PT  - JOURNAL ARTICLE
AU  - Raheel Shakoor Siddiqui
AU  - Manikandar Srinivas Cheruvu
AU  - Hamza Ansari
AU  - Marck van Liefland
TI  - Cauda equina compression in metastatic prostate cancer
AID  - 10.1136/bcr-2020-237779
DP  - 2020 Dec 01
TA  - BMJ Case Reports
PG  - e237779
VI  - 13
IP  - 12
4099  - http://casereports.bmj.com/content/13/12/e237779.short
4100  - http://casereports.bmj.com/content/13/12/e237779.full
SO  - BMJ Case Reports2020 Dec 01; 13
AB  - A 67-year-old man presented to his general practitioner with intermittent episodes of unilateral sciatica over a 2-month period for which he was referred for an outpatient MRI of his spine. This evidenced a significant lumbar vertebral mass that showed tight canal stenosis and compression of the cauda equina. The patient was sent to the emergency department for management by orthopaedic surgeons. He was mobilising independently, pain free on arrival and without neurological deficit on assessment. Clinically, this patient presented with no red flag symptoms of cauda equina syndrome or reason to suspect malignancy. In these circumstances, National Institute for Health and Care Excellence guidelines do not support radiological investigation of the spine outside of specialist services. However, in this case, investigation helped deliver urgent care for cancer that otherwise may have been delayed. This leads to the question, do the current guidelines meet clinical requirements?