Case Report: Multimodal treatment of cervical intramedullary spinal cord metastasis from gastric adenocarcinoma
Abstract
BackgroundIntramedullary spinal cord metastasis (ISCM) from gastric adenocarcinoma is extremely rare, and treatment is not standardized.Case presentationA 59-year-old man with a 22-month history of gastric adenocarcinoma developed acute quadriplegia during systemic therapy. Contrast-enhanced MRI showed a C3-C4 intramedullary enhancing lesion with extensive edema, and ISCM was suspected on clinical and radiological grounds. Because of the high cervical location and surgical risk, the patient received intensity-modulated radiotherapy (40 Gy in 20 fractions) with sintilimab, nab-paclitaxel, and capecitabine; dexamethasone and mannitol were used for spinal cord edema. Grade 4 neutropenia with febrile neutropenia occurred on radiotherapy day 3, and chemotherapy was stopped. Neurological function improved by radiotherapy day 10. Follow-up cervical MRI showed complete radiographic resolution of the lesion, and limb strength recovered to grade 5. The patient died approximately 6 months after the suspected ISCM diagnosis, about 3 weeks after the last cervical MRI; death was clinically attributed to cachexia from systemic tumor progression, without autopsy.ConclusionThis case showed temporary neurological and radiographic improvement after a multimodal non-surgical approach, but it does not establish the efficacy of an individual treatment component or an overall survival benefit.
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BibTeX
@article{wu2026case,
title = {{Case Report: Multimodal treatment of cervical intramedullary spinal cord metastasis from gastric adenocarcinoma}},
author = {Yingna Wu and Yu Dai and Tao Fan and Yingjie Song},
journal = {Frontiers in Oncology},
year = {2026},
month = nov,
doi = {10.3389/fonc.2026.1996172},
url = {https://www.frontiersin.org/articles/10.3389/fonc.2026.1996172},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Case Report: Multimodal treatment of cervical intramedullary spinal cord metastasis from gastric adenocarcinoma
AU - Yingna Wu
AU - Yu Dai
AU - Tao Fan
AU - Yingjie Song
PY - 2026
DA - 2026/11/06
JO - Frontiers in Oncology
DO - 10.3389/fonc.2026.1996172
UR - https://www.frontiersin.org/articles/10.3389/fonc.2026.1996172
AB - BackgroundIntramedullary spinal cord metastasis (ISCM) from gastric adenocarcinoma is extremely rare, and treatment is not standardized.Case presentationA 59-year-old man with a 22-month history of gastric adenocarcinoma developed acute quadriplegia during systemic therapy. Contrast-enhanced MRI showed a C3-C4 intramedullary enhancing lesion with extensive edema, and ISCM was suspected on clinical and radiological grounds. Because of the high cervical location and surgical risk, the patient received intensity-modulated radiotherapy (40 Gy in 20 fractions) with sintilimab, nab-paclitaxel, and capecitabine; dexamethasone and mannitol were used for spinal cord edema. Grade 4 neutropenia with febrile neutropenia occurred on radiotherapy day 3, and chemotherapy was stopped. Neurological function improved by radiotherapy day 10. Follow-up cervical MRI showed complete radiographic resolution of the lesion, and limb strength recovered to grade 5. The patient died approximately 6 months after the suspected ISCM diagnosis, about 3 weeks after the last cervical MRI; death was clinically attributed to cachexia from systemic tumor progression, without autopsy.ConclusionThis case showed temporary neurological and radiographic improvement after a multimodal non-surgical approach, but it does not establish the efficacy of an individual treatment component or an overall survival benefit.
SN - 2234-943X
ER -