Metastasis of Breast Cancer to a Lumbar Spinal Nerve Root Ganglion

Abstract

Although very rare, metastasis to the spinal nerve root ganglion can be the first manifestation of distant hematogenous metastases of breast cancer. The clinical course is characterized by increasing radicular symptoms-especially intractable pain. The radiologic appearance might mimic a benign lesion. Surgical intervention with tumor debulking followed by radiotherapy provides local tumor control and palliation from pain.

Pulmonary adenocarcinoma metastasis to a dorsal root ganglion: a case report and review of the literature

“…Intraoperative neurophysiological monitoring should be used in all unclear lesions. Previous reports indicate that clear delineation of tumor and nerve tissue or tumor capsules is usually not found, and subtotal resections were generally performed [3]. Complete tumor removal with preservation of neurological function is usually not an option.…”

“…Up to now, only four cases in three publications are listed, comprising two cases from autopsy series and two case reports. The underlying pathologies include ductal breast cancer, pulmonary oat-cell cancer, renal cell carcinoma and uterine carcinoma [1-3]. Although metastatic spread to the central nervous system is common in pulmonary adenocarcinoma, DRG metastasis has not yet been described.…”

Intradural Extramedullary Metastasis of the Upper Thoracic Spine – Case Report and Literature Review

“…They result from advanced primary neoplastic disease and most often originate from lung or breast adenocarcinoma, similarly as in the described case. 4,5,9,10 IEMs present a significant neurological complication of systemic neoplasms ranging from 3% to 43% according to clinical and autopsy studies, with only 0.8% -3.9% being symptomatic. 2,[9][10][11] Infiltration of tumor cells in the intradural space is possible via cerebrospinal fluid dissemination from brain metastases, via haematogenous pathway (arterial or via Batson venous plexus), via direct invasion of spinal cord sheaths or via the lymphatic perineural ducts.…”

“…4,5,9,10 IEMs present a significant neurological complication of systemic neoplasms ranging from 3% to 43% according to clinical and autopsy studies, with only 0.8% -3.9% being symptomatic. 2,[9][10][11] Infiltration of tumor cells in the intradural space is possible via cerebrospinal fluid dissemination from brain metastases, via haematogenous pathway (arterial or via Batson venous plexus), via direct invasion of spinal cord sheaths or via the lymphatic perineural ducts. 12 In the present case, the infiltration of the metastasis in the intradural space is Although patients with malignancies live longer due to the contemporary development of the treatment, spinal metastases impair their quality of life and shorten survival span.…”

Metastatic lobular breast adenocarcinoma presenting as cauda equina syndrome

“…These cases also demonstrate that breast carcinoma can metastasize to the lumbosacral leptomeninges and nerve roots even when there is no known primary breast cancer. A recent report described isolated metastasis to the lumbar spinal ganglion in a patient with known breast cancer ( Schultz et al, 2009 ). Breast cancer is the second most common form of CNS metastatic cancer ( Tsukada et al, 1983 ; Lassman and DeAngelis, 2003 ) , and CNS metastases may be increasing in prevalence due to failure of some forms of systemic therapy to penetrate the blood‐brain or blood‐nerve barrier.…”