[A case of intramedullary spinal cord metastasis from breast carcinoma: surgical resection for conus medullaris lesion].

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.