Metastatic Breast Carcinoma Diagnosed by Nerve Root Biopsy for the Cauda Equina Syndrome

Letters19 October 2010Metastatic Breast Carcinoma Diagnosed by Nerve Root Biopsy for the Cauda Equina SyndromeMark K. Lyons, MDMark K. Lyons, MDFrom Mayo Clinic Arizona, Phoenix, AZ 85054.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-153-8-201010190-00022 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Background: Lower-extremity weakness and numbness can be signs of the cauda equina syndrome. Causes of the syndrome include infectious, inflammatory, metabolic, structural, congenital, neoplastic, and psychological disorders. The usual diagnostic steps include recording patient history, conducting a neurologic examination, and performing appropriate noninvasive diagnostic testing (such as electromyography, cerebrospinal fluid analysis, and serologic testing).Objective: To illustrate when a nerve root biopsy might identify the cause of the cauda equina syndrome.Case Report: A 65-year-old woman developed paresthesia in her feet that progressed over 2 months. During the next 4 months, her symptoms included painless, progressive asymmetrical lower-extremity weakness and ...References1. Bril V. NIS-LL: the primary measurement scale for clinical trial endpoints in diabetic peripheral neuropathy. Eur Neurol. 1999;41 Suppl 1 8-13. [PMID: 10023123] CrossrefMedlineGoogle Scholar2. Kaal EC, Vecht CJ. CNS complications of breast cancer: current and emerging treatment options. CNS Drugs. 2007;21:559-79. [PMID: 17579499] CrossrefMedlineGoogle Scholar3. Chamberlain MC, Kormanik PR. Carcinomatous meningitis secondary to breast cancer: predictors of response to combined modality therapy. J Neurooncol. 1997;35:55-64. [PMID: 9266441] CrossrefMedlineGoogle Scholar4. Chang EL, Lo S. Diagnosis and management of central nervous system metastases from breast cancer. Oncologist. 2003;8:398-410. [PMID: 14530493] CrossrefMedlineGoogle Scholar5. Del Colle R, Bassi R, Adami F, Turazzini M, Gioga G, Pea M, et al. Multiple radiculopathy of the lower limbs in a cancer patient with meningeal carcinomatosis. Neurol Sci. 2000;21:113-5. [PMID: 10938191] CrossrefMedlineGoogle Scholar6. Balm M, Hammack J. Leptomeningeal carcinomatosis. Presenting features and prognostic factors. Arch Neurol. 1996;53:626-32. [PMID: 8929170] CrossrefMedlineGoogle Scholar7. DeAngelis LM. Current diagnosis and treatment of leptomeningeal metastasis. J Neurooncol. 1998;38:245-52. [PMID: 9696379] CrossrefMedlineGoogle Scholar8. Lee YT. Breast carcinoma: pattern of metastasis at autopsy. J Surg Oncol. 1983;23:175-80. [PMID: 6345937] CrossrefMedlineGoogle Scholar9. Tsukada Y, Fouad A, Pickren JW, Lane WW. Central nervous system metastasis from breast carcinoma. Autopsy study. Cancer. 1983;52:2349-54. [PMID: 6640506] CrossrefMedlineGoogle Scholar10. Boogerd W, Hart AA, van der Sande JJ, Engelsman E. Meningeal carcinomatosis in breast cancer. Prognostic factors and influence of treatment. Cancer. 1991;67:1685-95. [PMID: 2001559] CrossrefMedlineGoogle Scholar11. Ampil FL, Burton GV, Mills GM, Jawahar A, Pelser R, Nanda A. Cauda equina compression in breast cancer—incidence and treatment outcome. Eur J Gynaecol Oncol. 2001;22:257-9. [PMID: 11695803] MedlineGoogle Scholar12. Mosdal C, Bang F. Intradural spinal metastases. Acta Neurochir (Wien). 1981;56:107-10. [PMID: 6264750] CrossrefMedlineGoogle Scholar13. Lyons MK. Nerve rootlet and fascicular biopsy in patients with hypertrophic inflammatory neuropathy. Neurologist. 2009;15:40-1. [PMID: 19131857] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From Mayo Clinic Arizona, Phoenix, AZ 85054.Disclosures: None disclosed. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited ByNCCBM, a Nomogram Prognostic Model in Breast Cancer Patients With Brain MetastasisIntradural metastasis to the cauda equina found as the initial presentation of breast cancer: a case report18F-FDG PET/CT Imaging of Cauda Equina Syndrome Secondary to Leptomeningeal Metastatic Breast Cancer 19 October 2010Volume 153, Issue 8Page: 550-551KeywordsAdenocarcinomaBiopsyBreast cancerCerebrospinal fluidElectromyographyLesionsNervesProteinsSpineThorax ePublished: 19 October 2010 Issue Published: 19 October 2010 CopyrightCopyright © 2010 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...