Cauda Equina Syndrome -- Think of Cancer

Cauda Equina Syndrome -- Think of Cancer

 

Mohammad Sami Walid, MD, PhD; Mohammed Ajjan, MD; Kim W Johnston, MD, FACS; Joe Sam Robinson Jr, MD, FACS

Spring 2008 - Volume 12 Number 2

https://doi.org/10.7812/TPP/07-054

Abstract

Leptomeningeal carcinomatosis (LC) is a serious complication found in approximately 1% to 8% of patients with solid cancer and carries substantial rates of morbidity and mortality. Up to 48% of patients may present with LC before the presence of systemic cancer is known. We present the case of a patient who presented with symptoms of cauda equina syndrome and for whom subsequent investigations revealed intrathecal metastases and locally advanced lung cancer without respiratory symptoms or brain or bone 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, and myelography remains an important diagnostic method.

The Permanente Press

The Permanente Journal (ISSN 1552-5767) is a peer-reviewed journal of medical science, social science in medicine, and medical humanities published quarterly by The Permanente Press.

Circulation

27,000 print readers per quarter, 9725 eTOC readers, and in 2016, 1.4 million page views on TPJ articles in PubMed from a broad international readership.

Bookstore

The Permanente Press publishes books related to Kaiser Permanente and health care to advance knowledge in scientific research, clinical medicine, and innovative health care delivery.


ISSN 1552-5775 Copyright © 2018 thepermanentejournal.org.

The Permanente Press. All Rights Reserved.