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BMJ Support Palliat Care 3:200-202 doi:10.1136/bmjspcare-2012-000373
  • Case report

Unusual aetiology of malignant spinal cord compression

  1. Adrienne Rennick1
  1. 1Barnsley Hospice, Barnsley, UK
  2. 2Hull York Medical School, University of Hull, Hull, UK
  1. Correspondence to Dr Jason Boland, senior lecturer and honorary consultant in palliative medicine, Hull York Medical School, Hertford Building, University of Hull, Hull HU6 7RX, UK; jason.boland{at}hyms.ac.uk

Abstract

Malignant spinal cord compression (MSCC) is an oncological emergency requiring rapid diagnosis and treatment to prevent irreversible spinal cord injury and disability. A case is described in a 45-year-old male with renal cell carcinoma in which the presentation of the MSCC was atypical with principally proximal left leg weakness with no evidence of bone metastasis. This was due to an unusual aetiology of the MSCC as the renal carcinoma had metastasised to his left psoas muscle causing a lumbosacral plexopathy and infiltrated through the intervertebral disc spaces, initially causing left lateral cauda equina and upper lumbar cord compression, before complete spinal cord compression. This case illustrates the varied aetiology of MSCC and reinforces the importance of maintaining a high index of suspicion of the possibility of spinal cord compression.

  • Received 25 September 2012.
  • Revision received 8 February 2013.
  • Accepted 7 March 2013.

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