Clinicoradiological Features and Surgical Outcomes of Cauda Equina Neuroendocrine Tumors: A Single-Center...

Background/Objectives: Cauda equina neuroendocrine tumors (CENETs) are rare neuroendocrine tumors that predominantly arise in the cauda equina and filum terminale region. Due to their nonspecific clinical and radiological features, preoperative diagnosis remains challenging, and available data are limited to small case series. Methods: This retrospective single-center study included nine patients who underwent surgical treatment for histopathologically confirmed CENETs between 2014 and 2025. Clinical presentation, radiological findings, surgical management, histopathological features, and postoperative outcomes were analyzed. Results: The mean age was 51.2 years, with a slight male predominance. Pain was the most common presenting symptom (77.8%), followed by radiculopathy and sensory disturbances. All tumors were intradural and extramedullary, predominantly located in the lumbosacral region. Radiologically, all lesions were isointense on T1-weighted imaging and demonstrated predominantly homogeneous contrast enhancement. Vascular imaging features, including flow voids (55.6%), eccentric vessel sign (66.7%), and tadpole sign (44.4%), were frequently observed. Gross total resection was achieved in all patients, with no neurological deterioration or major complications. Over a mean follow-up period of 59.6 months, no tumor recurrence was detected. Conclusions: Cauda equina neuroendocrine tumors are rare but surgically curable tumors with excellent prognosis. Although preoperative diagnosis remains difficult, recognition of characteristic vascular imaging features may improve diagnostic accuracy. Gross total resection remains the cornerstone of treatment, providing durable disease control with minimal morbidity.