Open AccessPerineural invasion in intramedullary spinal cord metastasis
Author(s) -
Nithish Jayakumar,
Houssam Ismail,
Saima Athar,
Neil Ashwood
Publication year - 2020
Publication title -
annals of the royal college of surgeons of england
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.39
H-Index - 63
eISSN - 1478-7083
pISSN - 0035-8843
DOI - 10.1308/rcsann.2020.0009
Subject(s) - medicine , intramedullary rod , spinal cord , brachial plexus , metastasis , cord , surgery , magnetic resonance imaging , spinal cord neoplasm , lesion , cancer , radiology , psychiatry
A woman in her late sixties was referred to the orthopaedic clinic with progressive lower limb weakness and gait disturbance. She was known to have breast cancer with pre-existing infiltrative disease in the left brachial plexus. Magnetic resonance imaging of the spine revealed an intramedullary spinal cord metastasis in the lower cervical cord at C6-C7. She underwent surgical excision but died within six weeks of surgery. This rare case of an intramedullary spinal cord metastasis highlights the extremely poor prognosis in this condition as well as the possibility of perineural invasion into the spinal cord from the brachial plexus lesion. A detailed discussion of the literature on intramedullary spinal cord metastases is also presented.