Intramedullary spinal cord metastases: diagnosis and treatment - an illustrated review.

Background: Intramedullary spinal cord metastases (ISCM) are rare but, with increasing use of magnetic resonance imaging (MRI) are being encountered with increasing frequency. Optimum treatment remains controversial. On the basis of a review of previous reports and experience with a patient with an ISCM from a large cell lung cancer, we propose practical diagnostic and therapeutic approaches.

Findings: We found 284 patients who had an Intramedullary spinal cord metastasis reported in English literature up to February 2004. 32 had been treated surgically. The mean survival in these patients was two times longer than in those treated by a conservative approach. Improvement and prolonged survival occurred in patient we treated by microsurgical dissection of the metastasis.

Conclusion: Early diagnosis and early surgical resection can result in improvement in neurological deficits and in the quality of life of patients with a Intramedullary spinal cord metastasis.