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Review
. 2018 Aug;36(3):579-598.
doi: 10.1016/j.ncl.2018.04.011. Epub 2018 Jun 15.

Metastatic Complications of Cancer Involving the Central and Peripheral Nervous Systems

Joe S Mendez  1 , Lisa M DeAngelis  2
Affiliations
Review

Metastatic Complications of Cancer Involving the Central and Peripheral Nervous Systems

Joe S Mendez et al. Neurol Clin. 2018 Aug.

Abstract

Neurologic complications of cancer may involve both the central nervous system and peripheral nervous system manifesting as brain, leptomeningeal, intramedullary, intradural, epidural, plexus, and skull base metastases. Excluding brain involvement, neurologic complications affecting these other sites are relatively infrequent, but collectively they affect more than 25% of patients with metastatic cancer causing significant morbidity and mortality. Early diagnosis and intervention optimize quality of life and improve survival.

Keywords: CNS; Cancer; Epidural cord compression; Leptomeningeal; Neurologic complications; PNS; Skull base and nerve plexuses.

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Conflict of interest statement

Dr. Joe Mendez has no conflict of interest

Dr. Lisa DeAngelis has no conflict of interest

Figures

Figure 1
Figure 1. Leptomeningeal Metastases
(A) Metastatic breast cancer with leptomeningeal disease lining the cerebellar folia on axial, T1 post-contrast imaging. (B) Leptomeningeal disease coating the spinal cord on sagittal, T1 post-contrast imaging.
Figure 2
Figure 2. Intramedullary Metastases
(A) Sagittal, T1 post-contrast imaging reveals an enhancing intramedullary metastasis at C2/C3 in a patient with adenoid cystic carcinoma of the submandibular gland. (B) Surrounding vasogenic edema is best appreciated on sagittal, T2.
Figure 3
Figure 3. Dural Metastases
Enhancing, dural metastasis along the left hemisphere in a patient with metastatic prostate cancer. Note the irregular border of the lesion abutting brain and the marked mass effect.
Figure 4
Figure 4. Metastatic Epidural Spinal Cord Compression
(A) Sagittal, T1 post-contrast image showing extensive epidural disease arising from the vertebral body causing spinal cord compression at C6/C7 in a patient with metastatic breast cancer. (B) Cord compression is better visualized on T2.
Figure 5
Figure 5
Brachial Plexus Metastasis: Post-gadolinium MRI demonstrating a right brachial plexus metastasis in a patient with breast cancer.
Figure 6
Figure 6
Skull Base Metastases: Enhancing metastasis involving the left occipital condyle with hypoglossal canal involvement in a patient with breast cancer.
See this image and copyright information in PMC

References

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