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Metastasis to the conus medullaris: case report
Kern H Guppy1, Franklin Wagner
1Department of Neurosurgery, Kaiser Permanente, 2025 Morse Avenue, Sacramento, CA 95825-2115, USA. kguppy@yahoo.com
Neurosurgery
|December 5, 2006
Summary
This case report details a rare instance of lung cancer metastasizing to the conus medullaris, presenting atypically as lumbar radiculopathy. This highlights a unique diagnostic challenge for spinal cord tumors.
Area of Science:
- Neurology
- Oncology
- Spinal Surgery
Background:
- Metastasis to the conus medullaris is exceptionally rare.
- Lung cancer is a common primary malignancy but rarely metastasizes to the spinal cord.
Observation:
- A 54-year-old man presented with L5 radiculopathy initially misattributed to a disc herniation.
- Symptoms progressed to include urinary incontinence and leg weakness, prompting further investigation.
- MRI revealed a tumor at the conus medullaris.
Findings:
- The conus medullaris tumor was surgically removed and pathologically identified as adenocarcinoma.
- A concurrent lung mass was diagnosed as the primary source of metastasis.
- This represented the initial presentation of lung cancer for the patient.
Implications:
- This case underscores the importance of considering metastatic disease in the differential diagnosis of spinal tumors, even with atypical presentations.
- It highlights a rare but critical pathway for lung cancer spread.
- Early recognition of conus medullaris metastasis is crucial for patient management and prognosis.