Extra- and intradural spinal metastases from breast cancer
Aggravating low back pain, flaccid paresis and hypoesthesia of both legs, and urinary retention.
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Multiple nodules along the cauda equina, a large inhomogeneous lesion of the conus medullaris, and a bone metastasis invading the sacral canal.
After Gd administration, the intradural lesions show marked enhancement. The sacral metastasis enhances only moderately.
MRI of the lumbar spine a 60-year-old woman with advanced breast cancer and known skeletal metastases showed secondary neoplastic lesions in multiple locations:
- bone metastasis of the os sacrum invading the sacral canal (extradural)
- large metastasis of the conus medullaris (intradural-intramedullary)
- multiple nodular metastases of the cauda equina (intradural-leptomeningeal)