Abstract
Background: Tumor lysis syndrome is unknown to many neurosurgical teams. A dreaded complication, especially in the course of hematological malignancies, like it was the case in two of our patients operated for spinal cord compression by Burkitt’s lymphoma. Objectives: To describe the clinical and biological presentation of this potentially fatal complication, which can be improved by early preventive or curative treatments. Case Reports: Patient 1: A 49-year-old woman was admitted for vertebral and intercostal pain and paraparesis. Myelography revealed epidural medullary compression at the 7th thoracic vertebrae (Th7) level. Patient 2: A 67-year-old woman was admitted for cervico-thoracic pain and paraparesis. MRI showed posterior epidural medullary compression between the 1st thoracic vertebrae (Th1) and 5th thoracic vertebrae (Th5). In both cases, an urgent decompressive laminectomy was performed. They had also received postoperative corticosteroid therapy. The multi-visceral failure occurred on the 1st day (D1) and 3rd day (D3) postoperatively, respectively. In the absence of adequate management, the outcome was fatal for the two patients respectively at D3 and D5 postoperatively. This syndrome was retained in the presence of glucocorticoid (triggering factor) and the histological result in favor of Burkitt lymphoma (target disease). Conclusion: Malignant hemopathies is a common cause of spinal cord compressions. From these two cases, the importance of biological and clinical surveillance emerges, with patients requiring urgent management for radiculo-medullar tumor compression.
Highlights
Tumor lysis syndrome is unknown to many neurosurgical teams
Malignant hemopathies is a common cause of spinal cord compressions
Tumor lysis syndrome (TLS) includes all clinical and/or biological disturbances, secondary to the brutal and massive lysis of tumor cells of certain malignancies characterized by a rapid resolution time and a strong tumor mass [1] [2]
Summary
Tumor lysis syndrome (TLS) includes all clinical and/or biological disturbances, secondary to the brutal and massive lysis of tumor cells of certain malignancies characterized by a rapid resolution time and a strong tumor mass [1] [2]. Burkitt lymphoma is a rare cause of spinal cord compression, especially as a mode of revelation It is part, with other hematological malignancies and some solid tumors, of conditions that may present this complication. The unfavorable outcome of this serious syndrome, made this diagnosis during the mortality audit. This was the case of the two patients whose observations we report. The aim of these reports is to describe the presentation, treatment and outcome of these patients and to highlight this potentially fatal condition which can be improved by early preventive or curative treatments
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