Call-Orellana Francisco, Andrade de Almeida Romulo Augusto, Ramirez-Ferrer Esteban, Zuluaga-Garcia Juan P, Gubbiotti Maria A, North Robert Y
Department of Neurosurgery, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas.
J Neurosurg Case Lessons. 2025 Jun 16;9(24). doi: 10.3171/CASE25175.
Actinomycosis is a rare, globally distributed disease with an annual incidence of 1 case per 300,000 persons. It classically manifests as a cervicofacial disease with sinus tract formation and purulent discharge with or without sulfur granules. Spinal compromise occurs in less than 5% of cases; however, it causes significant morbidity associated with neurological impairment.
This case report presents a patient with thoracic actinomycosis invading the spinal column who presented with symptoms and imaging findings mimicking malignancy. Surgery was performed, and frozen section suggested infectious etiology. Diagnostic workup and targeted management improved the clinical status of the patient at the 3-month follow-up.
The differential diagnosis when dealing with spinal column lesions should include infectious etiologies. Intraoperative frozen section and Gram stain can be critical for a timely diagnosis and to avoid jeopardizing the clinical status of patients. Surgical management can be necessary when vertebral body destruction with neural compression is present. https://thejns.org/doi/10.3171/CASE25175.
放线菌病是一种罕见的、全球分布的疾病，年发病率为每30万人中有1例。其典型表现为颈面部疾病，伴有窦道形成及脓性分泌物，可伴有或不伴有硫磺颗粒。脊柱受累的病例不到5%；然而，它会导致与神经功能障碍相关的严重发病率。
本病例报告介绍了一名患有胸椎放线菌病侵犯脊柱的患者，其表现出的症状和影像学表现酷似恶性肿瘤。进行了手术，冰冻切片提示为感染性病因。诊断性检查和针对性治疗在3个月的随访中改善了患者的临床状况。
在处理脊柱病变时，鉴别诊断应包括感染性病因。术中冰冻切片和革兰氏染色对于及时诊断和避免危及患者临床状况可能至关重要。当存在椎体破坏并伴有神经受压时，可能需要进行手术治疗。https://thejns.org/doi/10.3171/CASE25175
