— Intramedullary spinal cord metastases were previously thought to be rare; however, increased use of MRI has resulted in more frequent recognition. About one-half of cases are associated with lung cancer, especially small cell lung cancer. Breast and renal cell cancer, Iymphoma, and melanoma are other less common causes

This complication usually arises in the setting of widespread metastatic disease; the majority of patients have brain and lung metastases, and leptomeningeal metastases are seen in approximately 25 percent. Patients typically present with weakness, numbness, and pain; the Brown-Sequard syndrome of hemicord dysfunction is a common initial finding and may raise suspicion of this diagnosis as compared to the more common epidural spinal cord compression. MRI is generally diagnostic, although CT-myelogram can be diagnostic in patients who cannot undergo MRI. see typical intra-medullar cord met at T2 from a patient with metastatic breast cancer (here and here)