Images in Clinical Medicine

Intramedullary Spinal Cord Metastases

Tahir Ijaz, M.D., and Keith Jones, M.D.

N Engl J Med 1997; 336:768March 13, 1997

• Slide

Article

Figure 1 A 54-year-old woman presented with paresthesias of the arms, occipital headache, and pain in the back of the neck. Neurologic examination revealed evidence of decreased sensitivity to pinprick, temperature, and light touch over the lower part of the left side of the neck, left hemithorax, left arm, left thigh, and left side of the abdomen. A sagittal T₁-weighted gadolinium-enhanced view (Panel A) shows an enhancing, elongated metastatic lesion (arrow) from small-cell carcinoma of the lung. A magnetic resonance image obtained three months after palliative radiotherapy (Panel B) shows only a faint area of intramedullary enhancement (arrow) on the T₁-weighted image. The patient's symptoms completely resolved, but she died of brain metastases 11 months after radiotherapy.

Tahir Ijaz, M.D.
Keith Jones, M.D.
Manitoba Cancer Treatment and Research Foundation, Winnipeg, MB R3E 0V9, Canada