Intramedullary spinal cord metastasis associated with pencil-shaped softening of the spinal cord: case report.
A 57-year-old man presented with a pulmonary mass and subacute onset of paraplegia. Laboratory examination revealed an increased protein content in the cerebrospinal fluid and a normal myelogram. Autopsy disclosed epidermoid carcinoma in the left lower lobe of the lung, intramedullary metastasis at the midthoracic level, and a central pencil-shaped softening above and below the metastatic lesion. The pencil-shaped softening was an ischemic infarct rather than of hemorrhagic or congestive origin. The pathogenesis of this rare association may be explained by the hypothesis of a tumor embolus in the arterial circulation that feeds the center of the cord, producing metastasis. This embolus was followed later by a second embolus to a radicular artery, causing the pencil-shaped softening of the spinal cord.
D002294:Carcinoma, Squamous Cell / Q000150:complications* / Q000473:pathology / Q000556:secondary; D006801:Humans; D008175:Lung Neoplasms / Q000150:complications* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009336:Necrosis; D013116:Spinal Cord / Q000098:blood supply; D013118:Spinal Cord Diseases / Q000150:complications* / Q000473:pathology; D013120:Spinal Cord Neoplasms / Q000150:complications* / Q000473:pathology / Q000556:secondary