Vaginal allodynia as the presentation of a thalamic tumor.
Central pain syndromes associated with damage to the thalamic sensory relay nuclei have been described predominantly in the stroke literature; however, pain syndromes associated with thalamic neoplasms are much less common. We describe a woman with dyspareunia secondary to vaginal allodynia as the presenting sign of a left thalamic juvenile pilocytic astrocytoma. Subsequent to an uneventful stereotactic biopsy, her vaginal allodynia progressed to hemi-body allodynia. We believe that this is the first reported case of isolated vaginal allodynia associated with a thalamic neoplasm or any other structural pathology of the central nervous system. Dyspareunia secondary to vaginal allodynia as the presenting sign of a left thalamic juvenile pilocytic astrocytoma is reported, in a rare case underscoring that thalamic pathology including neoplasms should be considered in evaluating patients with longstanding and unexplained pain syndromes.
Department of Neurological Surgery, University of Washington, Seattle, WA, USA.
Daniel L
DL
Silbergeld
Adam O
AO
Hebb
John D
JD
Loeser
D001254:Astrocytoma / Q000503:physiopathology* / Q000601:surgery; D001932:Brain Neoplasms / Q000503:physiopathology* / Q000601:surgery; D004414:Dyspareunia / Q000175:diagnosis* / Q000628:therapy; D005260:Female; D006801:Humans; D006930:Hyperalgesia / Q000175:diagnosis* / Q000628:therapy; D008279:Magnetic Resonance Imaging / Q000379:methods; D013786:Thalamic Diseases / Q000503:physiopathology / Q000601:surgery; D055815:Young Adult
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