Intramedullary Spinal Cord Involvement Research Articles

Intramedullary spinal cord involvement: a rare presentation of sarcoidosis.

Sarcoidosis is a systemic granulomatous disease of uncertain etiology, which predominantly affects the lungs, eyes, lymph nodes, and skin. Nervous system involvement (neurosarcoidosis) occurs in approximately 5–10% of patients, but spinal cord involvement is very rare, affecting <1% of patients. We present a rare case of intramedullary sarcoidosis.

Primary central nervous system lymphoma with intramedullary spinal cord involvement mimicking inflammatory demyelinating disease

Primary central nervous system lymphoma with intramedullary spinal cord involvement mimicking inflammatory demyelinating disease

Neurobrucellosis with intramedullary spinal cord involvement: A case report

article's abstract is no available.

Rapidly progressive quadriparesis heralding disseminated coccidioidomycosis in an immunocompetent patient

Coccidioides species are dimorphic fungi endemic to southwestern USA and northern Mexico. Disseminated coccidioidomycosis is rare with an estimated incidence of 1% in affected individuals and usually presents as meningitis when the central nervous system is involved. Spinal involvement with coccidioidomycosis, though not uncommon, predominantly manifests as osseous involvement leading to osteomyelitis and epidural abscess formation. Progressive quadriparesis as a presenting symptom secondary to intramedullary spinal cord coccidioidomycosis is very unusual and to our knowledge has not been described. We report a patient with disseminated coccidioidomycosis who presented with rapidly progressive quadriparesis due to cervical intramedullary spinal cord involvement. The absence of known coccidioidomycosis with atypical clinical presentation made the diagnosis elusive, requiring emergent cervical laminectomies with dural biopsy for decompression of the spinal cord and confirmation of the diagnosis. The patient eventually succumbed to the progressive course of the disease. Although rare, disseminated coccidioidomycosis can present as new, rapidly progressing quadriparesis in patients who have traveled to endemic areas. A high index of suspicion in such patients with appropriately directed laboratory investigations and consideration of early biopsy might unravel the diagnosis facilitating early antifungal treatment with the potential to minimize morbidity and mortality associated with disseminated coccidioidomycosis.

Lymphomatosis Cerebri with Intramedullary Spinal Cord Involvement

Lymphomatosis cerebri (LC) is a rare form of primary central nervous system lymphoma (PCNSL). Little is known about cases of LC with spinal cord involvement. Among the 11 PCNSL patients treated in our hospital during a four-year period, we identified two cases of LC with spinal cord lesions. One showed a spinal cord lesion followed by leukoencephalopathy. The other showed a spinal cord lesion after LC. In both cases, the histopathology was diffuse large B-cell lymphoma. It is possible that LC may affect the entire central nerve system, and tumor infiltration to the brain and spinal cord in LC may occur more frequently than has been previously considered.

Secondary intramedullary spinal cord non-Hodgkin’s lymphoma

Intramedullary spinal cord metastases of solid neoplasms are associated with poor long-term survival. As the characteristics of secondary intramedullary spinal cord non-Hodgkin's lymphoma (NHL) are not well understood, we sought to describe its clinical features and outcome. We retrospectively reviewed the Mayo Clinic patient database, lymphoma database, and pathology records from 1996 to 2010 and identified patients with clinical myelopathy and neuroimaging evidence of secondary intramedullary spinal cord involvement from pathologically confirmed systemic NHL. Seven patients were included in this study. The median age was 61 years (range, 41-81). Symptom onset was subacute (≤8 weeks) in six. Four patients were wheelchair-dependent at diagnosis. Spinal cord NHL was diagnosed by cerebrospinal fluid cytology in four; Positron emission tomography hypermetabolism in two; or MRI features alone. Myelopathy developed in five patients at a median 8 months (range, 1-58) following systemic NHL diagnosis, while myelopathy was the heralding symptom of NHL in two patients. Spinal cord MRI lesions were characteristically gadolinium enhancing and expansile. Four patients had co-existing MRI brain lesions. Six patients had B-cell NHL and one patient T-cell NHL. Six of the seven were treated (high dose intravenous methotrexate in three; radiation therapy in two; and R-CHOP in one). Median survival was 11.5 months (range, 1-28) with a 33% 2-year survival compared to historical median survival estimates of spinal cord metastases due to solid tumors of 3 months. In secondary intramedullary spinal cord involvement of NHL early neurological morbidity is common, but overall survival compares favorably to previously reported survival in spinal cord metastases from solid tumors.

Intramedullary spinal cord involvement from metastatic gastric carcinoma: case report

Intramedullary spinal cord metastasis (ISCM) is a rarely seen complication of cancer. We report a case of ISCM from gastric cancer. A 42-year-old male presented with a rare intramedullary spinal cord metastasis from gastric carcinoma manifesting as rapidly worsening motor and sphincter disturbances. The primary tumor had been treated 2 years previously. Magnetic resonance imaging (MRI) revealed the tumor localized in the thoracic spinal cord. The tumor was totally removed. The histological diagnosis was gastric adenocarcinoma. He has been stable postoperatively. Surgical treatment may be considered for cases with even rapid-growing tumors such as gastric carcinoma with no evidence of multi-organ dissemination, especially when presenting with progressive neurological deterioration.

Intramedullary Spinal Cord Metastasis from Ovarian Carcinoma

Background. Intramedullary spinal cord involvement by ovarian carcinoma is extremely rare.Case. A patient with stage IV serous cystadenocarcinoma of the ovary presented with neurologic complaints 16 months after primary treatment. Magnetic resonance imaging demonstrated a metastatic lesion in the intramedullary area of the spinal cord. No other site of metastatic disease was observed. The patient received three cycles of carboplatin with complete resolution of the neurologic symptoms and a remarkable reduction of the lesion. Following chemotherapy she was given radiotherapy on the spinal cord, but died 10 months later for disseminated abdominal disease, without neurologic symptoms.Conclusion. Spinal cord involvement is unusual in ovarian carcinoma; multidisciplinary treatment, including chemotherapy and radiotherapy, may offer good palliation of the symptomatology.

Intramedullary spinal cord involvement in Hodgkin's disease with an atypical systemic distribution.

Intramedullary spinal cord involvement in Hodgkin's disease with an atypical systemic distribution.