Primary intradural carcinoid tumor of the lumbar spine in a patient with lumbar radiculopathy

Abstract Carcinoid tumors are a subset of neuroendocrine tumors which are derived from enterochromaffin cells. They usually originate in the gastrointestinal tract or lungs. They rarely involve the central nervous system but can metastasise there. Primary carcinoid tumors of the central nervous system are exceedingly rare. There are only five reported cases of primary intradural extramedullary carcinoid tumor in the current literature. We present the case of a 60-year-old female with progressive severe axial lower back pain associated with left-sided sciatica. Magnetic Resonance Imaging of the lumbar spine showed an intradural extramedullary tumor centered at the L3 level with main differentials being a nerve sheath tumor, meningioma and myxopapillary ependymoma. During the operation, involvement of cauda equina nerve roots was confirmed. Debulking of the tumor was carried out with preservation of the involved nerve roots as it was deemed to represent a schwannoma or variant thereof. Pathological investigation and exhaustive workup however identified a primary intradural extramedullary carcinoid tumour of the lumbar spine. Although exceedingly rare, it must be considered as a differential diagnosis of any intradural extramedullary spinal tumour.