Low urgency
-Very severe
It is an increase in marrow pressure due to the uncontrolled growth of malignant cells that cause an expansive effect (mass effect).
It can be caused by a primary tumor that begins in the medullary tissue, or by a secondary tumor spread from another site (metastasis). The most frequent secondary tumors come from breast, prostate and lung.
It generally causes back pain, altered sensation (loss of touch or sensation of hot/cold), altered mobility and/or sphincter incontinence.
It is diagnosed by clinical questioning and physical examination. It is confirmed by cerebrospinal fluid puncture and imaging tests.
Treatment is aimed at reducing spinal cord pressure; corticosteroids, radiotherapy and surgery are used.
- David Schiff, MD. Clinical features and diagnosis of neoplastic epidural spinal cord compression, including cauda equina syndrome. UpToDate. Nov 09, 2015.
- David Schiff, MD. Paul Brown, MD. Mark Edwin Shaffrey, MD. Treatment and prognosis of neoplastic epidural spinal cord compression, including cauda equina syndrome. UpToDate. Aug 15, 2016.
- Mak KS, Lee LK, Mak RH, et al. Incidence and treatment patterns in hospitalizations for malignant spinal cord compression in the United States, 1998-2006. Int J Radiat Oncol Biol Phys 2011; 80:824.
- Cole JS, Patchell RA. Metastatic epidural spinal cord compression. Lancet Neurol 2008; 7:459.
Dr. Sara Vitoria
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