Gopakumar Sricharan, Daou Marc, Gadot Ron, Ropper Alexander E, Mandel Jacob
Department of Neurosurgery, Baylor College of Medicine.
Department of Neurosurgery, University of Texas, MD Anderson Cancer Center.
Surg Neurol Int. 2020 Jul 18;11:196. doi: 10.25259/SNI_221_2020. eCollection 2020.
Multiple sclerosis (MS) is the most common immune-mediated inflammatory demyelinating disease of the central nervous system. Multiple brain and spinal tumors have been linked to MS, but a causal relationship between the two has not been determined. Here, we report a case of spinal meningioma in a patient with MS and review literature discussing the possible connection between these two disease entities.
A 58-year-old female with MS presented with a 1-year history of progressively worsening back pain in conjunction with worsening right upper and lower extremity weakness. The patient was diagnosed with MS 19 months prior and had multiple known demyelinating plaques in her cervical spine. New MRI revealed an intradural extramedullary thoracic tumor with characteristics consistent with meningioma. She underwent T6- T8 laminectomies for tumor resection and pathology confirmed the radiological diagnosis. At 3-month follow- up, the patient reported complete resolution of her back pain and persistence of weakness-related gait issues.
CNS neoplasms including meningioma should be considered in MS patients presenting with newly onset neurological symptoms not entirely consistent with demyelinating disease. Both disease processes should be addressed with appropriate long-term follow-up.
多发性硬化症（MS）是中枢神经系统最常见的免疫介导性炎性脱髓鞘疾病。多种脑和脊髓肿瘤已与MS相关联，但两者之间的因果关系尚未确定。在此，我们报告一例MS患者发生脊髓脑膜瘤的病例，并回顾讨论这两种疾病实体之间可能联系的文献。
一名患有MS的58岁女性，有1年逐渐加重的背痛病史，同时伴有右上肢和下肢无力加重。该患者19个月前被诊断为MS，颈椎有多个已知的脱髓鞘斑块。新的MRI显示硬膜内髓外胸段肿瘤，其特征与脑膜瘤一致。她接受了T6 - T8椎板切除术以切除肿瘤，病理证实了影像学诊断。在3个月的随访中，患者报告背痛完全缓解，但与无力相关的步态问题仍然存在。
对于出现与脱髓鞘疾病不完全一致的新发神经症状的MS患者，应考虑包括脑膜瘤在内的中枢神经系统肿瘤。这两种疾病过程都应通过适当的长期随访来处理。
