Presentation
Bilateral lower limb paralysis for 1 week. Known prostatic acinar adenocarcinoma.
Patient Data
At the level of T7 and T8, there is prominent extraosseous paravertebral and epidural soft tissue tumor extension causing significant narrowing of the thecal sac, associated with complete CSF effacement and abnormal high T2 cord signal superior (T6) and inferior (T9) to these levels. Extensive osseous metastases.
Moderate narrowing of the left T7/T8 and left T8/T9 neural foramina with some preserved perineural fat. Posterior vertebral body bony retropulsion at L1 causes moderate narrowing of the central spinal canal with partial effacement of CSF spaces surrounding the cauda equina nerve roots at this level. Small volume extraosseous soft tissue tumor is also present at this level, with central spinal canal narrowing predominantly due to osseous material.
Case Discussion
Metastases to the bones of the axial skeleton is a common complication in advanced prostate cancer. This, unfortunately, remains incurable with therapies being palliative1. In this particular case, the known diagnosis of prostatic acinar adenocarcinoma was associated with a Gleason score of 4+5 = 9 (high grade).
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