CASE REPORT article
Front. Surg.
Sec. Neurosurgery
Case Report: Management of Cervical Intramedullary Spinal Cord Metastasis from NSCLC with a Literature Review
Provisionally accepted
- 1Department of Spinal Surgery, the 940th Hospital of the Joint Logistic Support Force of Chinese People's Liberation Army, Lanzhou Gansu, 730050, China, Lanzhou Gansu, China
- 2First Clinical Medical School, Gansu University of Chinese Medicine, Lanzhou Gansu, 730030, China, Lanzhou Gansu, China
- 3Department of Orthopedics, the 943rd Hospital of Joint Logistic Support Force of Chinese People's Liberation Army, Wuwei Gansu, 733000, China, Wuwei Gansu, China
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Background: Intramedullary spinal cord metastases (ISCM) from non-small cell lung cancer (NSCLC) are rare and carry a grave prognosis. Cervical segment involvement is exceptionally uncommon, and its distinct clinicopathological profile is not well characterized. Methods: We present the case of a 72-year-old male with a history of NSCLC who developed acute quadriparesis and sphincter dysfunction. Cervical magnetic resonance imaging (MRI) revealed a C7 intramedullary mass. The patient underwent C6-T1 laminectomy with microsurgical gross-total resection. Histopathology confirmed metastatic lung adenocarcinoma. We supplemented this case with a systematic literature review of NSCLC-derived ISCM cases to summarize demographic, clinical, and therapeutic outcomes. Results: Histopathology confirmed metastatic lung adenocarcinoma. Postoperatively, the patient's neurological function improved. Although local recurrence was detected at 11 months and treated with salvage radiotherapy, the patient nevertheless maintained ambulatory function and was alive at the 18-month follow-up. Our literature review of 68 cases with complete data identified a male predominance (4.2:1 ratio) and a mean age of 58.1 years. The cervical spine was the most commonly involved segment (47.1%). Analysis of treatment modalities revealed that multimodal therapy, particularly the combination of surgery and chemotherapy (potentially incorporating modern agents such as immune checkpoint inhibitors), was associated with improved survival, with a mean overall survival of 15.0 months in this subgroup. This paradigm, centered around maximal safe resection, successfully achieved long-term functional preservation and survival. Conclusion: Cervical ISCM from NSCLC represents one of the most challenging complications in spinal oncology. This case, supported by our literature review, provides a surgical-led, multimodal management template for spine surgeons, demonstrating that aggressive yet strategic intervention can achieve favorable long-term neurological and survival outcomes.
Keywords: case report, cervical spine, Intramedullary spinal cord metastases (ISCM), literature review, multimodal therapy, Non-small cell lung cancer (NSCLC), Survival
Received: 03 Dec 2025; Accepted: 06 Feb 2026.
Copyright: © 2026 Liu, Chen, Li, Zhang, Zhang and Li. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Hua Liu
Songkai Li
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