Intradural intramedullary metastasis of small cell lung cancer: A case report

Intradural metastasis of small cell lung carcinoma in conus medullaris is an uncommon disease. We report a case of lung cancer complicated with intradural metastasis in conus medullaris with just a symptom of hypoesthesia of the lower right limb and lower extremity weakness. The patient was initially suggested a clinical diagnosis of spinal meningioma or astrocytoma, according to the clinical symptom and the diseased region in imaging manifestation. Confirmed diagnosis was performed by histopathology and immunohistochemistry, revealing to be a malignant metastasis of small cell lung carcinoma. The patient underwent complete resection, and recovered well, although with pulmonary primary lesion to be treated. The tumor was 0.5×0.5×0.3cm in size and in contact with the conus medullaris. The aim of this study is to emphasize the importance of careful and comprehensive radiological examination and to reflect the difficulty of tumor resection. After the orthopedic surgery, the patient recovered well and got referral to pneumology department for follow-up treatment.

A rare case of an intramedullary metastasis of a myxopapillary ependymoma

Background: Myxopapillary ependimoma (MPE) is a benign slow-growing tumor, and it has been designated histologically as a Grade I neoplasm according to the 2016 World Health Organization classification. Despite the benign character, dissemination and metastasis have occasionally been reported. The retrograde dissemination to other levels of the neuraxis is extremely rare, being more frequent to the intracranial compartment. Case Description: We hereby present a case of medullary metastasis of cauda equina MPE, with a history of having undergone a subtotal resection and postoperative adjuvant radiotherapy. The patient presents complaints of night dorsal pain attributable to intradural metastasis twenty-one years after the first surgical intervention. Conclusion: The case reported highlights the importance of long follow-up in patients with MPE, since the possibility of secondary seeding to distant craniospinal sites or local spinal sites after surgery, and radiotherapy should be considered in metastatic disease.