T1 sagittal pre gad T1 sagittal post gad T2 sagittal

Diagnosis: Metastatic lung adenocarcinoma

Intramedullary spinal metastases are unusual. Metastatic disease to the spine typically presents as an epidural mass or as leptomeningeal spread. Some CNS tumors may seed the subarachnoid space, most commonly in the lumbosacral area. These include high grade astrocytoma, medulloblastoma, ependymoma, germinoma, choroid plexus papilloma, pineocytoma and pineoblastoma. Ependymomas may present as intramedullary masses in the conus. The ring enhancing appearance of this lesion is a atypical for ependymoma. They tend to enhance more heterogeneously. This appearance could also be consistent with a high grade astrocytoma of the conus but these typically occur in the cervical and thoracic cord. Spinal cord hemangioblastomas also occur in the thoracic or cervical cord. One third of patients with hemangioblastomas of the cord also have von Hippel-Lindau syndrome. Vascular flow voids are often seen along the surface of the cord in spinal cord hemangioblastoma. Paraganglioma is a very rare tumor which may be found in the cauda rather than the conus. They enhance intensely and resemble cauda schwannoma or ependymoma. This patient had known metastatic lung carcinoma Related Cases

Ependymoma Astrocytoma Lung cancer metastasis