Nasopharyngeal Carcinoma with Spinal Cord Metastasis and Secondary Syringomyelia: A Case Report

Nasopharyngeal cancer with central nervous system metastases is rare. True metastasis to the distal regions of the central nervous system, especially the spinal cord, is incredibly uncommon, although tumor invasion to intracranial locations through the skull base can be prevalent. We report on a 45-year-old male who had been suffering from progressive unsteady gait and numbness of lower limbs for 3 weeks. The numbness eventually ascended to the thigh area and the patient required a wheelchair. His muscle power was normal. Magnetic resonance imaging showed multiple enhancing nodular lesions in the thoracolumbar spinal cord with mild mass effect, causing diffuse syringomyelia and cord edema. Metastasis was confirmed by pathology after tumor excision. The patient underwent concurrent radiotherapy and steroid therapy, after which he eventually could walk with crutches. Due to the complexity and rarity of such case, the standard treatment for this type of disease is unclear. Management should be individualized and multidisciplinary.