© 1994 Kluwer Academic Publishers. Printed in the Netherlands. Clinical case Metastatic tumor of unknown primary site

A 67-year-old woman presented in April 1992 with a two-month history of paresthesia of her lower limbs with progressive weakness and impairment of ambula-tion. MRI of the thoracic vertebrae showed extradural neoplastic tissue with compression and lateral disloca-tion of the spinal cord at T2 (Figs. 1 and 2). A month later a percutaneous fine needle aspiration led to the cytological diagnosis of metastatic carcinoma, with im-munocytochemistry positive for cytokeratins. The pa-tient underwent a number of diagnostic procedures including chest X-ray, abdomino-pelvic ultrasonogra-phy, bone scintiscan, thorax and abdomen computed tomography (CT), gastrointestinal tract X-ray, barium enema, scintigraphy and ultrasonography of thyroid. The results of all of these procedures were inconclu