Mathieu, F;
Jiang, F;
Wilson, JRF;
Diamandis, P;
Choi, D;
Vajkoczy, P;
Fehlings, MG;
(2019)
Intradural Metastasis from Cutaneous Squamous Cell Carcinoma Causing Cauda Equina Syndrome.
Canadian Journal of Neurological Sciences
, 46
(5)
pp. 615-620.
10.1017/cjn.2019.234.
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Abstract
BACKGROUND: Spinal leptomeningeal carcinomatosis from a cutaneous squamous cell carcinoma (SCC) origin is exceedingly rare. Herein, we describe the first report of cauda equina syndrome secondary to drop metastases from a skin SCC. CASE DESCRIPTION: A 69-year-old male with a history of recurrent SCC of the face with known cranial nerve involvement presented with acute onset sphincter and lower extremity symptoms. Neuroimaging revealed a compressive intradural mass at the lumbosacral junction. The patient underwent urgent surgical decompression followed by adjuvant fractionated radiotherapy. Substantial improvement in function and quality of life was reported on postoperative follow-up. CONCLUSION: Cauda equina syndrome manifestations in a patient with a history of cutaneous SCC with perineural spread should raise suspicion for drop metastases. In this case, a relatively straight forward surgical procedure resulted in significant improvement in the quality of life. Therefore, operative intervention should be considered to prevent permanent neurological deficits depending on the patient’s goals of care and overall clinical status.
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