case_images: PMC11380904_01
case_images: (a) Magnetic resonance imaging revealed an intramedullary spinal cord tumor extending from C4 to C7, appearing as a high-intensity area on T2-weighted imaging and (b) a gadolinium-enhanced heterogeneous mass on T1-weighted imaging.
case_images: SNI-15-312-g001.jpg
case_images: PMC11380904_01_SNI-15-312-g001.jpg
case_images: F1
case_images: The cervical MR revealed an ICSM extending from C4 to C7; the lesion was hyperintense on T2-weighted imaging and showed heterogeneous enhancement with gadolinium [Figure 1].
case_images: (a: x200; b: x400) Hematoxylin and eosin staining of the resected specimen revealed adenocarcinoma. (c) The MIB-1/Ki-67 labeling index was 14.3%.
case_images: SNI-15-312-g002.jpg
case_images: PMC11380904_01_SNI-15-312-g002.jpg
case_images: F2
case_images: Following surgical resection, the ICSM pathology revealed an NSCLC tumor harboring an ALK rearrangement [Figure 2].
case_images: (a) When alectinib was discontinued, the patient had a relapse in the spinal cord at the C1 level after 1 year. (b) Alectinib administration was subsequently restarted, and the recurrent lesion disappeared after 3 years.
case_images: SNI-15-312-g003.jpg
case_images: PMC11380904_01_SNI-15-312-g003.jpg
case_images: F3
case_images: However, 1 year after stopping alectinib, he developed a new ICSM at the C1 level [Figure 3a]. Over the next 3 years, with the repeated administration of alectinib, this secondary lesion resolved, and he remains in remission now 6 years after that [Figure 3b].