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Published on: December 21, 2019
Pleural malignant mesothelioma causing cord infiltration through the nerve root. Case report
Hidehiro Okura1, Yasuo Suga, Osamu Akiyama
1Department of Neurosurgery, Juntendo Urayasu Hospital, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, Japan. hohkura@juntendo.ac.jp
Neurologia Medico-Chirurgica
|April 29, 2009
Summary
A rare case of spinal malignant mesothelioma developed in a patient with a history of asbestos exposure and pleural mesothelioma. This condition, manifesting as neurological decline, presents significant challenges for treatment and improvement.
Area of Science:
- Oncology
- Neurology
- Pathology
Background:
- Malignant mesothelioma, often linked to asbestos exposure, typically affects the pleura.
- Spinal involvement by mesothelioma is exceptionally rare, posing diagnostic and therapeutic challenges.
Observation:
- A 61-year-old man with a history of asbestos exposure and prior pleural mesothelioma developed progressive lower extremity weakness, sensory deficits, and bowel/bladder dysfunction.
- Spinal magnetic resonance imaging revealed an intramedullary tumor at T4, with operative findings showing nerve root and pial surface involvement.
- Histopathological examination confirmed malignant mesothelioma infiltrating the spinal cord via the posterior nerve root.
Findings:
- The patient's condition rapidly progressed to respiratory failure and death within 3 months of diagnosis.
- This case highlights the critical need to consider spinal metastasis in patients with known pleural mesothelioma experiencing neurological deterioration.
- Intramedullary spinal cord infiltration by mesothelioma presents a poor prognosis and limited potential for neurological recovery.
Implications:
- Clinicians should maintain a high index of suspicion for spinal metastasis in mesothelioma patients with new neurological symptoms.
- Advanced neuroimaging is crucial for early detection of thoracic spinal cord lesions.
- The rarity and aggressive nature of spinal mesothelioma underscore the importance of comprehensive patient monitoring and multidisciplinary care.
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