ArticleEuropean spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society2025
A case of sustained neurological improvement in a metastatic intramedullary spinal cord tumor from lung cancer treated with immune checkpoint inhibitor therapy.
Article in European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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- Case Report: Management of cervical intramedullary spinal cord metastasis from NSCLC with a literature review.Frontiers in surgery · 2026Article
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Abstract
purposeMetastatic intramedullary spinal cord tumors generally have poor prognosis, with chemotherapy often deemed ineffective. We report about a patient who achieved a favorable outcome with an immune checkpoint inhibitor following the resection of the extramedullary component of a metastatic intramedullary tumor.
methodA 74-year-old man underwent upper lobectomy for lung cancer. Seven months after surgery, he developed urinary retention and walking difficulty. Contrast-enhanced magnetic resonance imaging (MRI) revealed an intradural extramedullary tumor with homogeneous enhancement at the C7/Th1 level. Emergent tumor resection was performed.
resultsIntraoperatively, a part of the tumor was found to be firmly adhered to the spinal cord. The tumor was resected, and the adhered portion was cauterized. Postoperatively, the patient's paraparesis improved, enabling him to walk with a cane. Histopathological analysis confirmed the tumor as a metastasis of lung cancer. Postoperative MRI revealed residual intramedullary lesions, leading to a metastatic intramedullary tumor diagnosis. Given the high PD-L1 expression in the tumor cells, treatment with an immune checkpoint inhibitor was initiated. This resulted in the resolution of spinal cord edema and residual tumor disappearance on follow-up MRI. The patient maintained ambulatory function for 2 years.
conclusionRecent studies have demonstrated the efficacy of immune checkpoint inhibitors for brain metastases of lung cancer with high PD-L1 expression. In our case, spinal cord edema resolved, and the residual tumor regressed, with good neurological function sustained over 2 years. These findings suggest that immune checkpoint inhibitors may also be effective for metastatic intramedullary spinal cord tumors.
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