title: Postoperative paraplegia as a result of undiagnosed primitive neuroectodermal tumor, not epidural analgesia.
abstract: 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.
authors.affiliation: Department of Anesthesiology, Taichung Veterans General Hospital, Taichung, Taiwan, ROC.
authors.forename: Pei-Ching
authors.initials: PC
authors.lastname: Hung
authors.forename: Kuo-Tung
authors.initials: KT
authors.lastname: Fan
authors.forename: Hui-Chi
authors.initials: HC
authors.lastname: Lai
authors.forename: Ching-Hui
authors.initials: CH
authors.lastname: Shen
authors.forename: Hsiang-Ning
authors.initials: HN
authors.lastname: Luk
mesh_terms: 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