Solitary spinal dural syphilis granuloma mimicking a spinal meningioma.
Dural granuloma is extremely rare. To our knowledge, there has no case reported solitary spinal dural syphilis granuloma worldwide so far. Here we report our findings in a 49-year-old woman, who presented with 10-year progressive left lower-limb numbness and two weeks of right lower-limb numbness. Magnetic resonance imaging (MRI) suggested a homogeneous enhanced spindle-shaped lesion, 2.9 × 1.5 cm in size, occupying the spinal intradural extramedullary space, at the level of Thoracic (T)-2/3, which mimicked the appearance of spinal meningioma. The Treponema pallidum particle agglutination (TPPA) test titer of 1:8, and the venereal diseases research laboratory of cerebral spinal fluid (VDRL-CSF) was reactive, so confirmed neurosyphilis was considered. After formal anti-syphilis treatment, posterior laminectomy surgery was performed, and the lesion was completely separated and extirpated. Final histopathologic diagnosis of the lesion was confirmed as chronic granulomatous inflammation, combined with the neurosyphilis history, spinal dural syphilis granuloma was finally diagnosed. Postoperatively, the patient recovered without any further treatment.
First Affiliated Hospital, Zhejiang University, College of Medicine, Department of Neurosurgery, China.
Heng-Jun
HJ
Zhou
Ren-Ya
RY
Zhan
Man-Tao
MT
Chen
Fei
F
Cao
Xiu-Jue
XJ
Zheng
D003937:Diagnosis, Differential; D005260:Female; D006099:Granuloma / Q000175:diagnosis*; D006801:Humans; D007796:Laminectomy / Q000379:methods; D008279:Magnetic Resonance Imaging / Q000379:methods; D008577:Meningeal Neoplasms / Q000175:diagnosis*; D008579:Meningioma / Q000175:diagnosis* / Q000276:immunology; D008875:Middle Aged; D009494:Neurosyphilis / Q000175:diagnosis / Q000276:immunology / Q000628:therapy*