Isolated metastatic dorsal spinal cord compression revealing prostatic adenocarcinoma

Prostate cancer is the second common etiology of cord compression after lung cancer. Its slow natural history justifies an aggressive treatment. The fact that the metastatic lesion precedes the primary tumor remains rare. We report the case of a 86 year-old man who was admitted for heaviness of both lower limbs responsible for gait disorder. He had flaccid paraplegia. Spinal MRI showed an epidural lesion. Histology after surgery was compatible for a metastasis of prostatic adenocarcinoma. Spinal cord compression due to prostate cancer is correlated with poor prognosis. The fact that the metastatic lesion precedes the primary tumor remains rare.