474P Clinical features of intradural extramedullary spinal cord metastases in primary lung cancer

Abstract

Background Intradural extramedullary spinal cord metastases in lung cancer is rare, and it leads to severe neurological damage. The purpose of this study was to identify the clinical features of intradural extramedullary spinal cord metastases in primary lung cancer patients. Methods 8 cases of lung cancer with intradural extramedullary metastases, who were hospitalized in Peking Union Medical College Hospital (PUMCH) during May, 2013 to May, 2016, wereenrolled in the retrospective study. Medical charts of the 8 patients were reviewed systematically. Results Intradural extramedullary spinal cord metastases was diagnosed in 7 cases with non-small cell lung cancer (NSCLC) and 1 case with small cell lung cancer (SCLC). Cauda equina syndrome was the most common clinical manifestation. Malignant cells in cerebrospinal fluid were positive in all the 5 cases (100%) who underwent lumbar puncture. Contrast-enhanced magnetic resonance imaging (MRI) of spine manifested as diffuse abnormal enhancement of pial lining of spinal cord in 3 cases, intradural extramedullary nodules in 4 cases, and both of themin 1 case. Neurological symptoms were improved or stable in 4 cases who underwent targeted therapy and/or radiotherapy. The median overall survival was 5.8 months (95%CI, 1.9-9.6m). Table: Clinical characteristics and treatment outcomes of patients with intradural extramedullary spinal metastasis Conclusions Intradural extramedullary spinal cord metastases canbe diagnosed with caution according to its neurological symptoms and contrast-enhanced MRI presentation. Targeted therapy and/or radiotherapy may be effectivefor symptoms control. Legal entity responsible for the study Peking Union Medical College Hospital Funding N/A Disclosure All authors have declared no conflicts of interest.