Intramedullary spinal cord metastasis from renal cell carcinoma - Detection by positron emission tomography

Although positron emission tomography (PET) is an established diagnostic me thod in brain and lung cancer, its use is often confined to research. The a uthors report a case of a minimally symptomatic intramedullary spinal cord metastasis, an uncommon and often diagnostically challenging lesion, that w as confirmed by PET. A 37-year-old man with a history of metastatic renal c ell carcinoma treated with systemic agents, an autologous stem cell transpl ant, and local palliative radiotherapy with a 2-month history of vague righ t foot numbness and right leg dysesthesias was found to have an intramedull ary lesion at the level of T12. Although the findings of magnetic resonance imaging suggested central necrosis, a PET scan revealed a metabolically ac tive lesion and confirmed the diagnosis of intramedullary metastasis. PET c an be used to detect and confirm intramedullary spinal cord metastatic carc inoma. PET imaging may have a vital role in clinical diagnosis by helping t o distinguish diagnostically troublesome lesions based on metabolic activit y.