Solitary spinal epidural metastasis from lung carcinoma

Fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography (F-18 FDG PET/CT) has revealed many unusual presentations and early detection of metastasis in many carcinomas. Epidural involvement in the spine is mostly sequelae of direct infiltration from bony involvement. Direct hematogenous spread to epidural space is very rare. Early diagnosis and treatment before the development of permanent neurologic and functional deficits is essential for a favorable prognosis in such cases. We report here a case of solitary spinal epidural metastasis from lung cancer which was the only systemic metastasis detected on F-18 FDG PET/CT and later confirmed by clinical and regional magnetic resonance imaging findings. This report is, to the best of our knowledge, the first description of such a presentation of systemic metastasis from lung cancer on F-18 FDG PET/CT.