Postoperative paraplegia as a result of undiagnosed primitive neuroectodermal tumor, not epidural analgesia.
Postoperative paraplegia is a rare complication after epidural analgesia and often occurs with spinal hematoma or cord injury. We present the case of a 16-year-old girl who suffered from a tumor mass in the neck and abdomen who underwent gynecologic operation. Preoperatively, liver metastasis was found by computed tomography. Pathologic findings revealed that the abdominal mass was an ovarian dermoid cyst. After the operation, the patient complained of paraplegia while receiving epidural analgesia for postoperative pain control. A peripheral primitive neuroectodermal tumor in the thoracic and lumbar spines with spinal cord compression was later detected using magnetic resonance imaging. Learning from this case, we suggest that when a patient is preoperatively diagnosed with tumor metastasis, back pain and soreness, spinal cord compression from tumor metastasis should be excluded before epidural analgesia is implemented.
Hung
Pei-Ching
PC
Department of Anesthesiology, Taichung Veterans General Hospital, Taichung, Taiwan, ROC.
Fan
Kuo-Tung
KT
Lai
Hui-Chi
HC
Shen
Ching-Hui
CH
Luk
Hsiang-Ning
HN
D000293:Adolescent; D015360:Analgesia, Epidural / Q000009:adverse effects*; D005260:Female; D006801:Humans; D018242:Neuroectodermal Tumors, Primitive / Q000150:complications*; D010149:Postoperative Pain / Q000628:therapy; D010264:Paraplegia / Q000209:etiology*; D011183:Postoperative Complications / Q000209:etiology*; D013125:Spinal Neoplasms / Q000150:complications* / Q000556:secondary