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Table 1 Indications for neurosurgery in the presence of malignancy [35]

From: Bladder metastasis presenting as neck, arm and thorax pain: a case report

Surgical Indications
• Pain due to mechanical compression of pain producing structures or clear instability
• Symptomatic mechanical compression of neurostructures (neurological deficit)
• Rapidly progressing neurological deficit due to mechanical compression
• Unknown primary tumor with clearly defined metastatic involvement of the spine
• Radioresistant tumor
• Neurological deterioration or increasing pain during or after radiotherapy (should be avoided by a careful evaluation of the tumor potential before irradiation is decided)