Knowing this, what is your favoured diagnosis?
Although it is possible that the patient has dual pathology, a metastasis is likely. The lung mass either represents the primary tumour (likely given its morphology) or also represents a metastasis from a tumour located elsewhere.
What are the common primaries to metastasis to the spinal cord?
Lung cancer accounts for approximately 50% of cases. Other primary malignancies are breast carcinoma, lymphoma, leukaemia, melanoma, renal cell carcinoma and colorectal carcinoma.
A 27 mm diameter spiculated nodule is present in the region of the anterior segment of the right upper lobe. No definite left upper lobe pulmonary nodule is seen. No significant hilar/mediastinal lymphadenopathy is identified. Minor bibasal fibrosis is noted. No gross bony destructive lesion is seen.