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Combined intramedullary and intradural extramedullary spinal metastases in malignant melanoma
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  1. Michael Kevin O'Reilly⇑,
  2. Gavin Sugrue,
  3. Danielle Byrne,
  4. Peter MacMahon
  1. Department of Radiology, Mater Misericordiae University Hospital, Dublin, Ireland
  1. Correspondence to Dr Michael Kevin O'Reilly, Radiology, Mater Misericordiae University Hospital, Eccles Street, Dublin 7, Ireland; michael.oreilly3{at}gmail.com

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A patient in their 30s presented with a 3-day history of lower back pain, lower limb weakness and new onset of urinary incontinence. The patient had a history of metastatic melanoma, including to brain, for which they had previously been treated with adjuvant chemotherapy and radiotherapy. Clinical exam revealed a palpable bladder at the umbilicus and reduced power in the lower limbs bilaterally.

An MRI whole spine with gadolinium contrast agent revealed multiple enhancing lesions at the T5/6, T9 and T12–L3 levels, pronounced spinal cord oedema and a markedly distended bladder (figures 1 and 2). The location of these lesions within the spinal canal …

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