title: Hypertrophied cauda equina presenting as intradural mass: case report and review of literature.
abstract: BACKGROUND
  Hereditary motor and sensory neuropathy types I and III usually lead to enlargement of peripheral nerves. Rarely, spinal nerve roots may also be involved, leading to radiculopathy and/or myelopathy.
  
  
  METHODS
  This 44-year-old man with back and lower extremity radicular pain and distal lower extremity weakness and numbness was found to have a nonenhancing intradural mass that caused a nearly complete myelographic block from L1-L4. He underwent a decompressive laminectomy with intradural exploration.
  
  
  RESULTS
  Hypertrophic but otherwise normal-looking nerve roots were observed. Subsequent electrodiagnostic testing and sural nerve biopsy confirmed that this patient had a previously unsuspected hereditary motor and sensory neuropathy (HMSN). His pain resolved, but at latest follow-up his weakness and numbness persisted.
  
  
  CONCLUSIONS
  Nonenhancing spinal intradural mass lesions may represent enlarged nerve roots, which have a number of potential etiologies. Electrodiagnostic studies and peripheral nerve biopsy are instrumental in establishing the diagnosis of HMSN.
authors.affiliation: Department of Neurosurgery, St. Vincent's Hospital, New York, New York 10011, USA.
authors.forename: M
authors.initials: M
authors.lastname: Hahn
authors.forename: A
authors.initials: A
authors.lastname: Hirschfeld
authors.forename: H
authors.initials: H
authors.lastname: Sander
mesh_terms: D000328:Adult; D002420:Cauda Equina / Q000473:pathology* / Q000601:surgery; D003937:Diagnosis, Differential; D015417:Hereditary Sensory and Motor Neuropathy / Q000175:diagnosis*; D006801:Humans; D006984:Hypertrophy / Q000175:diagnosis; D007796:Laminectomy; D008279:Magnetic Resonance Imaging; D008297:Male; D009192:Myelography