This 39 y/o world class athlete was referred for thoracic MRI with a history of persistent back pain for one year and recent onset of leg weakness and difficulty with urination. Selected T1, T2 and post gadolinium T1 weighted images shown above demonstrate lesions at T3 and T10 which are extradural and which show bone involvement. While metastases were considered, lymphoma or myeloma seemed more likely in this young patient. Emergency decompression surgery to relieve his cord compression was performed and the final pathologic diagnosis was metastatic carcinoid tumor. An extensive workup was subsequently performed but failed to demonstrate a primary source.

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