Metástasis intramedular de adenocarcinoma gástrico: caso clínico y revisión de la literatura / Intramedullary spinal cord metastasis from gastric adenocarcinoma: Case report and review of literature

RESUMEN

Las metástasis intramedulares son entidades infrecuentes relacionadas con el cáncer de pulmón o de mama, siendo excepcional su origen gástrico. Es frecuente que desarrollen clínica más rápidamente que los tumores intramedulares primarios, con déficit motor, dolor, alteraciones esfinterianas, así como trastornos sensitivos de diversa índole, siendo altamente sugestiva la existencia de un síndrome de Brown-Séquard en pacientes con antecedentes oncológicos. El pronóstico de estos pacientes es ominoso, con una supervivencia media aproximada de 4 meses, aunque revisiones recientes postulan que la cirugía puede aportar un leve incremento en la supervivencia, así como una mayor capacidad funcional. Presentamos el caso de un paciente de 61años con una metástasis intramedular cervical de un adenocarcinoma gástrico y revisamos la literatura científica, habiendo 3 casos publicados previamente

ABSTRACT

Intramedullary spinal cord metastases are very rare and usually associated with lung or breast cancer, with gastric origin being exceptional. Their clinical onset tends to be faster than that of primary intramedullary tumours. The most common early symptoms of intramedullary spinal cord metastasis are motor deficit in one or more limbs, pain, sensory loss, and sphincter disturbances. The appearance of a rapidly progressive Brown-Séquard syndrome in an oncology patient should orientate the diagnosis of this condition. The prognosis is very poor, with a median survival of 4months. However, recent research has shown that surgery could offer a slight benefit in survival and functionality. The case is reported of a 61-year-old man with an intramedullary spinal cord metastasis from a gastric carcinoma, as well as a literature review of this topic. It has been found that this case is the fourth one reported in the literature