Spinal cord metastasis from testicular seminoma detected by F-18 FDG PET/CT study prior to neurological symptoms: An unusual presentation

A 60-year-old patient with testicular seminoma was referred for F-18 FDG PET/CT Study to evaluate recurrence. In addition to hypermetabolic cervical, mediastinal and hilar lymph node tumoral metastases, segmental intense FDG uptake along the lumbar spinal cord suggestive of tumoral metastasis was noted which quite an unusual presentation is. At the time of PET study the patient was symptomless, and neurological symptoms and signs associated with spinal cord metastasis developed only several days afterwards, emphasizing the role of FDG PET study in early detection of spinal cord metastasis. The patient underwent radiotherapy of the spinal cord with consequent clinical improvement.