title: Intramedullary non-specific inflammatory lesion of thoracic spine: a case report.
abstract: BACKGROUND
  There are several non-neoplastic lesions which mimick intramedullary spinal cord neoplasm in their radiographic and clinical presentation. These can be classified as either infectious (TB, fungal, bacterial, parasytic, syphilis, CMV, HSV) and non-infectious (sarcoid, MS, myelitis, ADEM, SLE) inflammatory lesions, idiopathic necrotizing myelopathy, unusual vascular lesions and radiation myelopathy. Although biopsy may be indicated in many cases, an erroneous diagnosis of intramedullary neoplasm can often be eliminated pre-operatively.
  
  
  METHODS
  the authors report a very rare case of intramedullary non-specific inflammatory lesion of unknown origin, without signs of infection or demyelinization, in a woman who showed no other evidence of systemic disease.
  
  
  CONCLUSIONS
  Intramedullary lesions that mimick a tumor can be various and difficult to interpret. Preoperative MRI does not allow a certain diagnosis because these lesions have a very similar signal intensity pattern. Specific tests for infective pathologies are useful for diagnosis, but histological examination is essential for establishing a certain diagnosis. In our case the final histological examination and the specific tests that we performed have not cleared our doubts regarding the nature of the lesion that remains controversial.
authors.affiliation: Department of Neurosurgery, University of Rome Sapienza, Rome, Italy. link55@libero.it
authors.forename: Alessandro
authors.initials: A
authors.lastname: Landi
authors.forename: Valerio
authors.initials: V
authors.lastname: Di Norcia
authors.forename: Demo Eugenio
authors.initials: DE
authors.lastname: Dugoni
authors.forename: Roberto
authors.initials: R
authors.lastname: Tarantino
authors.forename: Martina
authors.initials: M
authors.lastname: Cappelletti
authors.forename: Manila
authors.initials: M
authors.lastname: Antonelli
authors.forename: Antonio
authors.initials: A
authors.lastname: Santoro
authors.forename: Roberto
authors.initials: R
authors.lastname: Delfini
mesh_terms: D000368:Aged; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007249:Inflammation / Q000175:diagnosis* / Q000628:therapy; D008279:Magnetic Resonance Imaging; D013120:Spinal Cord Neoplasms / Q000175:diagnosis* / Q000628:therapy; D035441:Thoracic Wall / Q000473:pathology*