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Epidural inflammatory pseudotumor in the thoracic spine in a patient with polymyalgia rheumatica

Satoshi Kato1, Hideki Murakami, Satoru Demura

  • 1Department of Orthopaedic Surgery, Kanazawa University School of Medicine, 13-1 Takara-machi, Kanazawa 920-8641, Japan. skato323@gmail.com

The Spine Journal : Official Journal of the North American Spine Society
|July 4, 2012
PubMed
Abstract

Insights

This case report details a rare spinal epidural inflammatory pseudotumor in a polymyalgia rheumatica (PMR) patient. Surgical removal resolved the compression and neurological symptoms, with no recurrence.

Area of Science:

  • Neurology
  • Rheumatology
  • Spinal Surgery

Background:

  • Epidural inflammatory pseudotumors are exceptionally rare spinal lesions.
  • Polymyalgia rheumatica (PMR) is an inflammatory condition typically affecting the elderly.
  • No prior cases linked spinal epidural inflammatory pseudotumors to PMR.

Observation:

  • A 63-year-old male with a history of PMR presented with gait disturbance.
  • MRI revealed a posterior epidural mass at T5-T6 causing spinal cord compression.
  • The mass involved the ligamentum flavum and epidural fat, adhering to the dura.

Findings:

  • Histopathology showed lymphoplasmacytic infiltration and fibrosis, excluding tumor or hematoma.
  • Surgical excision via laminectomy was performed.
  • Immediate resolution of neurological deficits occurred post-surgery.

Implications:

  • This case highlights a novel association between PMR and spinal epidural inflammatory pseudotumor.
  • Early diagnosis and surgical intervention are crucial for favorable outcomes.
  • Further research may elucidate the pathogenesis of this rare condition in PMR patients.

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