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Cancer - Principles & Practice of Oncology
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CHAP49
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F2_2.CAP
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1999-06-07
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FIGURE 49.2-2. Metastatic involvement of the spine. Intramedullary
metastases reach the cord through hematogenous dissemination and grow
within the cord parenchyma (1). Leptomeningeal metastases involve the
meningeal membranes of the subarachnoid space, which are
extramedullary and intradural (2). Epidural metastases usually arise
from the highly vascular posterior aspect of the vertebral body and
produce compression of the anterior aspect of the spinal cord (3).
Epidural compression can also result from paravertebral tumors that
invade the vertebral foramina (4) and, less often, from metastases
arising in the epidural space itself (5). (Adapted from Byrne TN.
Current concepts: spinal cord compression from epidural metastases. N
Engl J Med 1992;327:614)