Intramedullary spinal metastasis in small cell lung cancer

Case contributed by Dr Roberto Schubert

Presentation

Numbness and muscle twitching in the right arm.

Patient Data

Age: 60
Gender: Female

An enhancing intramedullary nodule at C7 is present with extensive perilesional oedema. It is an isolated lesion, with no evidence of leptomeningeal disease. 

A heterogeneous vividly enhancing nodule ( * ) is associated with extensive cord oedema above and below it (green arrows). The nodule appears intramedullary with a visible 'claw sign' - cord (C) is seen wrapping around it (yellow arrows), rather than being pushed away (red arrows) as would be expected in an extramedullary mass. 

This patient had had a left upper pulmonary lobe resection for small cell lung cancer 2 years ago, and had extensive metastatic disease elsewhere. 

Case Discussion

This case illustrates an fairly typical appearance of intramedullary spinal cord metastatic deposit, a rare occurrence even in patients with widespread metastatic disease. 

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Case information

rID: 14882
Case created: 2nd Sep 2011
Last edited: 14th Jan 2017
Inclusion in quiz mode: Included

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