, J. J., Reynard, J. D.: Infarction of spinal cord and medulla oblongata caused by fibrocartilaginous emboli. Virchows Arch. Abt. A. Path. Anat. Histol. 361, 185–193 (1973)
Meyer, P. C., Reah, T. G.: Secondary neoplasms of the central nervous system and meninges. Brit. J. Cancer 7, 438–448 (1953)
Morariu, M. A., Serban, M.: Intramedullary cervical cord metastasis from a nasopharynx carcinoma. Europ. Neurol. 11, 317–321 (1974)
Olson, M. E., Chernik, N. L., Posner, J. B.: Infiltration of the leptomeninges by systemic cancer. A clinical and pathologic study. Arch. Neurol. (Chic.) 30, 122–137 (1974)
Péquignot, H., Grivaux, M., Bonduelle, M., Delavierre, P., Najman, A.: Métastases médullaires simulant un syndrome neurologique para-néoplasique au cours d'un cancer bronchique méconnu à petites cellules. Sem. Hôp. Paris 47, 1139–1141 (1971)
Price, R. A., Johnson, W. W.: The central nervous system in childhood leukemia. I. The arachnoid. Cancer 31, 520–533 (1973)
Rubinstein, L. J.: Tumors of the central nervous system. Atlas of tumor pathology, 2nd ed., Fasc. 6. Washington, D. C.: Armed Forces Institute of Pathology 1972
Sadelkow, P.: Ein Fall von röhrenförmiger Rückenmarksblutung auf der Basis einer intramedullären Karzinommetastase. Dtsch. Z. Nervenheilk. 63, 275–285 (1919)
Sloof, J. L., Kernohan, J. W., MacCarty, G. S.: Primary intramedullary tumors of the spinal cord and filum terminale, p. 181. Philadelphia: Saunders 1964
Strang, R. R.: Metastatic tumor of the cervical spinal cord. Med. J. Austr. 1, 205–206 (1962)
Wilson, G., Rupp, C.: Spinal cord lesions associated with metastatic tumors. Trans. Amer. Neurol. Assn. 72, 125–127 (1947)
Zülch, K. J.: Mangeldurchblutung an den Grenzzonen zweier Gefäßgebiete als Ursache bisher ungeklärter Rückenmarksschädigungen. Dtsch. Z. Nervenheilk. 172, 81–102 (1954)
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Jellinger, K., Kothbauer, P., Sunder-Plassmann, E. et al. Intramedullary spinal cord metastases. J. Neurol. 220, 31–41 (1979). https://doi.org/10.1007/BF00313146
Received:
Issue Date:
DOI: https://doi.org/10.1007/BF00313146