Department of Neurosurgery, Gui de Chauliac Hospital, Montpellier University Medical Center, Montpellier, France.
Department of Neurosurgery, Bicêtre University Hosptial, Assistance Publique Hôpitaux de Paris, Université Paris-Sud, Paris, France; Reference Center for Rare Diseases: Chiari-Syringomyelia and Rare Malformations of the Spine and Spinal Cord, Assistance Publique Hôpitaux de Paris, Université Paris-Sud, Paris, France.
World Neurosurg. 2021 Jan;145:338-339. doi: 10.1016/j.wneu.2020.09.162. Epub 2020 Oct 3.
With the increasing frequency of neuroimaging, incidental intramedullary cavities are diagnosed more frequently. We present a case of asymptomatic incidental intramedullary cervical cavity diagnosed as an idiopathic syringomyelia as initial magnetic resonance imaging (MRI) showed an isolated cystic image without contrasted component. The patient had no subsequent MRI follow-up, but eventually showed symptoms 8 years later. By this stage of the disease, the MRI appearance had changed, showing a solid and enhanced component. The patient underwent surgical resection and histopathology concluded a papillary ependymoma (grade 2). This case illustrates how asymptomatic intramedullary cavities may hide an underlying tumoral process and why these cavities should not be considered as idiopathic syringomyelia by default, except after prolonged MRI follow-up.
随着神经影像学检查的日益普及，偶然发现的脊髓内空洞越来越常见。我们报告了一例无症状的偶然发现的颈髓内空洞，最初的磁共振成像（MRI）显示为孤立的囊性图像，没有对比成分，被诊断为特发性脊髓空洞症。患者没有进行后续的 MRI 随访，但 8 年后最终出现了症状。此时，MRI 表现已经发生变化，显示出实性和增强的成分。患者接受了手术切除，组织病理学诊断为乳头状室管膜瘤（2 级）。这个病例说明了无症状的脊髓内空洞可能隐藏着潜在的肿瘤过程，以及为什么这些空洞不应该被默认视为特发性脊髓空洞症，除非经过长时间的 MRI 随访。
