Intramedullary spinal cord metastatic of nasopharyngeal carcinoma: A case report

Nasopharyngeal carcinoma (NPC) with metastasis to the central nervous system (CNS) is considered to be quite rare (3,3%). Metastatic to intramedullary of spinal cord constitutes only 8.5% of all CNS metastases with the most common source is from lung. The pathologic mechanisms is due to hematogeneous spread, meningial carcinomatosis, and direct invasion by malignant neoplasm. A 37 years old woman suffered from pain in back region and weakness in both leg progressively with history of NPC since December 2016. Patient had neurological deterioration (Motor power is 0/5 from L2 level and decreased sensation 1/2 from T11 level). MRI showed intradural intramedullary mass at T9-T10 level. The patient underwent tumor excision followed by posterior spinal instrumentation. The histopathology result showed undifferentiated carcinoma which confirmed as metastatic from the NPC. Clinical improvement were reported, based on SF-36 health survey, with pain relief as the main factor of improvement.