Cauda equina cavernoma: case report and review of literature.

BACKGROUND

Cavernous malformations (CMs) are benign, low-flow vascular malformations of the central nervous system, most commonly located intracranially. Spinal CMs are rare, and involvement of the cauda equina is exceptionally uncommon. Owing to their rarity and nonspecific clinical presentation, cauda equina cavernomas pose a diagnostic challenge and are often misdiagnosed as more common intradural extramedullary tumors.

CASE PRESENTATION: We report the case of a 55-year-old woman presenting with several weeks of low back pain radiating to the right gluteal region, associated with urinary dysfunction consistent with a neurogenic bladder. Imaging findings revealed a well-circumscribed intradural extramedullary mass at the L1-L2 level, causing significant compression of the cauda equina. The patient underwent surgery, and total resection was achieved.

CONCLUSIONS

Cauda equina CMs are rare entities that should be considered in the differential diagnosis of intradural extramedullary lesions, particularly in patients presenting with radicular pain and autonomic dysfunction. Magnetic resonance imaging (MRI) is the diagnostic modality of choice, while complete microsurgical resection remains the treatment of choice, offering excellent neurological outcomes when performed early.