Insights in Neurosurgery

Medular compression syndrome as a presentation of a spinal epidural lymphoma.

Abstract Lymphomas are solid tumors of the immune system. Spinal cord compression by these tumors is a late manifestation and not always present in all of patients. Sometimes, lymphomas can be present only in the spinal epidural space but this is a very rare condition. Case report: This is a 23 years old patient who 6 month ago started with dorsal pain after a sudden movement. With time, the pain got worse in intensity and frequency. Four month after his first manifestation noted a progressive loss of weight and weakness in both lower limbs. Discussion: In the CT and MRI studies, we found images suggestive of lymphadenopathy in the mediastinum and abdominal cavity, as well as in the dorsal spine an intra-spinal extradural image that the enhancement with contrast neuroimaging. Thinking in a Para paresis caused by a extradural lymphoma, the patient was taken to the operating room and a three- space laminectomy was performed with a gross total resection of the tumor. Histopathological examination revealed a Hodgkin lymphoma and 5 days after surgery the patient presented improvement in the muscular strength of the lower limbs. He was transferred to the oncology service to begin with adjuvant chemotherapy and radiotherapy treatment. Conclusion: Despite the low incidence of lymphomas with spinal epidural presentation, it is a diagnosis to bear in mind when differentiating intra-spinal extradural tumors. Surgery in patients with signs of medullary compression that are clinically expressed with progressive neurological deterioration should be performed as soon as possible to achieve an adequate improvement of the neurological picture.

Author(s):

Leniel Laud Rodriguez

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