A woman with breast cancer has MRI-confirmed single-level thoracic metastatic spinal cord compression. She is ambulant, has mechanical instability,

Question

A woman with breast cancer has MRI-confirmed single-level thoracic metastatic spinal cord compression. She is ambulant, has mechanical instability, is fit for surgery and has an expected survival well beyond three months. What local strategy should be considered?

Accepted Answer

Urgent surgical decompression and stabilisation followed by radiotherapy, alongside immediate corticosteroid and oncology care

Answer

Use systemic chemotherapy alone because local treatment cannot preserve neurological function

Answer

Radiotherapy alone before completing surgical review in the setting of mechanical instability

Answer

Perform vertebroplasty alone before completing decompressing the cord

Answer

Observe until paraplegia develops because she remains ambulant

MSCC Surgery Indication — RACP Adult Medicine MCQ

A woman with breast cancer has MRI-confirmed single-level thoracic metastatic spinal cord compression. She is ambulant, has mechanical instability, is fit for surgery and has an expected survival well beyond three months. What local strategy should be considered?