How do you manage intramedullary spinal cord metastases in the presence of previous radiotherapy?  

This is an unusual presentation but can be treated when approached correctly and provide important palliative effect especially in good performance patients. First and foremost, a neurosurgical evaluation including the possibility of a cordotomy should be undertaken. Should the patient be deemed a n...

I have done this exact procedure in an otherwise highly functioning prostate cancer patient, with a recalcitrant T12 metastasis. This lesion locally persisted/progressed 12 months after SRS course number one, apparently primarily in the "penumbra" region from the original SRS course. He saw two diff...