Intramedullary spinal cord metastasis presenting as the initial manifestation of breast cancer: case report and review of the literature

• Published in: Spinal cord series and cases Vol. 11; no. 1; p. 13
• Main Authors: Bouattour, Nadia, Sellami, Sirine, Mzid, Yosra, Charfi, Slim, Hamza, Fatma, Sakka, Salma, Ben Mahfoudh, Khaireddine, Bahloul, Amine, Damak, Mariem
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 07.05.2025; Nature Publishing Group
• Subjects: 631/67/1347; 631/67/1922; Adult; Anatomy; Biomedical and Life Sciences; Biomedicine; Breast cancer; Breast Neoplasms - diagnosis; Breast Neoplasms - pathology; Case Report; Case reports; Fatal Outcome; Female; Human Physiology; Humans; Magnetic Resonance Imaging; Metastasis; Neurochemistry; Neuropsychology; Neurosciences; Spinal cord; Spinal Cord Neoplasms - diagnosis; Spinal Cord Neoplasms - diagnostic imaging; Spinal Cord Neoplasms - secondary
• ISSN: 2058-6124; 2058-6124
• DOI: 10.1038/s41394-025-00708-y

Background Intramedullary spinal cord metastasis (ISCM) is very rare. Symptoms from ISCM metastasis being the initial presentation are extremely rare. Case presentation We present a case of a 42-year-old woman without previous medical history who presented with complaints of progressive lower limb weakness of three weeks evolution. Neurological examination elicited a medullary syndrome, and physical examination showed a palpable mass on her right breast. A spinal MRI revealed a dorsal intramedullary tumor mass. A biopsy sample from the breast mass revealed the diagnosis of carcinoma. The diagnosis of an Intramedullary breast cancer metastasis (IMBCM) was made according to positron emission tomography. The patient received treatment with corticosteroids and radiation therapy without improvement, and she died, 3 months after the diagnosis. Conclusions As far as we know, this is the first reported case of IMBCM revealing a breast carcinoma. Although extremely rare, ISCM should be considered as a differential diagnosis of a spinal intramedullary lesion.