Idiopathic Hypertrophic Pachymeningitis as a Rare Cause of Spinal Cord Compression

Abstract

Hypertrophic pachymeningitis is a chronic diffuse inflammatory fibrosis of dural mater. We herein report a rare case of spinal cord compression caused by idiopathic spinal hypertrophic pachymeningitis. A 49-year-old man, with a history of HIV infection, presented with worsening thoracic back pain and right leg pain for one year. A continuous epidural mass from T1 to T4 and a second ventral epidural mass at L5 were found on the MRI scan of the spine. Laminectomy and spinal cord decompression were performed, and the histopathology reported fibrosis with mixed inflammatory cellular infiltrates in the dural mater without any evidence of mycobacterial and fungal infection. The diagnosis of idiopathic spinal hypertrophic pachymeningitis was concluded. He received steroids therapy and recovered full neurological functions. The existing English literature on this rare disease was reviewed and discussed. doi:10.4021/jmc637w