{"id":"1126e0f5-acff-4f0b-8d25-aa4d9e36f83a","slug":"cauda-equina-syndrome-caused-by-lumbar-leptomeningeal-metastases-from-lung-adenocarcinoma-mimicking-a-schwannoma","title":"Cauda equina syndrome caused by lumbar leptomeningeal metastases from lung adenocarcinoma mimicking a schwannoma","authors":["Giovanni Federico Nicoletti","Giuseppe Emmanuele Umana","Francesca Graziano","Alessandro Calì","Marco Fricia","Salvatore Cicero","Gianluca Scalia"],"abstract":"Background: Cauda equina syndromes (CESs) due to leptomeningeal metastases from primitive lung tumors are rare. Despite recent advancements in neuro-oncology and molecular biology, the prognosis for these patients remains poor. Here, we present a case in which a patient developed lumbar leptomeningeal metastases from lung carcinoma that contributed to a CES and reviewed the appropriate literature. Case Description: A 55-year-old female presented with the left lower extremity sciatica/weakness. Two years ago, a then 53-year-old female had received Gamma Knife stereotactic radiosurgery (SRS) for a cerebellopontine angle schwannoma. Recently, she underwent resection of lung carcinoma and SRS for a right hemispheric cerebellar metastasis. Now at age 55, she presented with the left lower extremity sciatica/weakness. When her new lumbar MR was interpreted as showing a L5 schwannoma, a L4-L5 laminectomy was performed at surgery, the authors encountered multifocal leptomeningeal metastases densely infiltrating the cauda equina. Although only subtotal resection/decompression of tumor was feasible, she did well for the ensuing year. The histological diagnosis confirmed the lesion to be a poorly differentiated lung adenocarcinoma. Conclusion: Patients with a history of prior metastatic lung cancer may present with spinal leptomeningeal metastases resulting in a CES.","thumbnailUrl":"https://sni-digital-videos.s3.amazonaws.com/articles/1126e0f5-acff-4f0b-8d25-aa4d9e36f83a/featured/hero-1781563264444.png","publishDate":"2020-08-01T00:00:00.000Z","doi":"10.25259/SNI_365_2020","categories":["Spine","Case Report"],"fullTextUrl":"https://surgicalneurologyint.com/wp-content/uploads/2020/08/10180/SNI-11-225.pdf"}