Sacral nerve root metastasis in a patient with lung carcinoma resembling neurinoma - a case report and literature review

Folia Med (Plovdiv). 2024 Feb 29;66(1):136-141. doi: 10.3897/folmed.66.e111619.

Abstract

Intradural extramedullary metastases from systemic neoplasms are very rare, with an incidence ranging from 2% to 5% of all secondary spinal diseases. We present the case of a 53-year-old man diagnosed with lung adenocarcinoma with symptoms of severe back pain and tibial paresis. The magnetic resonance imaging (MRI) revealed an intradural lesion originating from the right S1 nerve root mimicking neurinoma. Total tumor removal was achieved via posterior midline approach. The histological examination was consistent with lung carcinoma metastasis. Due to the rarity of single nodular nerve root metastases, MRI images may be misinterpreted as nerve sheath tumors, such as schwannomas or neurofibromas. We performed a brief literature review outlining the mainstay of diagnosis, therapeutic approach, and the prognosis of these rare lesions.

Keywords: intradural leptomeningeal metastasis MRI nerve root spine surgery.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adenocarcinoma of Lung*
  • Humans
  • Lung / pathology
  • Lung Neoplasms* / pathology
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Neurilemmoma* / diagnostic imaging
  • Neurilemmoma* / surgery
  • Spinal Nerve Roots / diagnostic imaging
  • Spinal Nerve Roots / pathology