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

BackgroundIntramedullary 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.MethodsA 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.ResultsFrom 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.ConclusionCervical 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.