Intradural Metastasis to the Cauda Equina From Carcinoma of the Anus

Cho, Der Yang; Wang, Yeou Chih; Chen, Jung Ta

doi:10.1097/00007632-199511000-00014

Cited by 25 publications

(19 citation statements)

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“…[1][2][3][4][5] Disk hernisi, tümör, penetran travma, cerrahi manipulasyon, ankilozan spondilit, serbest epidural ya dokusu bas s , lomber spondilozis, dar kanal ve nadiren bu bölgeyi tutan metastazlar KES nedenleri aras ndad r. [6][7][8] Literatürde artan s kl kla KES' e neden olan ve kauda equinay tutan metastaz olgular bildirilmektedir. [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17] Biz, akci er kanseri tan s ile izlenen ve kauda equina-konus sendromu ile gelen, beyin metastaz olmadan, lomber düzeyde dissemine tarzda intradural ekstrameduller, leptomeningeal metastazlar saptanan olguyu sunmak istedik.…”

Section: G Runclassified

“…[1][2][3][4][5]9] Bu bölgede en s k, primer komponentlerinden kaynaklanan tümörler görülmekle beraber, metastazlar gittikçe artan s kl kta bildirilmektedir. [1][2][3][4][5][9][10][11][12][13][14][15][16][17] Beyin metastaz olmadan spinal leptomeningeal karsinomatozise oldukça nadir rastlanmakla beraber, nadir bir tabloyla, kauda equina-konus sendromu olarak kar m za ç kan bu olguyu sunmak istedik.…”

Section: Tarti Maunclassified

“…%2-4 olguda primer odak saptanamamaktad r. [2,6] Spinal metastazlar da son y llarda artan s kl kta KES nedenleri aras nda bildirilmektedir. [1][2][3][4][5][9][10][11][12][13][14][15][16][17] Kotil ve ark [3] primer maligniteye ait bulgular saptanmadan, L4/5 düzeyinde kitle ve KES sendromu ile ortaya ç kan …”

Section: Tarti Maunclassified

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Disseminated Leptomeningeal Carcinomatosis; Presenting With Cauda Equina-conus Syndrome

Sarsilmaz¹,

Apaydin²,

Varer³

et al. 2009

TUTFD

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© Trakya Üniversitesi T p Fakültesi Dergisi. AVES Yay nc l k taraf ndan bas lm t r. Her hakk sakl d r. © Medical Journal of Trakyantradural ekstrameduller metastazlar, leptomeningeal karsinomatozisin alt grubudur ve spinal metastazlar n yakla k %4-6's n olu turur. Genellikle intrakranial metastazlardan damla sekonder metastaz olarak kar m za ç kar ve lomber bölgede kauda equina düzeyinde, sinir kökler boyunca yay l r. Günümüzde, kanser olgular nda survinin uzamas nedeniyle, geç komplikasyon olarak daha s k görülmeye ba land bildirilmi tir. Bunun yans ra, kauda equina sendromu, ilk tablo olarak gelen ve primer malignite oda sonradan saptanan olgular da bildirilmektedir. Biz, akci er adenokarsinomu tan s alm ve takip edilmekte olan, kauda equina-konus sendromu bulgular ile gelen ve MRG' sinde, beyin metastaz izlenmedi i halde, lomber bölgede diffuz leptomeningeal karsinomatosis saptanan olguyu sunduk. A r , alt ekstremitelerde güçsüzlük ve üriner, anal disfonksiyon triad ; kauda equina sendromu (KES) ile gelen olgularda intradural ekstrameduller metastaz, leptomeningeal karsinomatozis akla gelmelidir. MRG tetkiki, bu olgu grubunda erken tan ve bilinmiyorsa, daha erken primer malignite oda n n saptanmas aç s ndan önemlidir.Anahtar sözcükler: Leptomeningeal karsinomatozis; kauda equinakonus sendromu; akci er kanseri; manyetik rezonans görüntüleme.Intradural extramedullary(intrathecal) metastases; a subtype of leptomeningeal carcinomatosis (LC), constitute approximately 4-6% of spinal metastases. They most commonly represent drop metastases from accompanying intracranial secondary lesions that become entangled within the nerve roots of the cauda equina. Generally, they occur as a late complication. However, there are some cases related to cauda equina syndrome (CES) that are the first presentation of primary malign lesion. We present the case of a patient who presented with symptoms of cauda equina-conus syndrome and for whom subsequent investigations revealed diffuse lumbar intrathecal metastases and locally advanced lung cancer without brain metastases. The case emphasizes the need for thorough investigation in the presence of the triad: back pain, weakness in the lower extremities, and urinary urgency/incontinence. Cauda equina syndrome due to intrathecal metastases should always be considered. Spine MRI with contrast is the most informative investigative study for these patients. Olgu Sunumu / Case Report 440 G RSpinal kolonun metastazlar nadirdir ve genellikle ekstradural yerle imlidir. ntradural metastazlar, spinal metastazlar n %4-6's n olu turur. Lomber düzeyde, subaraknoid mesafe, kauda equina veya spinal kordu tutarlar. [1][2][3][4][5][6] Mesane ve/veya barsak ve/veya cinsel fonksiyonlarda bozulma ile birlikte bel a r s , iki veya tek tarafl bacak a r s , alt ekstremitede ilerleyici paraplejiye kadar giden kuvvet kayb , eyer tarz nda perianal anestezi veya hipoestezi, kauda equina sendromunu (KES) akla

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Section: G Runclassified

Section: Tarti Maunclassified

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Disseminated Leptomeningeal Carcinomatosis; Presenting With Cauda Equina-conus Syndrome

Sarsilmaz¹,

Apaydin²,

Varer³

et al. 2009

TUTFD

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“…In two case studies, Perrin et al [4] recommended a non-operative method and Chow et al [30] recommended an operation. Both reports had a small number of cases (n=10).…”

Section: Introductionmentioning

confidence: 99%

“…The average life expectancy was 8.6 months and 84.6% patients died within one year. There were a total of 70 cases of which 55 were improved [5,6,8,10,11,13,14,[16][17][18]20,[23][24][25][28][29][30][31][32][33]35,[37][38][39][40][41][44][45][46][47][48][49]52,[54][55][56][57][58][59][61][62][63][64][65][66][67][68][69], eight remained unchanged [8,21,26,…”

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confidence: 99%

Intradural-Extramedullary Metastatic Tumor from Lung Cancer-A Case Report and Review

Sasaji¹

2017

MOJCR

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A 62-year-old male presented with a thoracic intradural-extramedullary metastasis from lung cancer. He complained of walking difficulty and bilateral lower leg numbness. He had a past history of lung adenocarcinoma three years prior. Thoracic spine magnetic resonance imaging showed that the tumor occupied the right subarachnoid space and spinal nerve roots had shifted to the left side at Th12. He was diagnosed with cauda equina syndrome by an intradural-extramedullary tumor. Surgery was performed (Th12 laminectomy) and we opened the dura mater and arachnoid membrane. The tumor was in the right side and was removed. After the operation, his neurological condition soon improved and he could walk with a cane. By four moths postoperatively, a metastatic brain tumor occurred and he had to use a wheel chair. He died one year after surgery. Immunohistochemical staining was positive for thyroid transcription factor-1 in both the lung adenocarcinoma and intraduralextramedullary tumor. We diagnosed a metastatic tumor. Including the present case, 102 cases of a metastatic intradural-extramedullary tumor have been reported and, thus, the condition may not be rare. In more than twenty years there have only been two case studies, which recommended both operative and non-operative methods. We reviewed the validity of an operation base on the prognosis and surgical results of previous reports. The average life expectancy was 8.6 months. The functional improvement rate was 78%. We recommend an operation for an intradural-extramedullary metastatic tumor because it improves the quality of a patients' short life. Keywords: IntroductionMetastases are by far the most common skeletal tumors seen by orthopedists, and the spine is the most common site of skeletal involvement [1]. A spinal epidural metastasis is the most common neoplastic myelopathy [2]. In a total of 1215 cases of primary lung cancer in an autopsy study, 20 (1.65%) revealed intradural parenchymal involvement [3]. Among 200 patients treated for symptomatic spinal metastases, a localized intradural extramedullary tumor was discovered in 10 cases [4]. Among 136 patients who underwent surgery for spinal metastases, an intradural extramedullary tumor was observed in two cases (1.5%) [5]. To our knowledge, Rogers et al. [6] were the first to report on an intradural-extramedurally metastatic tumor in 1958 since then, 101 cases have been reported in 66 articles . Including our case, the total number of reported cases is now 102. Many authors have described an intradural-extramedullary metastasis as a rare metastatic condition, however, we do not consider it to be rare given the number of reported cases.Two types of treatment have been reported for an intraduralextramedullary tumor, the recommended operative and nonoperative methods [4,18,31,38,45,63]. In two case studies, Perrin et al.[4] recommended a non-operative method and Chow et al.[30] recommended an operation. Both reports had a small number of cases (n=10). There have been no reviews of many cases that were n...

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Cancer of the Anus and the Anal Canal

Debois¹

2000

Selected Topics in Clinical Oncology

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Intradural Metastasis to the Cauda Equina From Carcinoma of the Anus

Cited by 25 publications

References 0 publications

Disseminated Leptomeningeal Carcinomatosis; Presenting With Cauda Equina-conus Syndrome

Disseminated Leptomeningeal Carcinomatosis; Presenting With Cauda Equina-conus Syndrome

Intradural-Extramedullary Metastatic Tumor from Lung Cancer-A Case Report and Review

Cancer of the Anus and the Anal Canal

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