title: Non-Hodgkin lymphoma in a child presenting with acute paraplegia: a case report.
abstract: Spinal cord compression is a rare presentation of non-Hodgkin lymphoma. Extradural location at onset is a rare but devastating event in pediatric oncology. The authors describe a girl with acute spinal cord compression due to epidural non-Hodgkin lymphoma, emphasizing the encouraging perspective for a complete recovery in children with this condition. A 5-year-old girl presented with pain followed by progressive hyposthenia and paraplegia after a trauma. CT scan and MRI showed homogeneous tissue extending from T2 to L4, occupying the entire vertebral canal and extending to the para- and peri-vertebral soft parts. Emergency surgical debulking was carried out through T6-L1 laminectomy. The patient began chemotherapy (LMB 89 Protocol) and the tumor quickly disappeared. The patient is maintaining a complete remission 42 months after diagnosis. Significant results may be obtained with the chemotherapy treatment of epidural non-Hodgkin lymphoma when the disease is promptly diagnosed. Considering the effectiveness of chemotherapy, the authors believe that a neuro-surgical approach should be employed only when rapid worsening of symptoms is observed or for diagnostic purpose.
authors.affiliation: Dipartimento di Pediatria, Ostetricia e Medicina della Riproduzione, Universita di Siena, Siena, Italy. acquaviva@unisi.it
authors.forename: A
authors.initials: A
authors.lastname: Acquaviva
authors.forename: S
authors.initials: S
authors.lastname: Marconcini
authors.forename: G
authors.initials: G
authors.lastname: Municchi
authors.forename: I
authors.initials: I
authors.lastname: Vallone
authors.forename: L
authors.initials: L
authors.lastname: Palma
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002675:Child, Preschool; D003937:Diagnosis, Differential; D015174:Epidural Neoplasms / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008228:Lymphoma, Non-Hodgkin / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy; D008279:Magnetic Resonance Imaging; D010264:Paraplegia / Q000209:etiology*; D013117:Spinal Cord Compression / Q000209:etiology / Q000601:surgery; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome