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Intramedullary spinal cord metastases in breast cancer: report of four
cases and review of the literature Christos Kosmas,
Maria Koumpou, Maria Nikolaou, John Katselis,
Georgia Soukouli, Nina Markoutsaki,
Vassiliki Kostopoulou, Assimina Gaglia,
Nikolaos Mylonakis, Athanassios Karabelis
and Dimitrios Pectasides
Second Department of Medical Oncology,
'Metaxa'
Cancer Hospital, Piraeus, Greece [C.K., M.K., M.N., J.K., G.S., N.Ma.,
V.K., A.G., N.My., A.K., D.P.].
2nd Department of Medical Oncology, 'Metaxa'
Cancer Hospital, GR-16341, 21 Apolloniou Street, Athens, Greece
[C.K.].
Correspondence to: Christos Kosmas,
Email: ckosm@ath.forthnet.gr, Phone: +30-1-991-8301, Fax:
+30-1-996-2917.
Intramedullary spinal cord metastases (ISCM) are usually the result
of rapidly progressing systemic cancer.
Breast cancer represents one
of the most common solid tumors associated with the development of
ISCM at rather advanced stages of disease.
In the present report we
describe four new cases with advanced breast cancer developing ISCM.
All cases presented herein indicated that ISCM is a late manifestation
of disseminated breast cancer.
Three of these patients had been
treated for approximately 1–3 years for metastatic disease.
Once
ISCM developed, concurrent asymptomatic brain metastases were detected
in one case, concurrent symptomatic brain disease (cerebellar) was
present at the time of cervical ISCM diagnosis in another patient, and
in another case, ISCM developed metachronously at 18 months after the
diagnosis of symptomatic brain metastases treated by whole brain
radiotherapy.
One of these cases had brain metastases at presentation,
while at relapse developed leptomeningeal carcinomatosis treated
successfully, but followed shortly, as a terminal event, by ISCM and
parenchymal brain recurrence.
All but one patient experienced a rather
rapidly evolving disease course leading to death after 2–5 months
from widespread neuraxis dissemination of their cancer, while one
patient is still alive 6 months after the diagnosis of ISCM.
All four
cases, added to the list of the anecdotally reported cases of ISCM
after breast cancer, undermine the ominous prognosis and limited
treatment options available for this disease manifestation, and an
extensive literature review and discussion of similar cases is
provided.
Keywords: breast
cancer - carcinomatous meningitis - docetaxel - intramedullary
spinal cord metastases - paclitaxel - taxanes
© Springer 2005
Source: http://springerlink.metapress.com/openurl.asp?genre=article&eissn=1573-7373&volume=71&issue=1&spage=67
DOI: http://dx.doi.org/10.1007/s11060-004-9177-z
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