Anaplastic oligodendroglioma presenting with drop metastases in the cauda equina.
Metastatic involvement of the cerebro-spinal fluid (CSF) pathway in oligodendrogliomas is not uncommon; however, symptomatic involvement of the spinal cord is very rare: less of 10 cases have been published. To our knowledge, an intracranial oligodendroglioma presenting with symptoms of drop metastases in the cauda equina has never been reported. We report a case of 67-year-old woman who after 1 month of severe low back and legs pain developed symptoms of raised intracranial pressure. A spinal cord MRI showed multiple intradural nodular lesions at the level of the cauda equina, a MRI of the brain showed an intraventricular brain tumor. The histopathological diagnosis of both surgically treated lesions was anaplastic oligodendroglioma. The choices adopted in planning diagnostic and therapeutical procedures are discussed. The importance of the clinical and neuroradiological data in the diagnosis is stressed. Pathophysiology of the seeding of intracranial tumours via the cerebrospinal fluid is reviewed.
Natale
Massimo
M
Department of Neurosurgery, Second University of Naples, c/o Ospedale CTO, Viale dei Colli Aminei 21, 80100, Naples, Italy.
Spennato
Pietro
P
Savarese
Luciano
L
Bocchetti
Antonio
A
Esposito
Salvatore
S
Barbato
Rosario
R
D002420:Cauda Equina; D002551:Cerebral Ventricle Neoplasms / Q000175:diagnosis / Q000473:pathology* / Q000628:therapy; D005260:Female; D006801:Humans; D020547:Lateral Ventricles; D008159:Lumbar Vertebrae; D008875:Middle Aged; D009837:Oligodendroglioma / Q000175:diagnosis / Q000556:secondary* / Q000628:therapy; D010524:Peripheral Nervous System Neoplasms / Q000175:diagnosis / Q000556:secondary* / Q000628:therapy