Dural metastases responsible for benign vertebral collapses

Excerpt

A 17-year-old male patient was transferred to our centre for an invasive ethmoidal carcinoma extending to both frontal lobes of the brain. Bone scintigraphy with single photon emission tomography (SPECT) showed hyperactivity at the level of the 3^rd to 5^th and 7^th to 9^th vertebral bodies of the dorsal spine. Standard X-ray suggested benign bone fractures. ¹⁸F-fluorodeoxyglucose (FDG) positron emission tomography (PET) showed no increased uptake of the tracer in any vertebral body but there were highly hypermetabolic lesions posterior to the vertebral body at multiple levels where hyperactivity was present on the bone scan images. Magnetic resonance imaging (MRI) showed multiple metastases in the intradural extramedullary space evoking benign bone fractures, confirming the PET observations (see figure). The most probable phenomenon explaining the association of intradural metastases with benign bone fractures is vascular compression leading to vertebral infarction [1]. Indeed, vertebral infraction may accompany anterior spinal artery syndrome since the arterial supply to the dorsal part of the vertebral body derives from this artery [2]. …