Abstract
Spinal cord ependymoma presenting as letm: A case report
Highlights
Spinal cord ependymomas may present as a diagnostic challenge, especially when they appear as longitudinally extensive transverse myelitis (LETM), they are the most common intramedullary tumours
Longitudinal extensive transverse myelitis (LETM) is a descriptive term that has been introduced in order to guide proper diagnostic work up, and is defined as a spinal cord lesion that extends over three or more vertebral segments
The majority of cases of LETM are usually associated with neuromyelitis optica spectrum disorders (NMOSD)
Summary
Spinal cord ependymomas may present as a diagnostic challenge, especially when they appear as longitudinally extensive transverse myelitis (LETM), they are the most common intramedullary tumours. We present a patient with a spinal lesion over 6 vertebral segments, diagnosed as a spinal cord ependymoma. A 60 year old man presented to the emergency department, complaining of difficulty in walking and constipation during the last 10 days which was gradually becoming worse He mentioned a tingling sensation in the distal lower extremities. Neurological examination showed decreased muscle strength (MRC 3/5) on both his lower limbs, with the proximal muscles being more seriously involved and a left Babinski sign. Immunological tests (ANA, ENA, anti-dsDNA, anti-Ro, anti-La, RF), serum B12, copper, ACE and anti-aquaporin 4 antibodies were reported negative His cerebrospinal fluid (CSF) examination was normal (0 cells/μL, Glu: 69 mg/dL, TP: 40, 8 mg/dL) and no infective causes for the lesion were identified. We are not aware of his current clinical condition, because the patient was lost in follow up
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