An inflammatory pseudotumor within the thoracic epidural house presenting with progressive paraplegia: a histopathological prognosis with medical and radiological uncertainty. Case report with literature assessment.
Eur Backbone J. 2016 Might;25 Suppl 1:75-9
Authors: Kanagaraju V, Rai D, Alluri RV, Prasanna C, Shyam Sundar V, Arvind Kumar SM, Venkatesh Kumar N
INTRODUCTION: Inflammatory pseudotumors (IPTs) are benign lesions with unknown etiology, in all probability an immunological response to a traumatic or an infective insult or generally thought of as an IgG4-related autoimmune dysfunction. It may happen as an remoted or multi-centric lesion and are reported to contain nearly all components of the human physique. Though lung and orbital IPTs are reported generally, central nervous system involvement is a uncommon prevalence. Solely seven circumstances of spinal epidural IPTs have been reported so far. These are clinically and radiologically a prognosis of exclusion. It’s an unique histopathological prognosis.
CASE REPORT: We current right here a 49-year-old feminine with 2 months historical past of progressive weak point in decrease limbs, with no historical past suggestive of any traumatic, infective, inflammatory, or neoplastic pathology. Each medical and radiological investigations had been inconclusive. There was a mass lesion within the epidural house (predominantly within the posterior and proper lateral house) at T1-T3 vertebral ranges compressing the thoracic spinal twine. Contemplating the progressive nature of her neurological deficit, an emergency decompressive laminectomies of T1-T3 vertebrae had been carried out with excision of the compressive mass lesion. Histopathological examination confirmed a wealthy lympho-plasmacytic cell infiltrates with storiform spindle cells and dense fibrosis, which was diagnostic of IPT. Submit-operatively there was a speedy restoration in neurology and he or she grew to become ambulatory on the finish of two weeks. The aim of this case report is to debate the medical, histopathological and radiological options, differential prognosis, administration, and prognosis of spinal IPT on the background of related literature assessment.
PMID: 26155896 [PubMed – indexed for MEDLINE]