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[Lumbosacral neoplastic radiculopathy].

S L Rossitti1, A A Roth-Vargas, A Sperlescu

  • 1Departamento de Neuro-Psiquiatria da Faculdade de Ciências Médicas, Pontifícia Universidade Católica de Campinas, Brasil.

Arquivos De Neuro-Psiquiatria
|March 1, 1990
PubMed
Summary

Neoplastic spinal disease can mimic lumbar-disc protrusions (LDP). Early diagnosis requires systematic CT evaluation of the sacrum and conus medullaris, especially with atypical presentations or normal CT scans.

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Area of Science:

  • Neurosurgery
  • Radiology
  • Oncology

Background:

  • Lumbar-disc protrusions (LDP) are common causes of radiculopathy.
  • Clinical signs often guide diagnosis, supplemented by non-contrasted CT and spine roentgenograms.
  • Neoplastic spinal disease can present atypically, mimicking LDP.

Observation:

  • Three cases are presented where neoplastic spinal disease mimicked classic LDP.
  • These included a cauda equina schwannoma and two metastatic carcinomas.
  • The neoplastic cases posed diagnostic challenges for routine radiodiagnostic evaluations.

Findings:

  • Neoplastic spinal conditions can present with symptoms indistinguishable from LDP.
  • Standard imaging may fail to detect underlying malignancy in such cases.

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  • The presented cases highlight the potential for diagnostic errors.

    • Implications:

    • Systematic CT evaluation of the sacrum and conus medullaris is recommended for all patients with lumbosacral radiculopathy.
    • Intrathecal contrast-enhanced imaging should be considered for patients with equivocal or normal CT findings.
    • This approach can improve the detection of spinal neoplasms masquerading as LDP, ensuring timely and appropriate treatment.