PET/CT fused image of a 65 year old smoker showing large intensely FDG avid mass lesion in the left upper lobe with areas of necrosis and mediastinal FDG avid lymphadenopathy.
Sagittal PET/CT fused whole spine image showing intraspinal intense FDG avid focal lesions at C7-D1 and L1 levels suggestive of metastases.
Sagittal PET/CT fused cervical spine image showing intraspinal intense FDG avid focal lesion.
Axial PET/CT fused cervical spine image at C7 level showing intraspinal intense FDG avid focal lesion.
Axial PET/CT fused cervical spine image at L1 level showing intraspinal intense FDG avid focal lesion
Discussion:
The intraspinal metastases may spread through several routes, such as arterial dissemination; venous spread through the network of communicating venous channels in the spinal cord and the cauda equina; spread via the perineural lymphatic vessels or the subarachnoid space; invasion of a dorsal root; or direct extension of the primary tumor.
Lung carcinoma commonly metastasize by arterial dissemination.