gms | German Medical Science

Objective: Spinal Metastases are common and are often the first symptom of a malignant disease when the primary tumor is unknown. Nearly all metastases are epidural and the treatment of choice is operative decompression with adjuvant radiotherapy. Intradural intramedullary metastases are very rare and have to be kept in mind as differential diagnosis to other lesions like ependymoma and astrocytoma.

Methods: During a 4 year period there were 2 patients with known carcinoma who presented with paraparesis and intradural intramedullary metastasis.

Results: We present two patients with intramedullary metastases who presented with paraparesis and had known lung carcinoma. The 66-year-old male patient had lung carcinoma since 2 years and was treated primarily with radio- and chemotherapy. He presented with paraparesis for 3 weeks and MRI showed a intramedullary lesion at D 11. It was removed and the neurological function improved. The other 63-year-old female patient had also lung carcinoma since 3 years with intracranial metastases known for one year, also treated with radio- and chemotherapy. She presented with progressive paraparesis and MRI showed an intramedullary metastases at D2/3 with accompanying syrinx. Her neurological function was unchanged postoperatively.

Conclusions: We remind of rare metastasis in the spinal cord in patients with known carcinoma in the medical history. Especially in patients with malignant disease who live longer due to better medical treatment the possibility of developing late intramedullary metastases should be kept in mind and early operation is recommended.