Nasopharyngeal carcinoma metastatic to the cauda equina

A case of nasopharyngeal carcinoma metastatic to the cauda equina is reported. The patient, treated 3 years earlier for his primary disease, presented with bilateral weakness of his legs. Myelographic studies showed only patchy thickening of certain lumbosacral nerve roots. A biopsy from a root in the cauda equina was made through a T-12 to L-2 laminectomy revealing carcinomatous involvement. Careful examination of the specimen was necessary to distinguish the tumor from a lymphoma. Review of the literature has revealed no other cases of this type of neoplastic metastasis.