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 la minectomy with tumor removal for relief of pain. Summary of Background Data. Only 25 cases of intradural spinal metastasis have been reporte d in the English literature. This is the first report of a metastatic case, moving from the carcinoma of the anus to the cauda equina. Metho ds. Magnetic resonance imaging showed an ill-defined mass, with centra l necrosis, to the cauda equina. The possibility of intradural metasta sis to the cauda equina was indicated by unique pain symptoms. Results . The patient's back pain subsided after total laminectomy of L3-L5 wi th subtotal removal of the tumor. The residual tumor became smaller wi th postoperative radiation. Conclusion. Magnetic resonance imaging is a good diagnostic choice in this situation. The cause of the metastasi s was unclear, but is was presumed to have occurred through the perine ural lymphatic ducts. Laminectomy with tumor removal is feasible for r elieving pain and demonstrating pathology.