Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2010, 154(2):175-177 | DOI: 10.5507/bp.2010.027

INTRAMEDULLARY SPINAL CORD AND CAUDA EQUINA METASTASIS OF BREAST CARCINOMA: CASE REPORT

Lumir Hrabalek^a, Ondrej Kalita^a, Hana Studentova^b, Jana Jankova^c, Jiri Ehrmann^c, Radek Trojanec^d, Marian Hajduch^d

^a Department of Neurosurgery, Palacky University and University Hospital Olomouc, Czech Republic

^b Department of Oncology, Palacky University and University Hospital

^c Department of Pathology, Laboratory of Molecular Pathology, Faculty of Medicine and Dentistry, Palacky University and University Hospital

^d Laboratory of Experimental Medicine, Department of Pediatrics, Palacky University and University Hospital

Aim: We present a case report of a female patient with metastasis of breast carcinoma to the medullary conus and cauda equina.

Methods: A 48-year-old woman with a history of breast tumor, suddenly felt severe weakness and numbness of the lower extremities. MRI of the spine disclosed a mass lesion within the medullary conus, with leptomeningeal involvement of cauda equina at the spinal level L1. Laminectomy was performed and partial resection of the medullary conus tumor and especially release of nerve roots of cauda equina was achieved using microsurgical techniques.

Results: Her clinical status, especially right leg weakness and sensory loss in the lower extremities have immediately improved but bladder dysfunction remained and she was unable to walk. The histological picture and immunophenotype indicates the presence of metastatic ductal adenocarcinoma of the mammary gland. Patient died 4 months after the spinal cord and cauda equina surgery.

Conclusion: To our knowledge, this is the first report of successful surgical treatment of metastatic leptomeningeal infiltration of breast carcinoma.

Keywords: Intramedullary, Spinal cord, Metastasis, Breast cancer, Surgery, Leptomeningeal disease

Received: November 2, 2009; Accepted: April 1, 2010; Published: June 1, 2010  Show citation