Abstract
IntroductionNerve root metastasis without extension from an adjacent process has been seldom reported in case of solid tumors. We describe a case of solitary nerve root metastasis of gastric adenocarcinoma, likely due to hematogenous spread. Case presentationA 75-year-old man presented with radiculopathy refractory to medical treatment. MRI and CT demonstrated a right-sided S1 nerve root mass involving the spinal ganglion in its intra-foraminal region with avid enhancement, initial erosive bone changes on sacral foramina and focal hyperaccumulation on 18F – FDG CT-PET, suspicious for metastasis. The histopathological examination confirmed a metastasis of gastric adenocarcinoma. DiscussionA review of the current literature revealed only ten cases of hematogenous metastases to spinal nerve root ganglia; the primary lesions in those cases were an oat cell carcinoma of the lung, two cases of colonic adenocarcinoma, a case of uterine adenocarcinoma, a ductal breast carcinoma, a Ewing’s sarcoma, a Renal Cell Carcinoma, a gastro-intestinal stromal tumor, a follicular thyroid carcinoma, a pulmonary adenocarcinoma. ConclusionIn the setting of a known malignancy, a nerve root metastasis should be considered in the differential diagnosis of a nerve root mass, although it occurs very rarely.
Highlights
Nerve root metastasis without extension from an adjacent process has been seldom reported in case of solid tumors
Nerve root metastases of solid tumors have been rarely reported and, to the best of our knowledge, no cases of gastric adenocarcinoma metastasis to the nerves have been reported to date [1,2]
We describe a case of a patient presenting a S1 nerve root metastasis of gastric adenocarcinoma
Summary
Nerve root metastasis without extension from an adjacent process has been seldom reported in case of solid tumors. We describe a case of solitary nerve root metastasis of gastric adenocarcinoma, likely due to hematogenous spread. MRI and CT demonstrated a right-sided S1 nerve root mass involving the spinal ganglion in its intraforaminal region with avid enhancement, initial erosive bone changes on sacral foramina and focal hyperaccumulation on 18F – FDG CT-PET, suspicious for metastasis. DISCUSSION: A review of the current literature revealed only ten cases of hematogenous metastases to spinal nerve root ganglia; the primary lesions in those cases were an oat cell carcinoma of the lung, two cases of colonic adenocarcinoma, a case of uterine adenocarcinoma, a ductal breast carcinoma, a Ewing’s sarcoma, a Renal Cell Carcinoma, a gastro-intestinal stromal tumor, a follicular thyroid carcinoma, a pulmonary adenocarcinoma. CONCLUSION: In the setting of a known malignancy, a nerve root metastasis should be considered in the differential diagnosis of a nerve root mass, it occurs very rarely
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