title: Intramedullary spinal cord metastasis from papillary thyroid carcinoma.
abstract: BACKGROUND
  Intramedullary spinal cord metastasis (ISCM) is an uncommon complication of malignancy. ISCM from thyroid cancer is extremely rare, only a few cases had been reported and most were found at autopsy. Here we report a patient with progressive lower leg weakness due to ISCM from papillary thyroid carcinoma who had a good response to surgery.
  
  
  METHODS
  A 44-year-old woman presented with bilateral lower leg pain in December 2009. She underwent a total thyroidectomy in 1997 because of large mass in the right neck, which was diagnosed as papillary thyroid carcinoma. She had repeated I-131 therapies, but brain metastasis developed in 2002. When she was admitted, lower leg pain and weakness progressed rapidly. We performed magnetic resonance of the spine and whole-body fluorodeoxyglucose (FDG)-positron emission tomography scan, which demonstrated a 2×6 cm intramedullary mass enhanced by gadolinium with FDG-uptake. She underwent emergency laminotomy with subtotal tumor removal. Pathology revealed metastatic papillary thyroid carcinoma. After the emergent operation she could walk without help.
  
  
  CONCLUSIONS
  We report a patient with ISCM from papillary thyroid carcinoma. Surgical resection should be considered in patients with ISCM from papillary thyroid carcinoma. Early diagnosis and surgical resection could improve the quality of life and the neurologic deficits.
authors.affiliation: Department of Internal Medicine, University of Ulsan College of Medicine, Songpa-gu, Seoul, Korea.
authors.forename: Min Ji
authors.initials: MJ
authors.lastname: Jeon
authors.forename: Tae Yong
authors.initials: TY
authors.lastname: Kim
authors.forename: Ji Min
authors.initials: JM
authors.lastname: Han
authors.forename: Ji Hye
authors.initials: JH
authors.lastname: Yim
authors.forename: Seung Chul
authors.initials: SC
authors.lastname: Rhim
authors.forename: Won Bae
authors.initials: WB
authors.lastname: Kim
authors.forename: Young Kee
authors.initials: YK
authors.lastname: Shong
mesh_terms: D000328:Adult; D002277:Carcinoma; D002291:Carcinoma, Papillary; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D007457:Iodine Radioisotopes / Q000627:therapeutic use; D007796:Laminectomy / Q000379:methods; D007866:Leg / Q000503:physiopathology; D008279:Magnetic Resonance Imaging; D049268:Positron-Emission Tomography / Q000379:methods; D019275:Radiopharmaceuticals; D013120:Spinal Cord Neoplasms / Q000175:diagnosis / Q000532:radiotherapy / Q000556:secondary* / Q000601:surgery; D000077273:Thyroid Cancer, Papillary; D013964:Thyroid Neoplasms / Q000473:pathology* / Q000532:radiotherapy / Q000556:secondary / Q000601:surgery; D013965:Thyroidectomy; D016896:Treatment Outcome; D016138:Walking; D051598:Whole Body Imaging / Q000379:methods
chemical_list: D007457:Iodine Radioisotopes; D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18