An upper thoracic spinal cord tumor presenting as hemifacial hyperhidrosis.
BACKGROUND
Hyperhidrosis as the sole presenting symptom of an upper thoracic intramedullary tumor has never been reported in the English literature.


METHODS
A 17-year-old boy presented with a long history of hemifacial flushing and hyperhidrosis on the left side of his face and neck. The MRI revealed a large spinal cord tumor at the T1-T2 levels. The patient underwent total excision of the intramedullary tumor via a posterior myelotomy. The histopathological diagnosis was low-grade astrocytoma. The symptoms resolved immediately after the surgery and did not return during the follow-up period of 9 months.


CONCLUSIONS
We suggest that sympathetic irritation on the left side is the mechanism behind this clinical presentation. Its unusual presentation and lack of motor and sensory deficits resulted in delayed diagnosis of this potentially disabling lesion. When autonomic dysfunction of the face and neck is encountered, in addition to the cranial and cervical regions, the upper thoracic levels should be investigated using MRI.
Kilinçer
Cumhur
C
Department of Neurosurgery, Medical Faculty, Trakya University, 22030 Edirne, Turkey. ckilincer@hotmail.com
Oztürk
Levent
L
Hamamcioglu
M Kemal
MK
Altunrende
Emre
E
Cobanoglu
Sebahattin
S
D000293:Adolescent; D001254:Astrocytoma / Q000150:complications / Q000175:diagnosis*; D001342:Autonomic Nervous System Diseases / Q000209:etiology / Q000503:physiopathology; D005483:Flushing; D007839:Functional Laterality / Q000502:physiology; D006801:Humans; D006945:Hyperhidrosis / Q000209:etiology*; D008279:Magnetic Resonance Imaging; D008297:Male; D013120:Spinal Cord Neoplasms / Q000150:complications / Q000175:diagnosis*