Intramedullary spinal cord metastases in breast cancer discovered on fluorodeoxyglucose-positron emission tomography-computed tomography
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Abstract
Breast cancer ranks among the most prevalent solid tumors that may metastasize to multiple sites but less commonly to intramedullary spinal cord metastases. It represents perhaps the rarest form of central nervous system involvement stemming from breast cancer, with only sporadic cases documented in the literature. We represent a case of a female patient with right breast cancer treated, then was lost of sight, she presented after 8 months with worsening general condition. Fluorine-18 fluorodeoxyglucose (18F-FDG) PET/CT revealed a pathological hypermetabolic mass in the right breast associated with multiple intramedullary pathological hypermetabolic foci were found disseminated over the spinal cord of the cervical, dorsal, and lumbar spine. Breast cancer is the second most prevalent primary tumor causing this type of metastasis, following lung cancer. 18F-FDG PET/CT is currently the primary imaging technique for whole-body screening for metastases, and thus can ideally detect most sites of metastasis, including those within the spine. Several studies have demonstrated that PET/CT combines the high sensitivity of PET for detection with the accurate anatomical localization provided by CT. In specific contexts, such as instances of contraindication to MRI, PET may serve as an alternative for assessing intramedullary spinal cord metastases.
Keywords: 18F-FDG PET/CTintramedullary spinal cord metastasesbreast cancer
References
- Engstrøm MJ, Opdahl S, Vatten LJ, et al. Invasive lobular breast cancer: the prognostic impact of histopathological grade, E-cadherin and molecular subtypes. Histopathology. 2015; 66(3): 409–419.
- Lee SS, Kim MK, Sym SJ, et al. Intramedullary spinal cord metastases: a single-institution experience. J Neurooncol. 2007; 84(1): 85–89.
- BARRON KD, HIRANO A, ARAKI S, et al. Experiences with metastatic neoplasms involving the spinal cord. Neurology. 1959; 9(2): 91–106.
- Kalayci M, Cağavi F, Gül S, et al. Intramedullary spinal cord metastases: diagnosis and treatment - an illustrated review. Acta Neurochir (Wien). 2004; 146(12): 1347–54; discussion 1354.
- Kosmas C, Malamos NA, Stefanou S, et al. Intramedullary spinal cord metastases in breast carcinoma: report of two cases and review of the literature. J Chemother. 2002; 14(6): 631–634.
- Amin R. Intramedullary spinal metastasis from carcinoma of the cervix. Br J Radiol. 1999; 72(853): 89–91.
- Mostardi PM, Diehn FE, Rykken JB, et al. Intramedullary spinal cord metastases: visibility on PET and correlation with MRI features. AJNR Am J Neuroradiol. 2014; 35(1): 196–201.
- Kosmas C, Koumpou M, Nikolaou M, et al. Intramedullary spinal cord metastases in breast cancer: report of four cases and review of the literature. J Neurooncol. 2005; 71(1): 67–72.
- Dam-Hieu P, Seizeur R, Mineo JF, et al. Retrospective study of 19 patients with intramedullary spinal cord metastasis. Clin Neurol Neurosurg. 2009; 111(1): 10–17.
- Zheng F, Wanjun X, Shuaishuai W, et al. Diagnostic value of F-FDG PET/CT and MRI for intraspinal lesions: A comparative study. Med Int (Lond). 2021; 1(5): 23.
- Almuhaideb A, Papathanasiou N, Bomanji J. 18F-FDG PET/CT imaging in oncology. Ann Saudi Med. 2011; 31(1): 3–13.
- Aiello D, Mazzola R, Gregucci F, et al. Surprising complete response of intramedullary spinal cord metastasis from breast cancer: a case report and literature review. Tumori. 2017; 103(Suppl. 1): e28–e30.
- Scalia G, Costanzo R, Viola A, et al. Intramedullary Spinal Cord Metastases from Breast Cancer: A Systematic Review. Anticancer Res. 2023; 43(2): 523–535.