A Rarely Seen Pathology "Intramedullary Spinal Metastasis"; Clinical Series of Five Patients in a Single Institution

Objective: Our study is related to our experiences with intramedullary spinal cord metastasis (ISCM). The purpose of the present study was to evaluate the clinical features, treatment, and natural course of patients in the context of the literature. Methods: Five patients with ISCM who were admitted to the neurosurgery department between October 2011 and December 2016 and who underwent surgery were identified. Relevant clinical data were obtained. Results: Of the five patients, three had lung cancer, one had breast cancer, and one had renal cell carcinoma. The presenting symptoms were pain, urinary incontinence, and/or weakness. Tumors were at the thoracic level in three patients, cervical level in one patient, and thoracolumbar level in one patient. One patient with lung cancer had undergone metastasectomy for intracranial metastasis. The pathological examination of one patient had been reported as anaplastic ependymoma in a previous health facility, but breast cancer metastasis was found to be the primary diagnosis following the examination of the material obtained from the excision of the relapsed tumor. Conclusion: The diagnosis of ISCM is difficult, and treatment is usually ineffective. Although there is no exact treatment modality in ISCM, appropriate surgery positively affects morbidity and mortality. Planning the right treatment for the right patient is the most important step of ISCM management.