Tumors of the cauda equina: the importance of an early diagnosis

The natural history of cauda equina tumors was studied in 13 patients. Pain was the most prominent clinical manifestation. Neurological dysfunction mainly consisted of sensory disturbances. The pre-operative course was in 62% three years or longer. A relation was found between the histology of the tumor and the delay of diagnosis: ependymomas were discovered much later than schwannomas. Other histological types of tumors were meningioma, sarcoma and metastasis of a medulloblastoma. The effect of treatment, in nine cases only surgical, was excellent in seven of the 13 patients. The prognosis was determined by histology and length of pre-operative period.