Successful treatment of quadriparesis from radiation myelopathy with bevacizumab in a patient with metastatic breast cancer

Radiation myelopathy (RM) is rare condition defined as injury to the spinal cord by ionising radiation. Due to improved survival in patients with advanced malignancies, there is a renewed interest in recognition and treatment of RM. There are very few reports on treatment of RM. A 64-year-old woman with metastatic oestrogen receptor, progesterone receptor weakly positive and human epidermal growth factor 2 negative breast, stereotactic radiosurgeries to brain metastases and a history of reradiation to the cervical spinal cord presented with neck pain, arm weakness, hyperreflexia and gait ataxia. RM was suspected and the patient was started on high dose corticosteroid therapy. However, the patient's condition deteriorated and she developed quadriparesis. A timely treatment with an antivascular endothelial growth factor antibody, bevacizumab reversed her neurological deficits and preserved her walking ability. Our case illustrates a prompt diagnosis and successful treatment of RM with bevacizumab.