Intramedullary metastasis

Clinical history
During the prior 6 months, this 60-year-old female was treated with chemotherapy for a small cell lung cancer. Spinal MRI was performed as the patient presented with progressive paraparesis and weakness of the lower limbs. Dysesthesia as well as hypoesthesia developed in both lower extremities.

MRI findings
Image 1: Sagittal T1WI. On this first series of sagittal T1WI, enlargement of the cord is seen with minimal irregularity of contour, without definite signal abnormalities. Multiple metastases to the vertebral bodies are seen as hypointense areas.
Image 2: Sagittal T2WI. The presence of multiple intramedullary hyperintense lesions scattered throughout the spinal cord are much better seen.
Image 3: Sagittal Gd T1WI. On these images, multiple enhancing metastatic lesions are now clearly visible.

Clinical evolution
Clinically, the patient responded well to a new oral chemotherapy and follow-up MRI was performed one month later.

Image 4: Sagittal Gd T1WI and image 5: sagittal T2WI demonstrate dramatic positive response and clear reduction in size of the multiple metastatic lesions is seen. Unfortunately, the patient died a couple of days later from intercurrent infection.

Search also:
- Metastasis

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