The purpose of this educational exhibit is to illustrate the MR imaging of metastases to the spine with the emphasis on intramedullary spinal metastatic lesions.

Metastases to the spine involving the bones are often diagnosed since they are the third most common site for metastatic disease, following the lung and the liver. We discuss here less common sites of spinal metastases which often represent a diagnostic challenge. With that in mind, the three possible locations for spinal metastases are intradural intramedullary, commonly shortened to intramedullary, intradural extramedullary and extradural (Fig.1). Intramedullary spinal metastasesare very rare, occurring in only 0.5-2% cancer patients with advanced disease and comprise 1–3% of all intramedullary...

Metastases to the spine can involve the bone, epidural space, leptomeninges, and spinal cord. While interpreting spinal cord images it is essential to carefully observe the scans and to detect the exact location of the spinal lesion. The lesions can be located intradural intramedullary, intradural extramedullary or extradural. Intramedullary tumors arise within the substance of the spinal cord, whereas extramedullary tumors are extrinsic to the cord. The extradural lesions account for up to 95% of spinal lesions and can be divided into pure epidural lesions...

While reading the spinal MR scans in cancer patients, especially with known disseminated disease,it is important to carefully analyze the scans and search for the signs of possible metastatic lesions, not only in bony parts, but also in and around the spinal cord.

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