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Metastatic spinal cord compression: the hidden danger

Nature Clinical Practice Oncology volume 3, pages 458–461 (2006)Cite this article

Abstract

Background A 47-year-old male underwent resection of a left-shoulder melanoma in 1997. In November 2004 he was found to have multiple brain lesions and adrenal, lung, and bone metastases, and in January 2005 underwent resection of his symptomatic right parietal lobe lesion and subsequent whole-brain radiation. In February 2005 he experienced headaches and word-finding difficulty and was found to have four progressive brain lesions on MRI. These were resistant to conventional radiotherapy and were treated with stereotactic radiosurgery. The patient later developed an obstruction of the jejunum and underwent resection of multiple abdominal masses. In April 2005, the patient commenced temozolomide and underwent radiation therapy to the left arm for pain thought to be caused by an increase in size of his melanoma metastasis. In August 2005 the patient reported persistent and worsening arm pain, despite a further course of radiotherapy in June 2005.

Investigations Physical examination including a thorough neurological examination, radiography, X-ray, CT scan, and MRI.

Diagnosis Metastatic melanoma to the cervical spine (C7 vertebra) with spinal cord compression.

Management Involved field radiotherapy, temozolomide, opioids, gabapentin, corticosteroids, and Cyberknife® therapy.

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Figure 1: X-ray of the patient's left arm.
Figure 2: MRI of the patient's cervical spine.

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Author information

Authors and Affiliations

  1. Cancer Institute and Brigham and Women's Hospital, Boston, MA, USA

    Kathy Selvaggi & Janet Abrahm

  2. Associate Professor of Medicine at Harvard Medical School, Boston, MA, USA

    Kathy Selvaggi & Janet Abrahm

  3. Advisory Board member of Nature Clinical Practice Oncology,

    Kathy Selvaggi & Janet Abrahm

Authors
  1. Kathy Selvaggi
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  2. Janet Abrahm
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Correspondence to Janet Abrahm.

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The authors declare no competing financial interests.

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Selvaggi, K., Abrahm, J. Metastatic spinal cord compression: the hidden danger. Nat Rev Clin Oncol 3, 458–461 (2006). https://doi.org/10.1038/ncponc0561

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