Solitary thoracic intramedullary metastasis from a lung primary.  Lung cancer is the commonest malignancy to give rise to intramedullary mestatases.

Fine needle aspiration cytology of the lung mass was acquired under CT guidance.

Histological diagnosis:  Adenocarcinoma of the lung

This case provides a good basis on which to examine a fellowship candidate for describing the findings on the MRI, giving a differential and suggesting further investigations.