[The importance of a complete diagnostic workup in patients with nontraumatic (partial) paraplegia].
In two women, aged 86 and 56 years, respectively, who suffered from back pain and loss of strength, and in a 55-year-old man who lost sensation and strength in his left leg, spinal-cord compression in connection with vertebral destruction was seen on radiological examination. When spinal-cord compression is the result of a local malignant tumour, the therapy often entails emergency radiotherapy. In the first two patients, histological examination revealed a solitary plasmocytoma and curative high-dose radiotherapy was applied. The third patient also had a lung tumour and received low-dose palliative radiotherapy to the vertebrae, as a metastasis was suspected. Later, however, histopathologic examination of the vertebral lesion revealed osteomyelitis due to Listeria monocytogenes and the lung tumour was diagnosed as a pT2N0M0 broncho-alveolar carcinoma which was surgically removed. When a patient is referred with a nontraumatic spinal-cord injury, it is important to complete the radiological and histological examinations before starting emergency radiotherapy in order to prevent an inadequate or even incorrect treatment.
Schinagl
D A
DA
Afd. Radiotherapie, Universitair Medisch Centrum St Radboud, Postbus 9101, 6500 HB Nijmegen. d.schinagl@rther.umcn.nl
Kappelle
A C
AC
van der Maazen
R W
RW
Bussink
J
J
D002282:Adenocarcinoma, Bronchiolo-Alveolar / Q000175:diagnosis / Q000473:pathology / Q000601:surgery; D000368:Aged; D000369:Aged, 80 and over; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008088:Listeriosis / Q000150:complications / Q000175:diagnosis*; D008175:Lung Neoplasms / Q000175:diagnosis / Q000473:pathology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D010019:Osteomyelitis / Q000150:complications / Q000175:diagnosis*; D010264:Paraplegia / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy; D010954:Plasmacytoma / Q000150:complications / Q000175:diagnosis* / Q000532:radiotherapy; D013117:Spinal Cord Compression / Q000150:complications / Q000175:diagnosis* / Q000209:etiology; D013120:Spinal Cord Neoplasms / Q000150:complications / Q000175:diagnosis* / Q000532:radiotherapy / Q000556:secondary