W P Ng1, M G Fehlings. 1. Division of Neurosurgery, Toronto Western Division, Toronto Hospital, University of Toronto, Ontario, Canada.
Abstract
STUDY DESIGN: This is a case report. OBJECTIVE: This is an unusual case of a 69 year-old man with metastatic carcinoma to the C8 and T1 intradural roots, with extension through the intervertebral foramen of C7-T1 mimicking a nerve sheath tumor clinically and radiologically. This report reviews the clinical features, radiology, pathology, and pathogenesis of these metastatic lesions. SUMMARY OF BACKGROUND DATA: Nerve sheath tumors are the most common primary spinal tumors. In contrast, metastasis to the spinal nerve roots is very rare. Metastatic tumors may clinically simulate other diseases and, as in this case, a nerve sheath tumor. METHODS: A review and discussion of the case facts are presented. RESULTS: Metastatic carcinoma to C8 and T1 nerve roots was diagnosed intraoperatively during C7-T1 laminectomy and partial tumor debulking. The patient had a satisfactory recovery, with symptomatic relief of painful radiculopathy, but with no improvement in motor strength. CONCLUSION: Metastasis to spinal nerve roots can clinically mimic other diseases. As in this case, the proper diagnosis may be possible only at surgery.
STUDY DESIGN: This is a case report. OBJECTIVE: This is an unusual case of a 69 year-old man with metastatic carcinoma to the C8 and T1 intradural roots, with extension through the intervertebral foramen of C7-T1 mimicking a nerve sheath tumor clinically and radiologically. This report reviews the clinical features, radiology, pathology, and pathogenesis of these metastatic lesions. SUMMARY OF BACKGROUND DATA: Nerve sheath tumors are the most common primary spinal tumors. In contrast, metastasis to the spinal nerve roots is very rare. Metastatic tumors may clinically simulate other diseases and, as in this case, a nerve sheath tumor. METHODS: A review and discussion of the case facts are presented. RESULTS:Metastatic carcinoma to C8 and T1 nerve roots was diagnosed intraoperatively during C7-T1 laminectomy and partial tumor debulking. The patient had a satisfactory recovery, with symptomatic relief of painful radiculopathy, but with no improvement in motor strength. CONCLUSION: Metastasis to spinal nerve roots can clinically mimic other diseases. As in this case, the proper diagnosis may be possible only at surgery.