Skip to main content
Top

11-03-2025 | Metastasis | Review Article

Cervical intramedullary spinal cord metastasis from colon cancer: a systematic review and report of an illustrative case

Authors: Nicola Montemurro, Tamara Ius, Valerio Ortenzi, Francesco Pasqualetti, Francesco Acerbi

Published in: Neurological Sciences

Login to get access

Abstract

Background

Intramedullary spinal cord metastasis (ISCM) is rare and affects 0.9–2.1% of all cancer patients. Colorectal cancer accounts for about 3% of all ISCMs.

Methods

A systematic review of the literature in the most common electronic database (PubMed, Ovid MEDLINE and Ovid EMBASE) on cervical ISCM from colon cancer, according with “PRISMA statement” criteria, was done. In addition, we present a 76-year-old man with progressive paraparesis and negative anamnesis for primary tumors, who underwent surgical and complete resection of a C5-C6 intramedullary spinal cord colon metastasis.

Results

From a systematic review of the literature, only 8 previous cases of cervical ISCM from colon cancer were reported. The mean age at presentation was 68.3 years. Surgery was performed in 6 patients, including our case, whereas 1 patient was treated with radiotherapy and two patients were untreated. Survival time ranges from 2 weeks to 14 months (mean 3.8 months). The survival rates at 60 days and 120 days are 50% and 12.5%, respectively.

Conclusion

Cervical ISCM from colon cancer is rare and is usually detected at an advanced stage of primary tumor disease. The prognosis is poor and definitive recommendations cannot be made due to the lack of controlled comparative clinical studies.
Literature
1.
go back to reference Tsai TH, Lin IC, Lin PC et al (2016) Intramedullary spinal cord metastasis from colon cancer: analysis of 19 reported cases. Spinal Cord Ser Cases 2:15026CrossRefPubMedPubMedCentral Tsai TH, Lin IC, Lin PC et al (2016) Intramedullary spinal cord metastasis from colon cancer: analysis of 19 reported cases. Spinal Cord Ser Cases 2:15026CrossRefPubMedPubMedCentral
3.
go back to reference Grasso G, Meli F, Patti R, Giambartino F, Florena AM, Iacopino DG (2007) Intramedullary spinal cord tumor presenting as the initial manifestation of metastatic colon cancer: case report and review of the literature. Spinal Cord 45(12):793–796CrossRefPubMed Grasso G, Meli F, Patti R, Giambartino F, Florena AM, Iacopino DG (2007) Intramedullary spinal cord tumor presenting as the initial manifestation of metastatic colon cancer: case report and review of the literature. Spinal Cord 45(12):793–796CrossRefPubMed
4.
go back to reference Visocchi M, La Rocca G, D’Ercole M et al (2016) Isolated intramedullary cervical spinal cord metastasis from colon cancer: a surgical or medical challenge? J Neurosurg Sci 60(3):405–407PubMed Visocchi M, La Rocca G, D’Ercole M et al (2016) Isolated intramedullary cervical spinal cord metastasis from colon cancer: a surgical or medical challenge? J Neurosurg Sci 60(3):405–407PubMed
5.
go back to reference Skrap B, Tramontano V, Faccioli F et al (2021) Surgery for intramedullary spinal cord ependymomas in the neuromonitoring era: results from a consecutive series of 100 patients. J Neurosurg Spine 36(5):858–868CrossRefPubMed Skrap B, Tramontano V, Faccioli F et al (2021) Surgery for intramedullary spinal cord ependymomas in the neuromonitoring era: results from a consecutive series of 100 patients. J Neurosurg Spine 36(5):858–868CrossRefPubMed
6.
go back to reference Page MJ, McKenzie JE, Bossuyt PM et al (2021) The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ 29:372:n71CrossRef Page MJ, McKenzie JE, Bossuyt PM et al (2021) The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ 29:372:n71CrossRef
7.
8.
go back to reference Jellinger K, Kothbauer P, Sunder-Plassmann E, Weiss R (1979) Intramedullary spinal cord metastases. J Neurol 220(1):31–41CrossRefPubMed Jellinger K, Kothbauer P, Sunder-Plassmann E, Weiss R (1979) Intramedullary spinal cord metastases. J Neurol 220(1):31–41CrossRefPubMed
9.
go back to reference Kaballo MA, Brennan DD, El Bassiouni M, Skehan SJ, Gupta RK (2011) Intramedullary spinal cord metastasis from colonic carcinoma presenting as Brown-Séquard syndrome: a case report. J Med Case Rep 5:342CrossRefPubMedPubMedCentral Kaballo MA, Brennan DD, El Bassiouni M, Skehan SJ, Gupta RK (2011) Intramedullary spinal cord metastasis from colonic carcinoma presenting as Brown-Séquard syndrome: a case report. J Med Case Rep 5:342CrossRefPubMedPubMedCentral
10.
go back to reference Lunardi P, Corinaldesi R, Lunardi T, Floris R (2014) Solitary intramedullary spinal cord metastasis from Colon carcinoma: A case report and literature review. Open J Mod Neurosurg 4(1):47–51CrossRef Lunardi P, Corinaldesi R, Lunardi T, Floris R (2014) Solitary intramedullary spinal cord metastasis from Colon carcinoma: A case report and literature review. Open J Mod Neurosurg 4(1):47–51CrossRef
11.
go back to reference Ogino M, Ueda R, Nakatsukasa M, Murase I (2002) Successful removal of solitary intramedullary spinal cord metastasis from colon cancer. Clin Neurol Neurosurg 104(2):152–156CrossRefPubMed Ogino M, Ueda R, Nakatsukasa M, Murase I (2002) Successful removal of solitary intramedullary spinal cord metastasis from colon cancer. Clin Neurol Neurosurg 104(2):152–156CrossRefPubMed
12.
go back to reference Silva YJ, McSwain B (1967) Intramedullary spinal cord metastasis: the sole clinical manifestation of an adenocarcinoma of the colon. Can J Surg 10(3):341–344PubMed Silva YJ, McSwain B (1967) Intramedullary spinal cord metastasis: the sole clinical manifestation of an adenocarcinoma of the colon. Can J Surg 10(3):341–344PubMed
13.
go back to reference Vassiliou V, Papamichael D, Polyviou P, Koukouma A, Andreopoulos D (2012) Intramedullary spinal cord metastasis in a patient with colon cancer: a case report. J Gastrointest Cancer 43(2):370–372CrossRefPubMed Vassiliou V, Papamichael D, Polyviou P, Koukouma A, Andreopoulos D (2012) Intramedullary spinal cord metastasis in a patient with colon cancer: a case report. J Gastrointest Cancer 43(2):370–372CrossRefPubMed
14.
go back to reference Kumar R, Banerjee S (2014) Management and functional outcome of intramedullary spinal cord tumors: A prospective clinical study. Asian J Neurosurg 9(4):177–181CrossRefPubMedPubMedCentral Kumar R, Banerjee S (2014) Management and functional outcome of intramedullary spinal cord tumors: A prospective clinical study. Asian J Neurosurg 9(4):177–181CrossRefPubMedPubMedCentral
15.
go back to reference Woodworth GF, Chaichana KL, McGirt MJ, Witham TF et al (2007) Predictors of ambulatory function after surgical resection of intramedullary spinal cord tumors. Neurosurgery 61(1):99–105CrossRefPubMed Woodworth GF, Chaichana KL, McGirt MJ, Witham TF et al (2007) Predictors of ambulatory function after surgical resection of intramedullary spinal cord tumors. Neurosurgery 61(1):99–105CrossRefPubMed
16.
go back to reference Benes V 3rd., Barsa P, Benes VJ, Suchomel P (2009) Prognostic factors in intramedullary astrocytomas: a literature review. Eur Spine J 18(10):1397–1422 Benes V 3rd., Barsa P, Benes VJ, Suchomel P (2009) Prognostic factors in intramedullary astrocytomas: a literature review. Eur Spine J 18(10):1397–1422
17.
go back to reference Schellinger KA, Propp JM, Villano JL, McCarthy BJ (2008) Descriptive epidemiology of primary spinal cord tumors. J Neurooncol 87(2):173–179CrossRefPubMed Schellinger KA, Propp JM, Villano JL, McCarthy BJ (2008) Descriptive epidemiology of primary spinal cord tumors. J Neurooncol 87(2):173–179CrossRefPubMed
18.
go back to reference Islam MA, Afreen MS, Montemurro N, Chaurasia B (2021) Surgical approach for spinal tumors: our experience in combined military hospital Dhaka. Surgeries 2(3):303–307CrossRef Islam MA, Afreen MS, Montemurro N, Chaurasia B (2021) Surgical approach for spinal tumors: our experience in combined military hospital Dhaka. Surgeries 2(3):303–307CrossRef
19.
go back to reference Perrini P, Di Carlo DT, Montemurro N, Benedetto N, Ortenzi V, Naccarato AG (2020) Microsurgical resection of cervical intradural juxtamedullary solitary fibrous tumor: 2-Dimensional operative video. Oper Neurosurg (Hagerstown) 19(5):E532CrossRefPubMed Perrini P, Di Carlo DT, Montemurro N, Benedetto N, Ortenzi V, Naccarato AG (2020) Microsurgical resection of cervical intradural juxtamedullary solitary fibrous tumor: 2-Dimensional operative video. Oper Neurosurg (Hagerstown) 19(5):E532CrossRefPubMed
20.
go back to reference Acerbi F, Cavallo C, Schebesch KM et al (2017) Fluorescein-Guided resection of intramedullary spinal cord tumors: results from a preliminary, multicentric, retrospective study. World Neurosurg 108:603–609CrossRefPubMed Acerbi F, Cavallo C, Schebesch KM et al (2017) Fluorescein-Guided resection of intramedullary spinal cord tumors: results from a preliminary, multicentric, retrospective study. World Neurosurg 108:603–609CrossRefPubMed
21.
go back to reference Eicker SO, Floeth FW, Kamp M, Steiger HJ, Hänggi D (2013) The impact of fluorescence guidance on spinal intradural tumour surgery. Eur Spine J 22(6):1394–1401CrossRefPubMedPubMedCentral Eicker SO, Floeth FW, Kamp M, Steiger HJ, Hänggi D (2013) The impact of fluorescence guidance on spinal intradural tumour surgery. Eur Spine J 22(6):1394–1401CrossRefPubMedPubMedCentral
22.
go back to reference Sala F, Manganotti P, Tramontano V, Bricolo A, Gerosa M (2007) Monitoring of motor pathways during brain stem surgery: what we have achieved and what we still miss? Neurophysiol Clin 37(6):399–406CrossRefPubMed Sala F, Manganotti P, Tramontano V, Bricolo A, Gerosa M (2007) Monitoring of motor pathways during brain stem surgery: what we have achieved and what we still miss? Neurophysiol Clin 37(6):399–406CrossRefPubMed
23.
go back to reference Harel R, Angelov L (2010) Spine metastases: current treatments and future directions. Eur J Cancer 46(15):2696–2707CrossRefPubMed Harel R, Angelov L (2010) Spine metastases: current treatments and future directions. Eur J Cancer 46(15):2696–2707CrossRefPubMed
24.
go back to reference Tropeano MP, Rossini Z, Franzini A et al (2023) Multimodal intraoperative neurophysiological monitoring in intramedullary spinal cord tumors: A 10-Year single center experience. Cancers (Basel) 16(1):111CrossRefPubMed Tropeano MP, Rossini Z, Franzini A et al (2023) Multimodal intraoperative neurophysiological monitoring in intramedullary spinal cord tumors: A 10-Year single center experience. Cancers (Basel) 16(1):111CrossRefPubMed
25.
go back to reference Bujold A (2015) Impact of systemic therapy on spinal metastases in patients with colorectal cancer. J Clin Oncol. 33(15_suppl):15–20. Bujold A (2015) Impact of systemic therapy on spinal metastases in patients with colorectal cancer. J Clin Oncol. 33(15_suppl):15–20.
26.
go back to reference Van Cutsem E, Cervantes A, Adam R et al (2016) ESMO consensus guidelines for the management of patients with metastatic colorectal cancer. Ann Oncol 27(8):1386–1422CrossRefPubMed Van Cutsem E, Cervantes A, Adam R et al (2016) ESMO consensus guidelines for the management of patients with metastatic colorectal cancer. Ann Oncol 27(8):1386–1422CrossRefPubMed
27.
go back to reference Grothey A, Van Cutsem E, Sobrero A et al (2013) Regorafenib monotherapy for previously treated metastatic colorectal cancer (CORRECT): an international, multicentre, randomised, placebo-controlled, phase 3 trial. Lancet 381(9863):303–312CrossRefPubMed Grothey A, Van Cutsem E, Sobrero A et al (2013) Regorafenib monotherapy for previously treated metastatic colorectal cancer (CORRECT): an international, multicentre, randomised, placebo-controlled, phase 3 trial. Lancet 381(9863):303–312CrossRefPubMed
Metadata
Title
Cervical intramedullary spinal cord metastasis from colon cancer: a systematic review and report of an illustrative case
Authors
Nicola Montemurro
Tamara Ius
Valerio Ortenzi
Francesco Pasqualetti
Francesco Acerbi
Publication date
11-03-2025
Publisher
Springer International Publishing
Published in
Neurological Sciences
Print ISSN: 1590-1874
Electronic ISSN: 1590-3478
DOI
https://doi.org/10.1007/s10072-025-08084-z

Keynote series | Spotlight on menopause

Menopause can have a significant impact on the body, with effects ranging beyond the endocrine and reproductive systems. Learn about the systemic effects of menopause, so you can help patients in your clinics through the transition.   

Prof. Martha Hickey
Dr. Claudia Barth
Dr. Samar El Khoudary
Developed by: Springer Medicine
Watch now
Video

Advances in Alzheimer's

Alzheimer's research and care is changing rapidly. Keep up with the latest developments from key international conferences, together with expert insights on how to integrate these advances into practice.

This content is intended for healthcare professionals outside of the UK.

Supported by:
  • Lilly
Developed by: Springer Healthcare IME
Learn more