Intradural metastasis to the cauda equina from carcinoma of the anus.

STUDY

DESIGN

This is a report of a man with carcinoma of the anus and intradural metastasis to the cauda equina.

OBJECTIVE

To perform a laminectomy with tumor removal for relief of pain.

SUMMARY OF BACKGROUND DATA: Only 25 cases of intradural spinal metastasis have been reported in the English literature. This is the first report of a metastatic case, moving from the carcinoma of the anus to the cauda equina.

METHODS

Magnetic resonance imaging showed an ill-defined mass, with central necrosis, to the cauda equina. The possibility of intradural metastasis to the cauda equina was indicated by unique pain symptoms.

RESULTS

The patient's back pain subsided after total laminectomy of L3-L5 with subtotal removal of the tumor. The residual tumor became smaller with postoperative radiation.

CONCLUSION

Magnetic resonance imaging is a good diagnostic choice in this situation. The cause of the metastasis was unclear, but it was presumed to have occurred through the perineural lymphatic ducts. Laminectomy with tumor removal is feasible for relieving pain and demonstrating pathology.