Intramedullary non-specific inflammatory lesion of thoracic spine: a case report.
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.
Landi
Alessandro
A
Department of Neurosurgery, University of Rome Sapienza, Rome, Italy. link55@libero.it
Di Norcia
Valerio
V
Dugoni
Demo Eugenio
DE
Tarantino
Roberto
R
Cappelletti
Martina
M
Antonelli
Manila
M
Santoro
Antonio
A
Delfini
Roberto
R
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*