A 46-year-old female presented with gait disturbance and
urinary retention which had exacerbated over 3 weeks. The patient had a medical history of
breast cancer and
brain metastases that had been well controlled by serial
chemotherapy and gamma knife irradiation, and had remained independent with Karnofsky performance status (KPS) score of 100 %. On admission, neurological examination detected mild sensorimotor disturbance in the right lower extremity and
hypesthesia in the perianal region, in addition to
urinary retention and decreased anal tone. Spinal MR imaging demonstrated a well demarcated, heterogeneously enhanced, intramedullary
tumor at the L1 level, appearing as isointense on both T1 and T2-weighted images. The patient underwent subtotal
tumor resection via hemilaminectomy at the L1 and L2 levels. Postoperatively, the patient's motor weakness and vesicorectal dysfunction showed remarkable improvement, whereas sensory disturbance was only very slightly improved. Histological findings of the
tumor were consistent with metastatic
breast carcinoma. Surgical resection can be considered for the treatment of intramedullary spinal cord
metastasis if the lesion is located in the conus medullaris.