一位 46 歲女性，左上肺肺腺癌，臨床期別為 T4N2M1，合併腰椎第一節之脊髓壓迫。臨床症狀表現只有視力模糊與頭痛，原因證實為顱內壓增加合併兩側視乳突水腫。臨床評估包含多次腦部磁共振掃描、腰椎穿刺與會診眼科專科醫師。在藉助磁共振掃描完成全脊髓液系統（腦與全脊髓）檢查，診斷為腰椎第一節脊髓壓迫所導致。視乳突水腫與顱內壓在完成第一節腰椎放射線治療獲得短暫改善。九個月後，最終診斷為軟腦脊膜轉移，病因與診斷將進一步討論。

A case of adenocarcinoma of lef t upper lung, cT4N2M1, with spinal cord
compression over L1 in a 46-year-old woman is presented. The only clinical symptom was blurred vision and headache, which proved to be caused by increased intracranial pressure (IICP) with bilateral papilledema. Evaluations of IICP were performed including repeated MRI of brain, lumbar puncture and ophthalmologist consultation. After complete survey of the entire CSF system by MRI, the diagnosis of spinal cord compression over L1 region was made. After the completion of palliative radiotherapy for the L1 cord compression, the symptoms of blurred vision and headache improved transiently. The final diagnosis of leptomeningeal metastasis was established nine months latter. The cause as well as diagnosis is discussed.