Simultaneous leptomeningeal and intramedullary spinal metastases in small cell lung carcinoma.

A patient with small cell lung carcinoma and simultaneous intramedullary spinal and leptomeningeal metastases is described. A review of the literature revealed that 28 cases of intramedullary spinal metastases have been reported in small cell lung carcinoma patients since 1978. Fifteen of these were in patients who had coexisting carcinomatous meningitis. The pathogenesis of intramedullary spinal metastases is discussed and a potential mechanism is proposed to explain the simultaneous occurrence of intramedullary and leptomeningeal metastases. Therapy for leptomeningeal metastases should be considered in patients with small cell lung carcinoma and intramedullary spinal metastases.