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  • Epidural compression of the cauda equina caused by vertebral osteoblastic metastasis of prostatic carcinoma: resolution by hormonal therapy

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Epidural compression of the cauda equina caused by vertebral osteoblastic metastasis of prostatic carcinoma: resolution by hormonal therapy
  1. Keiichiro Susukia,
  2. Shunsuke Matsumotoa,
  3. Norikazu Kitagawab,
  4. Hiroyasu Shinoharac,
  5. Osamu Hasegawad,
  6. Yoshiyuki Kuroiwad
  1. aDepartment of Neurology, Higashimatsudo Municipal Hospital, Chiba, Japan, bDepartment of Urology, Matsudo Municipal Hospital, Chiba, Japan, cDepartment of Orthopaedic Surgery, Matsudo Municipal Hospital, Chiba, Japan, dDepartment of Neurology, Yokohama City University, Yokohama, Japan
  1. Dr Keiichiro Susuki, Department of Neurology, Dokkyo University School of Medicine, 880 Kitakobayashi, Mibu, Shimotsuga, Tochigi 321–0293, Japan email KSusuki{at}aol.com Received 26 April 1999 and in revised form 16 August 1999 Accepted 25 August 1999

Abstract

A 59 year old man with prostatic carcinoma developed epidural compression of the cauda equina caused by bony expansion from a vertebral osteoblastic metastasis. For medical reasons he could not undergo radiation or surgery. Hormonal therapy alone relieved his low back pain and restored ambulation and urinary function. Postmyelography CT showed that the bony expansion from the vertebra had completely disappeared after treatment. This is the first report of remarkable improvement due to hormonal therapy alone.

Figure

Postmyelography spinal CT. Before treatment: (A) the spinal cord is compressed laterally by the epidural mass (arrow) on the left side of the body of Th11; (B) the vertebral canal is narrowed by bony expansion (arrows) from both sides of the body at L2. After treatment: (C) the epidural mass in the body of Th11 has disappeared; (D) bony expansion from the body of L2 has also disappeared.

  • prostatic carcinoma
  • osteoblastic metastasis
  • epidural compression
  • hormonal therapy

https://doi.org/10.1136/jnnp.68.4.514

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