[Adolescent radiculopathy associated with extradural intraspinal tumor]

Area of Science:

• Neurosurgery
• Oncology
• Spinal Cord Research

Background:

• Intraspinal neoplasms present diagnostic challenges due to insidious onset and non-specific symptoms.
• Spinal tumors are categorized by location: extradural, intradural (extramedullary, intramedullary).
• Symptoms include pain, weakness, sensory loss, and sphincter dysfunction, necessitating surgical treatment upon diagnosis.

Observation:

• A 14-year-old male presented with a four-year history of progressive lumbar pain radiating to the lower extremities.
• The patient experienced worsening paresthesia and paresis, primarily in the right lower limb.
• Clinical presentation suggested an intraspinal process requiring further investigation.

Findings:

• Surgical exploration revealed a lipoma of the filum terminale, a rare spinal tumor accounting for <1% of spinal tumors.
• The tumor measured approximately 14x10x4 mm, with characteristics of adipose tissue and a notable vascular network.
• Resection involved L4-L5 bilateral laminotomy, tumor removal, and nerve root decompression.

Implications:

• This case underscores the importance of considering rare intraspinal tumors in adolescents with chronic, progressive neurological symptoms.
• Timely surgical intervention for spinal lipomas can lead to symptom resolution and prevent further neurological deficits.
• Further research into early diagnostic markers for insidious spinal neoplasms is warranted.