Abstract
IntroductionThe dorsal root ganglion is a rare manifestation of metastatic spread. We report what we believe to be the first case of metastasis of a pulmonary adenocarcinoma to the lumbar dorsal root ganglion. Only four descriptions for different primary tumors spreading to the dorsal root ganglion have been described in the literature so far.Case presentationA 70-year-old Caucasian woman with a four-month history of left-sided lumbar radiculopathy was admitted to our department under the assumption of a herniated lumbar disc. Her past medical history included a pulmonary adenocarcinoma and invasive ductal breast cancer.Lumbar magnetic resonance imaging revealed a space-occupying mass in her left neuroforamen L3-L4 with compression of her L3 nerve root. Neurinoma was taken into account as a differential diagnosis, although not considered typical. Surgery revealed a metastasis of pulmonary adenocarcinoma to her dorsal root ganglion.ConclusionsDorsal root ganglion metastases seem to be extremely rare and can mimic primary local nerve sheath tumors. Therefore, they usually present as incidental findings. Resection should be performed strictly under intraoperative monitoring as tumor spread between the nerve fibers is commonly observed. Metastases should be taken into account in spinal nerve tumors involving the dorsal root ganglion, especially in patients harboring known malignant diseases. The low incidence means that no clear treatment advice can be given. Resection is possible under intraoperative monitoring and relieves neurological symptoms.
Highlights
The dorsal root ganglion is a rare manifestation of metastatic spread
Metastases should be taken into account in spinal nerve tumors involving the dorsal root ganglion, especially in patients harboring known malignant diseases
Metastatic spread to the central nervous system is common in pulmonary adenocarcinoma, Dorsal root ganglion (DRG) metastasis has not yet been described
Summary
When there are inconclusive imaging and unusual intraoperative findings, rare causes have to be kept in mind, and in those patients with pre-existing malignancies. Based on the few cases reported, nerve root decompression, subtotal resection and adjuvant treatments including local radiation seem to represent the best management option. Consent Written informed consent was obtained from the patient’s relatives for publication of this case report and accompanying images. Authors’ contributions PJS, JFC and KMA analyzed and interpreted the patient data including follow-up and reviewed the literature. All authors read and approved the final manuscript. Author details 1Neurochirurgische Klinik, Heinrich-Heine-Universität Düsseldorf, Moorenstrasse 5, Düsseldorf 40225, Germany. Author details 1Neurochirurgische Klinik, Heinrich-Heine-Universität Düsseldorf, Moorenstrasse 5, Düsseldorf 40225, Germany. 2Institut für Neuropathologie, Heinrich-Heine-Universität Düsseldorf, Moorenstrasse 5, Düsseldorf 40225, Germany
Sign-in/Register to view highlights & summary 
Published Version (
Free)
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
