Cauda equina syndrome (CES) is a rare condition describing the constellation of symptoms resulting from the compression of the cauda equina. Metastatic lesions are a common cause of CES, with lung lesions often implicated as the primary source. A particularly rare cause of CES is leptomeningeal metastasis (LM) from primary solid tumors. In this case, a 63-year-old male presented with urinary and fecal retention, as well as altered sensation in the genitalia. The clinical diagnosis of CES was based on the constellation of symptoms. Computed tomography (CT) imaging demonstrated a metastatic lesion in the S2 and S3 sacral vertebral bodies, with extension into the right piriformis muscle. Magnetic resonance imaging (MRI) revealed an intramedullary lesion at L2 and leptomeningeal enhancement, indicative of metastasis. Further imaging identified a primary lesion in the right lower lobe of the lung, with additional metastases to the brain and liver. A pathological diagnosis of metastatic neuroendocrine carcinoma (NEC) was confirmed following a supraclavicular lymph node biopsy. The patient received steroid therapy, chemotherapy, and radiation to the pelvis. This case provides an important perspective on CES evaluation due to the scarcity of literature highlighting spinal metastases as the primary presentation in patients with NEC of the lung. The clinical diagnosis of CES should raise suspicion for metastasis and warrant further investigation.
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http://dx.doi.org/10.7759/cureus.69263 | DOI Listing |
Pak J Med Sci
December 2024
Dr. Asif Bashir, MD; FAANC; FACS, Punjab Institute of Neurosciences, Lahore, Punjab, Pakistan.
Objective: To assess the clinical presentation, causative agents, and treatment outcomes in patients diagnosed with Elsberg syndrome (ES).
Methods: A thorough literature search was conducted on the mentioned topic using PRISMA guidelines via PubMed, Google Scholar, and SCOPUS. Articles published between 2000 and 2023 were included using advanced search and Boolean strategy.
Front Immunol
December 2024
Department of Neurology, Osaka University Graduate School of Medicine, Suita, Japan.
Chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) is an immune-mediated disease that mainly affects the peripheral nerves and nerve roots and typically presents with distal dominant motor and sensory disturbances as clinical symptoms. Central nervous system (CNS) demyelination with inflammation occurs infrequently in patients with CIDP. Here, we present a unique autopsy report of CIDP causing severe demyelination along the entire spinal cord.
View Article and Find Full Text PDFCureus
November 2024
General Surgery, Tangier University Hospital, Abdelmalek Essaâdi University, Tangier, MAR.
Hydatid disease is a zoonotic infection caused by the tapeworm, primarily affecting the liver and lungs, and rarely involving muscle tissue. Humans are infected by ingesting eggs from contaminated food or water. Patients may present with painless, slow-growing masses, sometimes associated with nerve or vessel compression, especially in cases of muscle involvement.
View Article and Find Full Text PDFCureus
November 2024
Vascular Surgery, Unidade Local de Saúde São José, Lisbon, PRT.
Acute aortic occlusion (AAO) is a rare and life-threatening condition, mostly secondary to acute thrombosis or embolism. It usually presents as bilateral lower limb ischemia; however, in rare cases, spinal cord infarction might coexist, mimicking cauda equina syndrome. We present a rare case of AAO by saddle embolism of a thoracic aortic mural thrombus.
View Article and Find Full Text PDFJ Neurosurg Sci
December 2024
Department of Neurosurgery, School of Medicine, Stanford University, Stanford, CA, USA.
Background: Cauda equina syndrome (CES) is a critical condition requiring timely intervention to prevent severe morbidity. This study investigates the epidemiology and socioeconomic factors influencing access to CES care in USA Emergency Departments.
Methods: Data was used from the Nationwide Emergency Department Sample (NEDS) from 2016-2020.
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