Article révisé par les pairs
Résumé : Case report: A 52-year-old woman without relevant medical history presented neck pain and weakness of the right hand Since 2 months. We noted bilateral pyramidal signs With sensory disorders of the four limbs. Magnetic resonance imaging (MRI) evidenced a right-sided intramedullary lesion at the level of C6 and C7, measuring 10x15mm. The evoked diagnoses were astrocytoma and hemangioblastoma. Surgical resection was partial because of: i) the absence of cleavage plan between the tumor and the spinal cord, ii) the peroperative anatomopathological diagnosis of metastasis associated With poor prognosis and iii) the temporary loss of evoked potentials on neuromonitoring. The final anatomopathological diagnosis confirmed a metastatic pulmonary adenocarcinoma. The disease was pluri-metastatic and uncontrolled 8 months after neurosurgery. Discussion: Most intramedullary spinal cord tumors are ependymomas and astrocytomas. Intramedullary metastases from visceral cancers are rare, associated With advanced neoplasia and poor prognosis. Conclusion Intramedullary metastases rarely present as the revealing presentation of a neoplastic disease. However, the diagnosis must be kept in mind. The strategy is to exclude a primary cancer and Other metastatic lesions in cases of rapid clinical evolution, smoking patient or atypical MRI images. The present case underlines the importance of peroperative anatomopathological examination and intraoperative neuromonitoring during spinal cord surgery.