Intradural sacral nerve root metastasis mimicking herniated disc

Hirsh, Leonard F.; Finneson, Bernard E.

doi:10.3171/jns.1978.49.5.0764

Cited by 20 publications

(5 citation statements)

References 19 publications

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“…Since 1950, 49 patients (excluding those in the M. D. Anderson Cancer Center series) with such tumors have been reported, with histological confirmation by surgery. 2,3,7,[9][10][11][12][13]16,17,19,[24][25][26][27][28][32][33][34][35][36][37]42,45 The average age of 54 years at diagnosis (range 23-74 years) is similar to that found in both the present study (mean age 51 years) and in the only other published series of significant size reported by Perrin and colleagues 23,34 in 1982. Women outnumbered men in both series by 6:4, and the female/male ratio is 1.3:1 when all 59 cases now on record are considered.…”

Section: Review Of the Literaturesupporting

confidence: 87%

The surgical treatment of metastatic spinal tumors within the intradural extramedullary compartment

Chow

McCutcheon²

1996

Journal of Neurosurgery

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The authors retrospectively reviewed the surgical outcomes in 10 cases of symptomatic intradural extramedullary spinal metastases of nonneurogenic origin because the collective experience in treating this rare manifestation of systemic cancer is limited. Pain and weakness were the presenting complaints in 70% of the patients and sensory changes were found in all cases. Cytological tests on one specimen of cerebrospinal fluid (CSF) from each of seven patients showed malignant cells in two cases. Gadolinium contrast-enhanced biplanar magnetic resonance (MR) imaging was effective in localizing the lesion and showed evidence of leptomeningeal carcinomatosis in two cases; myelography showed leptomeningeal carcinomatosis in one case and erroneously identified the lesion as intramedullary in the other. Eight of 10 cases had antecedent intracranial metastatic foci with the interval from presentation of the intracranial lesion to appearance of the spinal disease ranging from 3 to 51 months. The majority of the spinal lesions occurred in the thoracolumbar area. The most frequent histological type was adenocarcinoma and the most frequent source was the lung. In all cases laminectomies, intradural exploration, and biopsy or subtotal excision aided by microscopy and ultrasonography were performed. Results of surgical decompression were poor with only 30% of the patients showing improvement, at a 20% risk of perioperative mortality and a 60% risk of morbidity. Plans for surgical intervention in patients with intradural extramedullary metastases from a distant noneurogenic source should be weighed against the high association with intracranial lesions, overall poor prognosis, and modest symptomatic results of decompression. Comprehensive evaluation including multiple specimens of CSF for cytology and contrast-enhanced MR imaging should be undertaken to exclude patients with diffuse leptomeningeal involvement, who should be treated by means other than surgery.

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Section: Review Of the Literaturesupporting

confidence: 87%

The surgical treatment of metastatic spinal tumors within the intradural extramedullary compartment

Chow

McCutcheon²

1996

Journal of Neurosurgery

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“…It has been reported that an isolated intradural metastasis might simulate lumbar disc disease. 14,23 As in this case, back pain that increases with recumbency and keeps the patient awake at night together with bilateral sciatica are symptoms indicative of a possible intradural source. 8 Based on the previous descriptions, it is apparent that the cauda equina is an exceedingly rare site of metastasis of RCC.…”

Section: Discussionmentioning

confidence: 92%

Unusual Metastasis to the Cauda Equina From Renal Cell Carcinoma

Takada

Doita

Nishida

et al. 2003

Spine

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The majority of cauda equina tumors are primary tumors, and metastases are very rare. Intradural spinal metastasis pain is a characteristic cramping pain provoked by light percussion on the lumbar spine, becoming severe when sleeping in the flexion or sitting position. Magnetic resonance imaging is a useful tool for detecting intraspinal metastasis when the patient is complaining of a unique pain. A recapping T-saw laminoplasty to preserve posterior elements with tumor removal is feasible for relieving pain and demonstrating the pathology.

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“…Em uma breve revisão sobre o assunto, Perrin et al 2 encontraram 9 de 10 casos envolvendo o cone medular e a cauda equina, embora autores de uma revisão mais recente tenham identificado casos na junção cervicotorácica, sendo disseminados pela via hematogênica, extensão direta do espaço epidural, disseminação pelos vasos linfáticos perineurais e líquor. 2,3,8,9 No entanto, alguns autores 2,9 acreditam que o principal mecanismo de disseminação seja pelo líquor, baseados no fato de que 80% destas metástases espinhais serem sincrônicas com metástases cerebrais, 2,4 o que não foi observado em nosso caso.…”

Section: Discussionunclassified

Metástase espinhal intradural e extramedular: relato de caso

Santos¹,

Cavalcante

Marques

et al. 2015

Arq Bras Neurocir

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IntroduçãoO câncer de mama é a principal causa de mortes relacionadas ao câncer em mulheres. 1 Metástase espinhal extramedular intradural é uma complicação rara de câncer sistêmico. No seu conjunto, mestástases espinhais ocorrem no compartimento extradural em mais de 90% dos casos. Estima-se que 5% dos casos de doença metastática envolvendo a coluna vertebral ocorrem no espaço extramedular intradural. 2,3Poucos casos estão relatados. 4,5 Descrevemos o caso de uma paciente com diagnóstico anterior de câncer de mama, que apresentou lombalgia e paraparesia como manifestação inicial da doença metastática na medula espinhal. Relato de CasoPaciente do sexo feminino de 41 anos de idade apresentava lombalgia progressiva há 15 dias, que se iniciou com paraparesia crural. Foi admitida na sala de emergência. Era capaz ResumoMetástases espinhais extramedulares e intradurais são peculiares e correspondem a pequena porcentagem dos casos de tumores da coluna vertebral. Os pacientes normalmente apresentam dor e sintomas neurológicos na primeira apresentação. A imagem por ressonância magnética (RM) é crucial para confirmar a suspeita do diagnóstico. Em geral, a manipulação requer tratamento paliativo representado por radioterapia e/ou cirurgia, para evitar futuros déficits neurológicos. O objetivo do autor é apresentar um caso incomum de metástase espinhal de câncer de mama em uma paciente de 41 anos de idade, com doença sistêmica controlada. Keywords► espinal tumor ► spinal cord compression ► low back pain Abstract Intradural extramedular spinal metastases are peculiar. They correspond to small percentage of spinal tumors cases. Patients ordinarily present pain and neurological symptoms at the first presentation. The magnetic resonance image (MRI) scan is crucial to confirm a diagnosis suspicion. On the whole, its handling requires a palliative management represented by radiotherapy and/or surgery to obviate future neurological deficits. The author's aim is present an unusual spinal metastasis of the breast cancer in a 41-year-old female patient with controlled systemic disease.

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Intradural sacral nerve root metastasis mimicking herniated disc

Cited by 20 publications

References 19 publications

The surgical treatment of metastatic spinal tumors within the intradural extramedullary compartment

The surgical treatment of metastatic spinal tumors within the intradural extramedullary compartment

Unusual Metastasis to the Cauda Equina From Renal Cell Carcinoma

Metástase espinhal intradural e extramedular: relato de caso

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