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脊髓原发性髓内结核瘤导致脊髓压迫症表现为截瘫:一例报告及文献复习

Spinal cord compression due to primary intramedullary tuberculoma of the spinal cord presenting as paraplegia: A case report and literature review.

作者信息

Mishra Sudhansu Sekhar, Das Deepak, Das Srikanta, Mohanta Itibrata, Tripathy Soubhagya Ranjan

机构信息

Department of Neurosurgery, SCB Medical College and Hospital, Cuttack, Odisha, India.

出版信息

Surg Neurol Int. 2015 Mar 23;6:42. doi: 10.4103/2152-7806.153844. eCollection 2015.

Abstract

BACKGROUND

Spinal cord compression can be due to various causes but spinal intramedullary tuberculoma is a rare cause. We report a case that had an intramedullary spinal cord tuberculomas in which the diagnosis was made histologically, without evidence of symptoms of systemic tuberculosis. This lesion, located in the thoracic region, mimicked as an intramedullary tumor radiologically.

CASE DESCRIPTION

The patient was a 25-year-old male who presented with a history of progressive paraparesis. Initial diagnosis was made as an intramedullary tumor by magnetic resonance imaging (MRI). The treatment of the patient involved is complete surgical excision of intramedullary lesion followed by appropriate antituberculous therapy. Postoperatively, his neurological symptoms were dramatically improved. With combination of both surgical and medical treatments, excellent clinical outcome was obtained.

CONCLUSION

This case illustrates the risk of misdiagnosis and the importance of histological confirmation of a pathological lesion as spinal cord tuberculoma prior to surgical therapy, which should be kept in mind as a differential diagnosis of the intramedullary spinal cord tumors.

摘要

背景

脊髓压迫可能由多种原因引起,但脊髓髓内结核瘤是一种罕见原因。我们报告一例脊髓髓内结核瘤病例,该病例经组织学诊断,无全身结核病症状证据。此病变位于胸段,影像学上酷似髓内肿瘤。

病例描述

患者为一名25岁男性,有进行性双下肢轻瘫病史。磁共振成像(MRI)初步诊断为髓内肿瘤。患者的治疗包括完整切除髓内病变,随后进行适当的抗结核治疗。术后,他的神经症状显著改善。通过手术和药物治疗相结合,获得了良好的临床结果。

结论

该病例说明了误诊的风险以及在手术治疗前对病理病变进行组织学确认作为脊髓结核瘤的重要性,应将其作为脊髓髓内肿瘤的鉴别诊断加以考虑。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/842c/4392528/0214adf0bdc8/SNI-6-42-g001.jpg

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