Oligodendroglioma presenting with intradural spinal metastases: an unusual cause of cauda equina syndrome.
We report a 37-year-old man with a primary intracranial oligodendroglioma presenting later with symptomatic multiple cerebrospinal fluid (CSF) intradural drop spinal metastases. This patient initially presented in 2006 with complex partial seizures. Initial histology demonstrated World Health Organization (WHO) grade 2 oligodendroglioma. The patient had further generalised seizures 7 months after initial tumour resection. MRI at that time confirmed tumour recurrence. The patient underwent a repeat craniotomy. Histology showed anaplastic transformation to a WHO grade 3 oligodendroglioma. About 30 months after his initial presentation, the patient developed a focal neurological deficit in the left leg with associated retention of urine. MRI of the neuraxis demonstrated widespread leptomeningeal metastatic drop deposits within the spinal canal. We discuss the mechanisms involved in tumour dissemination throughout the CSF. We also review the relevant literature regarding this phenomenon.
Fayeye
Oluwafikayo
O
Department of Neurosurgery, University Hospital Coventry and Warwickshire NHS Trust, Walsgrave, Coventry, CV2 2DX, UK. Fikayo19@hotmail.com
Sankaran
Vijay
V
Sherlala
Khaled
K
Choksey
Munchi
M
D000328:Adult; D000970:Antineoplastic Agents / Q000627:therapeutic use; D001099:Arachnoid / Q000473:pathology / Q000503:physiopathology; D001932:Brain Neoplasms / Q000473:pathology*; D002420:Cauda Equina / Q000473:pathology / Q000503:physiopathology; D003399:Craniotomy; D004388:Dura Mater / Q000473:pathology* / Q000503:physiopathology; D017809:Fatal Outcome; D005625:Frontal Lobe / Q000473:pathology / Q000503:physiopathology; D006429:Hemiplegia / Q000209:etiology / Q000503:physiopathology; D006801:Humans; D008159:Lumbar Vertebrae / Q000473:pathology* / Q000503:physiopathology; D008279:Magnetic Resonance Imaging; D008297:Male; D055756:Meningeal Carcinomatosis / Q000150:complications / Q000503:physiopathology / Q000556:secondary*; D008577:Meningeal Neoplasms / Q000150:complications / Q000503:physiopathology / Q000556:secondary*; D009837:Oligodendroglioma / Q000150:complications / Q000503:physiopathology / Q000556:secondary*; D010166:Palliative Care; D011128:Polyradiculopathy / Q000209:etiology / Q000473:pathology* / Q000503:physiopathology; D011878:Radiotherapy; D012640:Seizures / Q000209:etiology; D013120:Spinal Cord Neoplasms / Q000556:secondary; D017211:Treatment Failure; D001750:Urinary Bladder, Neurogenic / Q000209:etiology
D000970:Antineoplastic Agents