Locked-in syndrome caused by a tumor

Area of Science:

• Neurology
• Oncology
• Pathology

Background:

• Locked-in syndrome is a rare neurological condition characterized by complete paralysis and inability to communicate, while consciousness is preserved.
• Brain-stem lesions are the typical cause of locked-in syndrome, often resulting from vascular events.
• The differential diagnosis for brain-stem lesions includes tumors, demyelinating diseases, and infections.

Observation:

• A patient presented with clinical and radiologic findings suggestive of a brain-stem tumor.
• The patient exhibited symptoms consistent with locked-in syndrome.
• Despite initial clinical suspicions, the definitive diagnosis was only established post-mortem.

Findings:

• Autopsy revealed a reticulum cell sarcoma (a type of non-Hodgkin lymphoma) in the brain-stem.
• This represents the first documented case of locked-in syndrome directly caused by a reticulum cell sarcoma.
• The tumor's location and type were confirmed as the etiological agent for the patient's neurological state.

Implications:

• This case expands the known etiologies of locked-in syndrome, highlighting neoplastic processes as a potential cause.
• It underscores the importance of considering rare tumor types in the differential diagnosis of unexplained neurological deficits.
• Further research may be warranted to investigate the incidence and clinical presentation of brain tumors causing locked-in syndrome.