Presumed spinal cord metastasis in a female patient known to have breast cancer. MRI shows:
- Focal cord expansion with intramedullary enhancing mass,
- Thin enhancing rim along lower anterior cord surface and,
- Enhancing metastatic foci in the bone marrow.
Spinal cord metastases can be:
1-Intramedullary (within the cord): rare.
2-Pial (Superficial, along pial surface): in most of the cases.
Common primary CNS tumors: PNET/medulloblastoma and glioblastoma.
Common primary malignancy outside CNS: lung (70%), breast (11%), melanoma, kidney, lymphoma and leukemia.

Post contrast MRI demonstrates so called “sugar coating” or zuckerguss (German for sugar icing) of the lower portions of the spinal cord in keeping with leptomeningeal metastases.

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