title: Seropositive Neuromyelitis Optica imitating an Intramedullary Cervical Spinal Cord Tumor: Case Report and Brief Review of the Literature.
abstract: A 44-year-old woman with progressive cervical myelopathy and central cord syndrome was noted to have an extensive cervical intramedullary contrast-enhancing lesion on magnetic resonance imaging (MRI). The lesion resembled a spinal astrocytoma or ependymoma that required surgical intervention. She was subsequently diagnosed to have neuromyelitis optica (NMO), a rare idiopathic inflammatory demyelinating disorder, when the clinical examination revealed left optic atrophy. This was confirmed by a test showing seropositivity for NMO-immunoglobulin (IgG). Disease control was achieved with corticosteroids and immunosuppressive therapy. We report a rare case of a patient with NMO who had MRI features that could have easily led to the condition being misdiagnosed as a spinal cord tumor. The importance of careful history taking, awareness of typical radiological findings and the usefulness of serum NMO-IgG as a diagnostic tool are emphasized.
authors.affiliation: Department of Neurosurgery, Kwong Wah Hospital, Hong Kong SAR, China.
authors.forename: Peter Yat-Ming
authors.initials: PY
authors.lastname: Woo
authors.affiliation: Department of Neurosurgery, Kwong Wah Hospital, Hong Kong SAR, China.
authors.forename: Jennifer Hiu-Fung
authors.initials: JH
authors.lastname: Chiu
authors.affiliation: Department of Neurosurgery, Kwong Wah Hospital, Hong Kong SAR, China.
authors.forename: Kar-Ming
authors.initials: KM
authors.lastname: Leung
authors.affiliation: Department of Neurosurgery, Kwong Wah Hospital, Hong Kong SAR, China.
authors.forename: Kwong-Yau
authors.initials: KY
authors.lastname: Chan
keywords: Demyelinating disorders; Intramedullary spinal cord neoplasms; Magnetic resonance imaging; Neuromyelitis optica