Case Presentation: A 68-year-old woman with known metastatic breast cancer developed an ataxic gait, lower limb weakness and urinary retention over the course of one week. A magnetic resonance imaging (MRI) scan was performed which showed a T10/T11 intradural tumour. She was subsequently taken to theatre for decompression and resection of the tumour. The bulk of tumour was composed of densely packed bland tapered spindle cells arranged in fascicles. There were no features of schwannoma identified. Admixed within the tumour were cords and single cells of metastatic poorly differentiated adenocarcinoma with mucin droplets. Immunohistochemistry within the spindle cells confirmed the presence of a peripheral nerve sheath tumour, and within the epithelioid cells confirmed the presence of metastatic breast carcinoma. Discussion: Tumour to tumour metastasis (TTM) is a well described phenomenon. It involves lung, breast and gastrointestinal tract malignancies as the most common donors. Meningiomas and schwannomas are common receptive tumours. However in this case it is difficult to ascertain if the receptive tumour was a neurofibroma or a schwannoma. Distinguishing a TTM from a sarcomatous biphasic malignancy is an important consideration, especially in the setting of a primary diagnosis.
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