 Hello everyone, welcome to the case of the month, a 68 years old male patient presented with history of increasing numbness, paristhesia and weakness of the lower limbs over the past month. An MRI of L.S. pine with contrast was asked for. Let us take a look at the images, T2 weighted societal naxial images show an intramiddlery altered signal intensity lesion causing mild expansion of cord involving the lower dorsal part and extending into the converse mental areas. Lesion is predominantly solid with small cystic component in the inferior aspect, significant surrounding edema is seen within the cord extending superiorly, T1 societal image is undemarcable, T1 societal naxial and societal post-contratus images show heterogeneous enhancement of the lesion. Based on the location of the lesion, possibility of mix of upper appendymoma was considered and based on the solid cystic pattern, another possibility of hemangioblastoma was considered. We went on to screen the cervical dorsal spine, on the societal T2 weighted image there is a suspicious intramiddlery hyperintensity at C3-4 level, the corresponding axial T2 weighted image shows intramiddlery hyperintensity in left posterior lateral aspect of the cord. Another look at the post-contratus images shows ill-defined flame-shaped regions of enhancement at the superior and inferior margins of the lesion on the societal image, the so-called flame sign and a thin rim of more intense enhancement on the exerimage, the so-called rim sign. These signs suggest possibility of intramiddlery spinal metastasis and are helpful in distinguishing them from other intramiddlery lesions like appendymoma and hemangioblastoma. Further, on axial T2 image of dorsal spine, there is a suspicious left high-larb lesion, we obtained localizer images of the chest which confirmed a mass in left lung. The patient went on to have a CECD of the chest and a biopsy, confirming a squamous cell carcinoma, thus the lesions in lower dorsal cord involving the conus medullaris and cervical spine were intramiddlery spinal metastasis. Intramiddlery spinal metastasis are rare and are less common than leptomeningel metastasis. Lung is the most common primary and cervical cord is the most common location followed by thoracic cord and then lumbar cord. Lesions are usually well-defined and typically produce cord expansion over several segments. In contrast to primary intramiddlery neoplasms, associated cysts are rare, however an intra-lesion cyst was seen in our case. On T1, the lesions are usually hypotenters, on T2, they are hyperintense with prominent surrounding edema. On post-contrast scans, most of them show avid enhancement as seen in our case. Flame and rim sign are useful to distinguish these lesions from other intramiddlery neoplasms.