• Masahiro Morita, Masahiko Osawa, Hirotsune Naruse, and Hiroaki Nakamura.
• Department of Orthopaedic Surgery, Izumi Municipal Hospital, and Department of Diagnostic Pathology, Osaka City University Graduate School of Medicine, Osaka, Japan. m1908130@msic.med.osaka-cu.ac.jp
• Spine. 2009 Nov 15;34(24):E882-5.

Study DesignA case report with a review of the literature.ObjectiveTo describe an unusual case of primary lymphoma of the cauda equina and provide a review of the literature of this condition.Summary Of Background DataPrimary lymphoma of the cauda equina is extremely rare, and has been reported in 8 cases previously. This report is the first to describe a case of primary nasal type NK/T-cell lymphoma of the cauda equina.MethodsWe report the case of a 67-year-old man presenting the symptoms of cauda equina syndrome caused by primary lymphoma of the cauda equina.ResultsAfter laminectomy and removal of the tumor, the patient recovered from the symptoms of cauda equina syndrome except for bladder and bowel dysfunction. Further investigations including immunohistochemical stains made a diagnosis of primary nasal type NK/T-cell lymphoma of the cauda equina, and the patient received radiotherapy to the lumbosacral area. Brain metastasis was detected 8 months after surgery, and the patient died 14 months after his initial clinical presentation despite additional treatments including whole-brain radiotherapy and oral chemotherapy.ConclusionAlthough primary lymphoma of the cauda equina is extremely rare, the prognosis of this condition is thought to be poor. Early definitive diagnosis with examination of the cerebrospinal fluid followed by combined treatment with radiotherapy and high-dose methotrexate should be considered.

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