Solitary spinal epidural metastasis from lung carcinoma
A 78-year-old Indian lady was investigated for cough and weight loss. Initial baseline investigations suggested adenocarcinoma of right lung. Whole body F-18 FDG PET/CT was done for staging workup. The PET/CT scan showed right lung middle lobe mass with few ipsilateral mediastinal lymphnodes. An unusual tracer uptake in D12-L1 right neural foramina region was also noted []. On questioning, she reported lower backache and right hip region pain which was till that time being attributed to old age and degenerative changes. Due to persistent backache, regional MRI was advised after 15 days of PET/CT, which revealed enhancing focal epidural soft tissue thickening on right side at D12-L1 level []. Image-guided biopsy was not amenable and open biopsy was not performed in her clinical context. In view of clinical symptomatology and dual imaging findings, a diagnosis of solitary epidural metastasis was considered. Patient was given for D11-L2 radiotherapy which relieved her symptoms subsequently.