Figure 1

(a) Midline sagittal T1-weighted MRI shows a metastasis in the lower thoracic spine (T10). There is some epidural soft tissue, although this image does not confirm cord compression. Under these circumstances, orthogonal plane imaging should be undertaken. (b) Axial T2-weighted sequence shows epidural soft tissue disease extending from the posterior elements to the left of the midline. The cord is displaced to the right. The soft tissue component of disease frequently responds to radiotherapy, with resulting clinical improvement.