Devoted to diagnostic and interventional spine imaging and therapeutics

Library

A Rare Case of Pseudotumor of the Thoracic Spine 2011

General Spine

Sean, C., Chang, M.D.
Mark, Shiroishi, M.D., Non ASSR Member
Adrian, Correa, M.D., Non ASSR Member
Meng, Law, M.D., Non ASSR Member
Paul, E., Kim, M.D., Non ASSR Member
John, L., Go, M.D., Non ASSR Member

Excerpta

Purpose

To report a rare case of inflammatory pseudotumor involving the thoracic spine.

Methods & Materials

A 57 year old male presents with a one year history of gradual weakness of the bilateral lower extremities. At the time of presentation, the patient had rapid progression of leg weakness, urinary retention and bowel incontinence over a one week period. MR imaging of the thoracic spine demonstrated a dural based circumferential mass within the central canal extending from the C4 to T5 levels causing compression of the thoracic cord. The mass demonstrated isointensity on T1 weighted images and marked hypointensity on T2 weighted images with heterogenous, avid enhancement. A second area of involvement was also seen at the T8-T11 levels.

Results

The patient underwent emergency decompression of the thoracic spine, and tissue sample was obtained. Pathology demonstrated acute and chronic areas of inflammation and fibrosis with infiltration of a polyclonal population of lymphocytes and plasma cells diagnostic for inflammatory pseudotumor of the thoracic spine. The incidence of inflammatory pseudotumor of the spine is rare with a few isolated case report within the literature. This presentation will describe the imaging findings and frequency of inflammatory pseudotumor of the spine.

Conclusion

Inflammatory pseudotumor is a rare phenomenon, but should be included in the differential diagnosis of dural based lesions of the spine.

References/Financial Disclosures

1. Claude Gilliard, M.D., Beatrijs De Coene, M.D., Joseph Bou Lahdou, M.D., Yves Boutsen, M.D., Henri Noël, M.D., and Catherine Godfraind, M.D. Cervical epidural pseudotumor and multifocal fibrosclerosis-Case report and review of the literature. J Neurosurgery 2000;93:152-156 2. Mahjouba Boutarbouch MD, Yasser Arkha MD, Lobna Rifi MD, Said Derraz MD, Abdessamad El Ouahabi MD and Abdeslam El Khamlichi MD. Intradural cervical inflammatory pseudotumor mimicking epidural hematoma in a pregnant woman: case report and review of the literature. Surgical Neurology. 2008 69;3:302-305 3.Giovanni Liccardo, Pierpaolo Lunardi, Agazio Menniti, Roberto Floris, FrancescoSaverio Pastore and Bernardo Fraioli. Calcifying pseudo-tumor of the spine: description of a case and review of the literature. European Spine Journal;12:548-551

[gallery]