Prostatic Metastasis Mimicking a Ligamentum Flavum Cyst in Thoracic Spine: A Case Report

@#A rare finding of a prostatic carcinoma metastasized in a ligamentum flavum at thoracic spine causing posterior column spinal cord compression. We reported a man with prostatic carcinoma presented with ataxic gait. Magnetic resonance imaging revealed an extradural cystic mass adjacent to the T4 intralaminar region indenting on the spinal cord. T4 posterior decompression via en bloc excision of the ligamentum flavum cyst and laminectomy was performed. Histopathology confirmed glandular tissue within the cyst wall which corresponds to prostatic adenocarcinoma cells. Two months post-operative, patient showed improvement in his muscle strength on left L2 myotome. The preoperative diagnosis is a challenge because of the ligamentum flavum cysts rarity in the thoracic spine and non-specific clinical signs and symptoms. To our best knowledge, this is the first report of metastatic adenocarcinoma of the prostate found as ligamentum flavum cysts.

A case report of ligamentum flavum cyst in the lumbar vertebral canal and literature review / 中华老年医学杂志

Ligamentum flavum cysts in the spinal canal are rare space-occupying lesions.They usually occur in the middle-aged and people over 50 years old, without obvious sex or regional differences, and mostly involve the cervical, thoracic and lumbar vertebrae, especially the lumbar vertebrae(L4/5 and L5/S1). There are no characteristic manifestations for ligamentum flavum cysts.They can cause neurological symptoms due to compression of nerve roots or the dural sac.For example, patients with lumbar ligamentum flavum cysts may complain of symptoms of lumbar disc herniation-related sciatica, which can easily lead to misdiagnosis.Surgical excision of the cyst is the most effective method.Recently, one patient with this disease was admitted to our department.After surgical fenestration, the ligamentum flavum cyst in the lumbar canal was resected and its diagnosis was eventually confirmed histologically.After 17 months of follow-up, the patient recovered well.

Report of a Rare Case: Ligamentum Flavum Cyst.

A rare case of ligamentum flavum cyst of the lumbar spine in an elderly male is reported. The patient presented with low backache and features of bilateral radiculopathy of a sudden onset. The cyst was lying in the extradural space. After surgery, the patient reported complete relief of symptoms.