A rare case of synchronous multiplanar metastatic spinal deposits in a known case of breast carcinoma

Abstract Metastases to the spine from breast cancer are known. Intramedullary metastasis to the spinal cord is rare. Multiple synchronous multiplanar deposits in the spine, which include intramedullary, arachnoid seeding, and intradural-subpial deposits are even rare. Here, we report a case of a 47-year-old woman who underwent surgery for breast cancer 1 year before the onset of neurological symptoms. On magnetic resonance imaging (MRI), evaluation diagnosed to have a conus mass, and intraoperatively, imaging-occult, disease in the arachnoid and subpial compartments was also seen. Histopathology of the deposits turned out to be metastasis from adenocarcinoma breast. Our objective is to emphasize that a thorough preoperative MRI evaluation is important but can still miss the true burden of the disease, especially the leptomeningeal deposits. Hence a high index of suspicion should be kept in patients with suspected spinal metastases.