Dural Metastases in 14 Patients with Systemic Cancer: An Exploratory Retrospective Study (P4.232)

OBJECTIVE: To evaluate tumor type, clinical presentation and treatment strategies in dural metastases. BACKGROUND: Dural metastases are rare complications of advanced systemic cancers. Although they cause a variety of neurological symptoms, literature is limited to case reports and small reviews. Differential diagnoses include local hemorrhage, seroma or meningioma, which makes biopsy indispensable to confirm diagnosis. DESIGN/METHODS: We retrospectively evaluated the case files of 14 patients who were admitted to neurological departments between 2004 and 2015. All patients had histologically proven dural metastasis of a primary cancer. Age at diagnosis, systemic primary tumors, location of metastasis, clinical symptoms and treatment options were analysed. Due to the small case number, this study used descriptive statistics only. RESULTS: We evaluated 8 male and 6 female patients with a median age at dural metastasis diagnosis of 61 years. Primary tumors were lung cancer (n=3), prostate cancer (n=2), colorectal cancer (n=2), cancers of the female genital system (n=3) and individual others. Median Karnofsky performance status at diagnosis was 90[percnt]. 9 patients presented with dural metastasis in the cranial cavity, whereas 5 patients had dural metastasis located in the spinal cord. Patients with dural metastasis in the cranial cavity presented with hemiparesis, aphasia, hemianopsia, nausea/vomiting or headache, whereas patients with metastasis located in the spinal cord mostly had back pain, often in combination with para- or tetraparesis. Radiotherapy was the preferred treatment option. CONCLUSIONS: Dural metastases present with a variety of clinical symptoms. They occur in several types of cancer, often in advanced conditions. For appropriate diagnosis, biopsy is needed. Treatment options include surgical approaches or chemotherapy but usually radiotherapy is preferred. Disclosure: Dr. Ackerl has nothing to disclose. Dr. Loyoddin has nothing to disclose. Dr. Barbara has nothing to disclose. Dr. Grisold has nothing to disclose. Dr. Surboeck has nothing to disclose. Dr. Grisold has nothing to disclose.