A Case of Small Cell Carcinoma of the Lung with Intramedullary Metastases Diagnosed by MRI

Abstract

A 79-year-old man, complaining of weakness of the right upper and lower extremities, was referred to our hospital for evaluation of a left hilar tumor and multiple brain tumors which had been detected by a local doctor. The diagnosis of small cell carcinoma of the lung was made by lung biopsy, with metastasis to the brain (stage IV=T4NOM1). After chemotherapy (CBDCA+VP-16) plus radiotherapy (brain, 40Gy), he was discharged after partial response had been obtained. However, he was readmitted 4 months later because of gait disturbance. Weakness of both legs and disturbance of deep sensations could not be explained solely by the presence of brain metastases. The spinal cord MRI revealed intramedullary metastases at Th8 and Th10 levels. Lumber punctures (three times) were negative for cytology, and hematogenous metastasis was suggested. Case reports on lung cancer associated with intramedullary metastasis are rare, especially in cases diagnosed before death.