{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,3]],"date-time":"2026-02-03T11:01:10Z","timestamp":1770116470517,"version":"3.49.0"},"reference-count":24,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"24","license":[{"start":{"date-parts":[[2025,6,16]],"date-time":"2025-06-16T00:00:00Z","timestamp":1750032000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Cosmet Laser Ther"],"published-print":{"date-parts":[[2025,6,16]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND<\/jats:title>\n                    <jats:p>Intramedullary spinal cord metastasis from local transdural invasion is an exceedingly rare event. Therefore, specific guidance on the timing, type, and extent of surgical intervention is lacking.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>OBSERVATIONS<\/jats:title>\n                    <jats:p>A 60-year-old male with a known pulmonary neuroendocrine tumor presented with 2 days of progressive lower extremity paraplegia rendering him nonambulatory. MRI demonstrated transpleural and paravertebral invasion by the mass with extension through the left T1\u20132 and T2\u20133 neural foramina causing significant epidural compression. There was also transdural invasion at T2 extending intramedullary to the C4 spinal level, with associated cord edema. He underwent posterior cervicothoracic laminectomy and fusion with transpedicular epidural tumor debulking. The intramedullary component was not removed. He received adjuvant radiation therapy and chemotherapy and at the 6-month follow-up demonstrated significant return of motor function in his lower extremities, ambulating with a walker.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>LESSONS<\/jats:title>\n                    <jats:p>This case illustrates that rapid surgical decompression can still provide benefit even for aggressive tumors causing transdural and intramedullary invasion. The decision on whether to remove the intramedullary component should be made on a case-by-case basis and guided by the patient\u2019s neurological examination in combination with imaging findings.<\/jats:p>\n                    <jats:p>\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/thejns.org\/doi\/10.3171\/CASE25200\">https:\/\/thejns.org\/doi\/10.3171\/CASE25200<\/jats:ext-link>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/case25200","type":"journal-article","created":{"date-parts":[[2025,6,16]],"date-time":"2025-06-16T20:02:02Z","timestamp":1750104122000},"source":"Crossref","is-referenced-by-count":0,"title":["Surgical management of a pulmonary neuroendocrine tumor causing epidural spinal cord compression and transdural intramedullary invasion: illustrative case"],"prefix":"10.3171","volume":"9","author":[{"given":"Wesley","family":"Shoap","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Louisiana State University Health Sciences Center, New Orleans, Louisiana"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4273-1525","authenticated-orcid":true,"given":"Kion","family":"Gregory","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Louisiana State University Health Sciences Center, New Orleans, Louisiana"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jack A.","family":"Leoni","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Louisiana State University Health Sciences Center, New Orleans, Louisiana"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gabriel C.","family":"Tender","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Louisiana State University Health Sciences Center, New Orleans, Louisiana"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"issue":"1","key":"bib1","series-title":"Neurospine","first-page":"65","article-title":"Clinical features, treatments, and prognosis of intramedullary spinal cord metastases from lung cancer: a case series and systematic review","volume":"19","author":"Wu","year":"2022","unstructured":"Wu LWang LYang JJia WXu Y.Clinical features, treatments, and prognosis of intramedullary spinal cord metastases from lung cancer: a case series and systematic review. Neurospine. 2022;19(1):65-76."},{"issue":"2","key":"bib2","series-title":"Neurosurg Focus","article-title":"Intramedullary spinal cord metastases: an increasingly common diagnosis","volume":"39","author":"Payer","year":"2015","unstructured":"Payer SMende KCWestphal MEicker SO.Intramedullary spinal cord metastases: an increasingly common diagnosis. Neurosurg Focus. 2015;39(2):E15."},{"key":"bib3","series-title":"J Clin Neurosci","first-page":"124","article-title":"Lung adenocarcinoma presenting as intramedullary spinal cord metastasis: case report and review of literature","volume":"52","author":"Majmundar","year":"2018","unstructured":"Majmundar NShao BAssina R.Lung adenocarcinoma presenting as intramedullary spinal cord metastasis: case report and review of literature. J Clin Neurosci. 2018;52:124-131."},{"issue":"6","key":"bib4","series-title":"Neurosurg Rev","first-page":"3267","article-title":"Surgical treatment of intramedullary spinal cord metastases: functional outcome and complications\u2014a multicenter study","volume":"44","author":"Gazzeri","year":"2021","unstructured":"Gazzeri RTelera SGalarza MCallovini GMIsabella SAlfieri A.Surgical treatment of intramedullary spinal cord metastases: functional outcome and complications\u2014a multicenter study. Neurosurg Rev. 2021;44(6):3267-3275."},{"issue":"7","key":"bib5","series-title":"Intern Med","first-page":"795","article-title":"Intramedullary spinal cord metastasis with a longitudinally extensive spinal cord lesion","volume":"50","author":"Soga","year":"2011","unstructured":"Soga KIrioka TYano TMizusawa H.Intramedullary spinal cord metastasis with a longitudinally extensive spinal cord lesion. Intern Med. 2011;50(7):795-796."},{"issue":"9","key":"bib6","series-title":"J Clin Neurosci","first-page":"1196","article-title":"Bronchogenic carcinoid metastasis to the intramedullary spinal cord","volume":"17","author":"Li","year":"2010","unstructured":"Li DBrennan JWBuckland MParkinson JF.Bronchogenic carcinoid metastasis to the intramedullary spinal cord. J Clin Neurosci. 2010;17(9):1196-1198."},{"issue":"10","key":"bib7","series-title":"AJNR Am J Neuroradiol","first-page":"2043","article-title":"Intramedullary spinal cord metastases: MRI and relevant clinical features from a 13-year institutional case series","volume":"34","author":"Rykken","year":"2013","unstructured":"Rykken JBDiehn FEHunt CHIntramedullary spinal cord metastases: MRI and relevant clinical features from a 13-year institutional case series. AJNR Am J Neuroradiol. 2013;34(10):2043-2049."},{"key":"bib8","series-title":"World Neurosurg","first-page":"426","article-title":"Intramedullary spinal cord metastasis from primary lung neuroendocrine carcinoma: a case report and operative video","volume":"145","author":"Ginalis","year":"2021","unstructured":"Ginalis EEJumah FRaju BXiong ZNanda A.Intramedullary spinal cord metastasis from primary lung neuroendocrine carcinoma: a case report and operative video. World Neurosurg. 2021;145:426-431."},{"issue":"3-4","key":"bib9","series-title":"World Neurosurg","first-page":"576","article-title":"Intramedullary spinal cord metastases: a 20-year institutional experience with a comprehensive literature review","volume":"79","author":"Sung","year":"2013","unstructured":"Sung WSSung MJChan JHIntramedullary spinal cord metastases: a 20-year institutional experience with a comprehensive literature review. World Neurosurg. 2013;79(3-4):576-584."},{"key":"bib10","series-title":"J Clin Neurosci","first-page":"27","article-title":"Impact of surgical treatment for intramedullary spinal cord metastasis on neurological function and survival: a multicenter retrospective study by the Neurospinal Society of Japan","volume":"117","author":"Iwasaki","year":"2023","unstructured":"Iwasaki MNaito KEndo TImpact of surgical treatment for intramedullary spinal cord metastasis on neurological function and survival: a multicenter retrospective study by the Neurospinal Society of Japan. J Clin Neurosci. 2023;117:27-31."},{"issue":"3","key":"bib11","series-title":"J Neurosurg Spine","first-page":"324","article-title":"Reliability analysis of the epidural spinal cord compression scale","volume":"13","author":"Bilsky","year":"2010","unstructured":"Bilsky MHLaufer IFourney DRReliability analysis of the epidural spinal cord compression scale. J Neurosurg Spine. 2010;13(3):324-328."},{"issue":"6","key":"bib12","series-title":"Oncologist","first-page":"744","article-title":"The NOMS framework: approach to the treatment of spinal metastatic tumors","volume":"18","author":"Laufer","year":"2013","unstructured":"Laufer IRubin DGLis EThe NOMS framework: approach to the treatment of spinal metastatic tumors. Oncologist. 2013;18(6):744-751."},{"issue":"1","key":"bib1","series-title":"Neurospine","first-page":"65","article-title":"Clinical features, treatments, and prognosis of intramedullary spinal cord metastases from lung cancer: a case series and systematic review","volume":"19","author":"Wu","year":"2022","unstructured":"Wu LWang LYang JJia WXu Y.Clinical features, treatments, and prognosis of intramedullary spinal cord metastases from lung cancer: a case series and systematic review. Neurospine. 2022;19(1):65-76."},{"issue":"2","key":"bib2","series-title":"Neurosurg Focus","article-title":"Intramedullary spinal cord metastases: an increasingly common diagnosis","volume":"39","author":"Payer","year":"2015","unstructured":"Payer SMende KCWestphal MEicker SO.Intramedullary spinal cord metastases: an increasingly common diagnosis. Neurosurg Focus. 2015;39(2):E15."},{"key":"bib3","series-title":"J Clin Neurosci","first-page":"124","article-title":"Lung adenocarcinoma presenting as intramedullary spinal cord metastasis: case report and review of literature","volume":"52","author":"Majmundar","year":"2018","unstructured":"Majmundar NShao BAssina R.Lung adenocarcinoma presenting as intramedullary spinal cord metastasis: case report and review of literature. J Clin Neurosci. 2018;52:124-131."},{"issue":"6","key":"bib4","series-title":"Neurosurg Rev","first-page":"3267","article-title":"Surgical treatment of intramedullary spinal cord metastases: functional outcome and complications\u2014a multicenter study","volume":"44","author":"Gazzeri","year":"2021","unstructured":"Gazzeri RTelera SGalarza MCallovini GMIsabella SAlfieri A.Surgical treatment of intramedullary spinal cord metastases: functional outcome and complications\u2014a multicenter study. Neurosurg Rev. 2021;44(6):3267-3275."},{"issue":"7","key":"bib5","series-title":"Intern Med","first-page":"795","article-title":"Intramedullary spinal cord metastasis with a longitudinally extensive spinal cord lesion","volume":"50","author":"Soga","year":"2011","unstructured":"Soga KIrioka TYano TMizusawa H.Intramedullary spinal cord metastasis with a longitudinally extensive spinal cord lesion. Intern Med. 2011;50(7):795-796."},{"issue":"9","key":"bib6","series-title":"J Clin Neurosci","first-page":"1196","article-title":"Bronchogenic carcinoid metastasis to the intramedullary spinal cord","volume":"17","author":"Li","year":"2010","unstructured":"Li DBrennan JWBuckland MParkinson JF.Bronchogenic carcinoid metastasis to the intramedullary spinal cord. J Clin Neurosci. 2010;17(9):1196-1198."},{"issue":"10","key":"bib7","series-title":"AJNR Am J Neuroradiol","first-page":"2043","article-title":"Intramedullary spinal cord metastases: MRI and relevant clinical features from a 13-year institutional case series","volume":"34","author":"Rykken","year":"2013","unstructured":"Rykken JBDiehn FEHunt CHIntramedullary spinal cord metastases: MRI and relevant clinical features from a 13-year institutional case series. AJNR Am J Neuroradiol. 2013;34(10):2043-2049."},{"key":"bib8","series-title":"World Neurosurg","first-page":"426","article-title":"Intramedullary spinal cord metastasis from primary lung neuroendocrine carcinoma: a case report and operative video","volume":"145","author":"Ginalis","year":"2021","unstructured":"Ginalis EEJumah FRaju BXiong ZNanda A.Intramedullary spinal cord metastasis from primary lung neuroendocrine carcinoma: a case report and operative video. World Neurosurg. 2021;145:426-431."},{"issue":"3-4","key":"bib9","series-title":"World Neurosurg","first-page":"576","article-title":"Intramedullary spinal cord metastases: a 20-year institutional experience with a comprehensive literature review","volume":"79","author":"Sung","year":"2013","unstructured":"Sung WSSung MJChan JHIntramedullary spinal cord metastases: a 20-year institutional experience with a comprehensive literature review. World Neurosurg. 2013;79(3-4):576-584."},{"key":"bib10","series-title":"J Clin Neurosci","first-page":"27","article-title":"Impact of surgical treatment for intramedullary spinal cord metastasis on neurological function and survival: a multicenter retrospective study by the Neurospinal Society of Japan","volume":"117","author":"Iwasaki","year":"2023","unstructured":"Iwasaki MNaito KEndo TImpact of surgical treatment for intramedullary spinal cord metastasis on neurological function and survival: a multicenter retrospective study by the Neurospinal Society of Japan. J Clin Neurosci. 2023;117:27-31."},{"issue":"3","key":"bib11","series-title":"J Neurosurg Spine","first-page":"324","article-title":"Reliability analysis of the epidural spinal cord compression scale","volume":"13","author":"Bilsky","year":"2010","unstructured":"Bilsky MHLaufer IFourney DRReliability analysis of the epidural spinal cord compression scale. J Neurosurg Spine. 2010;13(3):324-328."},{"issue":"6","key":"bib12","series-title":"Oncologist","first-page":"744","article-title":"The NOMS framework: approach to the treatment of spinal metastatic tumors","volume":"18","author":"Laufer","year":"2013","unstructured":"Laufer IRubin DGLis EThe NOMS framework: approach to the treatment of spinal metastatic tumors. Oncologist. 2013;18(6):744-751."}],"container-title":["Journal of Neurosurgery: Case Lessons"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-case-lessons\/9\/24\/article-CASE25200.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-case-lessons\/9\/24\/article-CASE25200.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-case-lessons\/9\/24\/article-CASE25200.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,2]],"date-time":"2026-02-02T23:39:33Z","timestamp":1770075573000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-case-lessons\/9\/24\/article-CASE25200.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,6,16]]},"references-count":24,"journal-issue":{"issue":"24"},"URL":"https:\/\/doi.org\/10.3171\/case25200","relation":{},"ISSN":["2694-1902"],"issn-type":[{"value":"2694-1902","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,6,16]]}}}