Intradural metastasis of small cell lung carcinoma in conus medullaris is an uncommon disease. We report a case of lung cancer complicated with intradural metastasis in conus medullaris with just a symptom of hypoesthesia of the lower right limb and lower extremity weakness. The patient was initially suggested a clinical diagnosis of spinal meningioma or astrocytoma, according to the clinical symptom and the diseased region in imaging manifestation. Confirmed diagnosis was performed by histopathology and immunohistochemistry, revealing to be a malignant metastasis of small cell lung carcinoma. The patient underwent complete resection, and recovered well, although with pulmonary primary lesion to be treated. The tumor was 0.5×0.5×0.3cm in size and in contact with the conus medullaris. The aim of this study is to emphasize the importance of careful and comprehensive radiological examination and to reflect the difficulty of tumor resection. After the orthopedic surgery, the patient recovered well and got referral to pneumology department for follow-up treatment.

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