Sir,A 74-year-old man presented with a 2-week history of decreased sensation and weakness of bilateral lower extremities along with urinary incontinence. Neurologic examination showed decreased sensation from the lumbar one dermatome below. Thoracic magnetic resonance imaging (MRI) revealed a solitary intramedullary lesion located at thoracic 12 levels with homogeneous contrast enhancement [Figure la, c and e]. With the aid of intraoperative neuromonitoring, the tumor was resected radically after dorsal midline myelotomy and post-operative thoracic MRI demonstrated total resection of intramedullary spinal cord tumor [Figure lb, d and fj. Histopathological examination with hematoxylin and eosin revealed a malignant tumor consisting of nests of cells with abundant cytoplasm and prominent mitoses [Figure 2a]. Immunochemistry examination further showed prostatic specific acid phosphatase was positive [Figure 2b], which indicated the diagnosis of metastatic prostate adenocarcinoma. A needle aspiration biopsy of the prostate confirmed the diagnosis of prostate carcinoma and systemic bone scan showed numerous sites of metastases involved pelvis, thigh bones and vertebrae [Figure 3]. Post-operative period was uneventful and patient remained at his baseline neurological status except improved sensation. After receiving hormonal therapy, he remained neurologically stable for 6 months.
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