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孕妇硬脊膜内炎性假瘤酷似硬膜外血肿:病例报告及文献复习

Intradural cervical inflammatory pseudotumor mimicking epidural hematoma in a pregnant woman: case report and review of the literature.

作者信息

Boutarbouch Mahjouba, Arkha Yasser, Rifi Lobna, Derraz Said, El Ouahabi Abdessamad, El Khamlichi Abdeslam

机构信息

Department of Neurosurgery, Mohamed Vth University School of Medicine, Hôpital des Spécialités ONO, Rabat 10100, Morocco.

出版信息

Surg Neurol. 2008 Mar;69(3):302-5. doi: 10.1016/j.surneu.2006.12.056. Epub 2007 Sep 4.

Abstract

BACKGROUND

Inflammatory pseudotumors usually affect the lung and the orbit. They occur extremely rarely in the spine. We encountered a case of intradural extramedullary IPT of the cervical spine in a pregnant woman that initially presented as an epidural hematoma in MRI.

CASE DESCRIPTION

This is a case of a 30-year-old, HIV-negative, full-term pregnant lady presenting with 2-month history of progressive quadriparesis with rapid worsening of power in all 4 limbs for 3 days. Magnetic resonance imaging scanning revealed cervical extramedullary compressive lesion likely to be epidural bleed from its imaging characteristics. Intraoperatively, intradural extramedullary granulomatous lesion was found with dural thickening. Gross total excision was accomplished; histopathologic study assessed an IPT. The patient improved after surgery excision and is doing well at 6-month follow-up with remarkable neurological recovery.

CONCLUSION

Cervical intradural IPT is a very rare issue in the spine. Diagnosis can be confused with a neoplastic lesion like an "en plaque meningioma" or as epidural bleed like in the present case.

摘要

背景

炎性假瘤通常累及肺部和眼眶。它们在脊柱中极为罕见。我们遇到一例孕妇颈椎硬膜内髓外炎性假瘤,其在磁共振成像(MRI)上最初表现为硬膜外血肿。

病例描述

这是一名30岁、HIV阴性的足月孕妇,有2个月进行性四肢瘫病史,四肢力量在3天内迅速恶化。磁共振成像扫描显示颈椎髓外压迫性病变,从其影像学特征来看可能是硬膜外出血。术中发现硬膜内髓外肉芽肿性病变伴硬膜增厚。实现了肿瘤全切;组织病理学研究评估为炎性假瘤。手术切除后患者病情改善,6个月随访时情况良好,神经功能显著恢复。

结论

颈椎硬膜内炎性假瘤在脊柱中是一个非常罕见的问题。诊断可能与“斑块状脑膜瘤”等肿瘤性病变混淆,或者如本例一样与硬膜外出血混淆。

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