Intradural Intramedullary Conus Medullaris Metastasis of Colorectal Adenocarcinoma: A Case Report

Spinal cord metastasis is rarely seen. Intramedullary spinal metastasis has been defined between the rates of 0,9 -2,1% in the autopsies performed on the cancerous cases. And also intramedullary spinal metastases are defined at a rate of 8,5% in the cases which have metastasis at central nervous system. The male patient, who was at the age of 62, was admitted to our clinic with the complaints of serious back and left leg pain and weakness at the left leg which had begun 15 days before. Low anterior resection + total mesorectal excision + ileostomy were applied to the patient five years ago due to colorectal adenocarcinoma. The carcinoma was reported as adenocarcinoma grade II. Chemotherapy and radiotherapy were applied after postoperative period. Left SLR was positive and 3/5 monoparesis at left leg was determined in the patients neurological examination. Conus medullaris located tumor was determined in the magnetic resonance imaging of the patient. Intradural intramedullary tumor which was infiltrated to the conus medullaris was totally removed with microneurosurgical technique via Th12-L1-2 total laminectomy. Th11-L3 posterior instrumentation and fusion were added because of expansive laminectomy and L1 corpus involvement of the tumor. The histopathological examination was reported as colorectal adenocarcinoma metastasis. In this manuscript we report a colorectal adenocarcinoma metastasis to the conus medullaris for the first time in the literature.