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Multiple sclerosis presenting as an intramedullary cervical cord tumor
Kansas Medicine : the Journal of the Kansas Medical Society
|July 1, 1989
Summary
Multiple sclerosis can mimic spinal cord tumors, even with advanced MRI. This case highlights demyelinating plaques presenting as a cervical cord lesion, challenging diagnosis.
Area of Science:
- Neurology
- Neuroscience
- Pathology
Background:
- Multiple sclerosis (MS) is a chronic central nervous system demyelinating disease.
- Accurate MS diagnosis requires evidence of disseminated lesions in space and time.
- Diagnostic tools include spinal fluid analysis, evoked potentials, and advanced imaging.
Observation:
- A 21-year-old woman presented with rapidly progressive neurological deficits mimicking a cervical spinal cord tumor.
- Magnetic resonance imaging (MRI) revealed cervical cord enlargement suggestive of a tumor.
- Neurological decline persisted despite corticosteroid treatment.
Findings:
- Open biopsy and histopathological examination revealed demyelinated axonal plaques, confirming multiple sclerosis.
- This represents the first documented case of histopathologically confirmed spinal cord demyelination presenting as an intramedullary cervical cord tumor.
- The case underscores the potential for demyelinating disease to masquerade as a spinal cord neoplasm.
Implications:
- Demyelinating diseases, like MS, can present atypically, challenging diagnostic accuracy.
- Advanced imaging alone may not differentiate MS from tumors in all cases.
- This case emphasizes the importance of considering demyelinating processes in the differential diagnosis of spinal cord lesions.