Two cases of intramedullary spinal cord metastasis of lung cancer detected with MRI]

We report two cases of intramedullary spinal cord metastasis of lung cancer detected by MRI. Case 1: A 77-year-old man underwent chemotherapy and left lower lung lobectomy for squamous cell carcinoma of the lung (T2N0M0). About one year later, he complained of paresthesia of the lower extremities and claudication on walking, and then of weakness of the lower limbs and bladder dysfunction. Magnetic resonance imaging (MRI) revealed an enhanced mass in the dural sac at the level of the spines of L1-2. Volume reduction surgery was promptly performed. The pathological diagnosis was squamous cell carcinoma. Case 2: A small cell carcinoma of lung with metastasis to bone, kidney and cerebellum (T4 N3 M1) in a 73-year-old man was diagnosed. He showed a partial response to chemotherapies and to whole brain radiation (45 Gy). Three months later, he presented sudden onset paraplegia, paraesthesia and bladder dysfunction. MRI demonstrated an enhancing intramedullary lesion that delineated the conus of the cauda equina, and T 2-weighted MRI images showed multiple nodules in sacs.