Intramedullary spinal cord metastasis : an under-diagnosed entity

Intramedullary spinal cord metastatic tumours, generally considered to be rare, are increasingly being diagnosed due to aggressive management of the primary malignancy, better imaging facilities and attempts at total excision of these lesions. Sincethese lesions were diagnosed late in the course of the disease patients were earlier given only palliative treatment. Presently, with more intensive treatment protocols the immediate outcome appears to be better.The present report is about two patients in whom the spinal cord lesion was the primary manifestation of an underlying malignancy. Total excision of the lesion was done in both the patients. Post operatively, one patient had marked improvement in the neurological status. He underwent radiation and chemotherapy and survived for seven months. He later succumbed to multiple secondaries involving the brain. The other patient did not improve in her neurological function in the immediate post-operative period and was lost to follow up.