Hypertrophied cauda equina presenting as intradural mass: case report and review of literature.
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.
Hahn
M
M
Department of Neurosurgery, St. Vincent's Hospital, New York, New York 10011, USA.
Hirschfeld
A
A
Sander
H
H
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