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18F-FDG PET/CT imaging provides valuable information in the evaluation and staging of spinal tumors. Herein, we report the case of a 57-year-old man who presented with a sudden paraplegia below the fifth thoracic vertebra due to cord compression of a spinal lesion. After spinal canal decompression and spinal lesion biopsy, the diagnosis was a poorly differentiated neuroendocrine tumor. Subsequent PET/CT revealed that it was a primary site, showing intense FDG uptake. He was eventually referred for palliative radiotherapy.