Journal List > J Korean Soc Spine Surg > v.19(1) > 1075979

J Korean Soc Spine Surg. 2012 Mar;19(1):20-24. Korean.
Published online March 31, 2012.  https://doi.org/10.4184/jkss.2012.19.1.20
© Copyright 2012 Korean Society of Spine Surgery
Myelopathy due to Thoracic Intradural Extramedullary Tumor Misdiagnosed as the Cerebral Infarction -A Case Report-
Jae-Wan Soh, M.D., Jae Chul Lee, M.D.,* Sung-Yong Park, M.D., Jong-Seok Park, M.D. and Byung-Joon Shin, M.D.*
Department of Orthopedic Surgery, Soonchunhyang University Cheonan Hospital, Korea.
*Department of Orthopedic Surgery, Soonchunhyang University College of Medicine, Seoul, Korea.

Corresponding author: Byung-Joon Shin, M.D. Department of Orthopedic Surgery, Soonchunhyang University College of Medicine, 657 Hannam-dong, Yongsan-gu, Seoul, Korea. TEL: 82-2-709-9250, FAX: 82-2-794-9414, Email: schsbj@schmc.ac.kr
Received July 22, 2011; Revised November 27, 2011; Accepted November 28, 2011.

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.


Abstract

Study Design

A Case report.

Objectives

We report a case of thoracic intradural extramedullary tumor that has been misdiagnosed as the cerebral infarction.

Summary of Literature Review

Spinal meningioma is one of the common spinal tumors. Clinical symptoms were characteristically progressive myelopathy, rather than radiculopathy.

Materials and Methods

A 66-year-old female patient who had a history of cerebral infarction admitted as suffering from progressive lower extremities weakness for 6 months. The patient was diagnosed and has been treated as the cerebral infarction at another hospital. However, the patient showed worsening symptoms.

In magnetic resonance imaging, an intradural extramedullary space occupying mass compressing the spinal cord, between T8 and T9 level, was shown. By undergoing an operation, resected the mass. In a pathologic report, mass was confirmed to be meningioma.

Results

After the operation, symptoms were improved. The patient was able to walk 2 weeks after surgery.

Conclusions

We report the correct diagnosis and a successful surgical treatment of myelopathy, due to thoracic myelopathy that has been misdiagnosed as the cerebral infarction in another hospital.

Keywords: Thoracic; Intradural extramedullary tumor; Meningioma

Figures


Fig. 1
The tumor is located at the T8-9 level. (A) T1-weighted sagittal MR image shows peripheral low signal intensity and central iso-signal intensity mass. (B) T2-weighted sagittal MR image shows iso-signal intensity mass. (C) Gadolinium enhanced T1-weighted sagittal MR image shows high signal intensity mass. (D, E, F) T1, T2-weighted, Gadolinium enhanced T1-weighted axial MR image shows oval shape intradural extramedullary mass compressing spinal cord.
Click for larger image


Fig. 2
(A) Intraoperative finding shows well exposed dural sac. (B) Intraoperative finding shows oval shape mass compressed spinal cord in dura matter.
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Fig. 3
Gross finding of the tumor shows a well encapsulated ovoid mass including cartilage cap measured 1.2×1.2×1.0 cm.
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Fig. 4
Follow-up MR image was checked for 4 weeks after operation. (A) T2-weighted sagittal MR image shows complete removal of cord compression lesion. (B, C) T2 and Gadolinium enhanced T1-weighted axial MR image shows complete removal of cord compression lesion.
Click for larger image

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