title: Intramedullary spinal cord metastasis from renal cell carcinoma: detection by positron emission tomography.
abstract: Although positron emission tomography (PET) is an established diagnostic method in brain and lung cancer, its use is often confined to research. The authors report a case of a minimally symptomatic intramedullary spinal cord metastasis, an uncommon and often diagnostically challenging lesion, that was confirmed by PET. A 37-year-old man with a history of metastatic renal cell carcinoma treated with systemic agents, an autologous stem cell transplant, and local palliative radiotherapy with a 2-month history of vague right foot numbness and right leg dysesthesias was found to have an intramedullary lesion at the level of T12. Although the findings of magnetic resonance imaging suggested central necrosis, a PET scan revealed a metabolically active lesion and confirmed the diagnosis of intramedullary metastasis. PET can be used to detect and confirm intramedullary spinal cord metastatic carcinoma. PET imaging may have a vital role in clinical diagnosis by helping to distinguish diagnostically troublesome lesions based on metabolic activity.
authors.affiliation: Radiation Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, Maryland 20892, USA. mpoggi@usuhs.mil
authors.forename: M M
authors.initials: MM
authors.lastname: Poggi
authors.forename: N
authors.initials: N
authors.lastname: Patronas
authors.forename: J A
authors.initials: JA
authors.lastname: Buttman
authors.forename: S M
authors.initials: SM
authors.lastname: Hewitt
authors.forename: B
authors.initials: B
authors.lastname: Fuller
mesh_terms: D018262:Adenocarcinoma, Clear Cell / Q000473:pathology*; D000328:Adult; D002292:Carcinoma, Renal Cell / Q000473:pathology* / Q000628:therapy; D003131:Combined Modality Therapy; D003937:Diagnosis, Differential; D019788:Fluorodeoxyglucose F18; D006801:Humans; D007680:Kidney Neoplasms / Q000473:pathology* / Q000628:therapy; D008297:Male; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D013120:Spinal Cord Neoplasms / Q000000981:diagnostic imaging / Q000556:secondary*; D014057:Tomography, X-Ray Computed; D014915:Whole-Body Counting
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18