Figure 2.

A 64-year-old man who presented with acute neurological deterioration secondary to a T4 and T5 metastatic epidural spinal cord compression from a known lung adenocarcinoma (1a/1b). He underwent surgical debulking of the lesion, separation surgery with restauration of the epidural space and spinal fixation, followed by stereotactic body radiotherapy. His postoperative MRI confirmed good decompression and removal of the epidural tumor (2a/b). Six months later, on a follow-up MRI the patient had a recurrence locally (3a/b) and required a reoperation.