Metastatic disease to the spine: intramedullary and extradural compression

Case contributed by Dr Chris O'Donnell

Presentation

Presents with quadriplegia. Past history of carcinoid tumour.

Patient Data

Age: 80
Gender: Male

Mass lesions in the upper cervical cord with restricted diffusion consistent with metastases associated with extrinsic compression by extradural masses at the level of the C3 vertebra and in the upper thoracic spine.

Case Discussion

Intraparenchymal cord metastases are unusual but should be considered in patients with disseminated malignancy.  Note the restricted diffusion in these cord lesions due to the packed nature of the cytoplasm within malignant cells (higher nucleus to cytoplasm ratio compared with normal cells) and the trapping of water molecules in the interspaces between cells.

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Case Information

rID: 38592
Case created: 26th Jul 2015
Last edited: 21st Nov 2015
System: Spine
Inclusion in quiz mode: Included

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