Intradural spinal metastases

A medullary cone metastasis from an adenocarcinoma of esophagus, and a solitary lumbar spinal nerve root metastasis from a breast carcinoma, gave rise to two cases of cauda equina syndrome. Muscle strength in the lower limbs improved postoperatively, while the disturbances of bladder, bowel, and pelvic floor function remained unchanged in the 1st case. The second patient benefited from operation, and regained useful life despite vertebral osseous involvement. It is suggested that tumour cells reached the spinal cord and the subarachnoid space by haematogeneous spread and by way of perineural lymphatics respectively.