Clinical Analysis Of 3 Cases Of Intramedullary Spinal Cord Metastases

Objective:Intramedullary spinal cord metastases(ISCM)is a rare metastatic tumor of the nervous system.Due to the lack of specificity,it is often misdiagnosed and mistreated in clinical practice.In order to improve the understanding of the disease and provide the diagnosis and treatment ideas of ISCM for clinical oncologists,we analyzes the diagnosis and treatment process of 3 cases of ISCM patients and reviews related literature at home and abroad.Methods:We retrospectively analyzed the diagnosis and treatment process of 3 cases of ISCM patients admitted to the first hospital of Shanxi Medical University and People's Hospital of Shanxi Province between 2015 to 2018.Meanwhile we reviewed the relevant literature at home and abroad to discuss the epidemiology,clinical manifestations,diagnosis,treatment and prognosis of ISCM.Results:In three cases,that primary tumor in patients was 2 cases of small cell lung cancer and 1 case of esophageal low differentiation of squamous cell carcinoma.One case was a single metastasis and 2 cases were multiple.Two patients had multiple brain metastases.The time from the diagnosis of primary tumor to the occurrence of brain metastasis averaged 5.5 months(2 and 9 months,respectively).The median time for spinal cord metastasis was 10 months(average 14.7 months).The clinical manifestations are lowback pain,limb movement and sensory dysfunction,defecation dysfunction and so on.Radiotherapy was given to all 3 patients,and back pain and lower limb muscle strength were improved in 2 patients after radiotherapy.It was found that 1 case was lost after 7months of follow-up and 1 case survived for 4 months,and 1 patient survived only 19 days due to poor overall condition.Conclusion:1.Patients with a history of malignancy should be alert to the possibility of ISCM when a rapidly progressing neurological condition occurs.2.ISCM is now mainly diagnosed by MRI examination of the spinal cord or general PET examination.3.Once the diagnosis of ISCM is clear,patients can be treated with radiotherapy as soon as possible with or without adjuvant therapy,or the quality of life and prolonged survival of patients can be improved.