title: A 20-year-old man with back pain and lower extremity weakness.
abstract: A 20-year-old man presented with 1 week of low back pain and progressive lower extremity weakness. Results of cerebrospinal fluid analysis demonstrated elevated total protein and a mildly elevated white blood cell count with lymphocytic predominance. Findings from imaging studies revealed a multifocal, heterogeneously enhancing, intramedullary lesion involving the cervicothoracic spinal cord and nodular enhancement of the cauda equina. The patient eventually underwent spinal surgery for tissue diagnosis. The differential diagnosis, pathologic findings, and diagnosis are discussed.
authors.affiliation: Department of Neurology, Massachusetts General Hospital, Boston2Department of Neurology, Brigham and Women's Hospital, Boston, Massachusetts3Department of Neurology, Harvard Medical School, Boston, Massachusetts.
authors.forename: Mark R
authors.initials: MR
authors.lastname: Etherton
authors.affiliation: Department of Neurology, Massachusetts General Hospital, Boston2Department of Neurology, Brigham and Women's Hospital, Boston, Massachusetts3Department of Neurology, Harvard Medical School, Boston, Massachusetts.
authors.forename: Martha R
authors.initials: MR
authors.lastname: Neagu
authors.affiliation: Department of Neurology, Harvard Medical School, Boston, Massachusetts4Department of Pathology, Massachusetts General Hospital, Boston.
authors.forename: Derek H
authors.initials: DH
authors.lastname: Oakley
authors.affiliation: Department of Neurology, Harvard Medical School, Boston, Massachusetts5Department of Neurosurgery, Massachusetts General Hospital, Boston.
authors.forename: Matthew J
authors.initials: MJ
authors.lastname: Koch
authors.affiliation: Department of Neurology, Harvard Medical School, Boston, Massachusetts5Department of Neurosurgery, Massachusetts General Hospital, Boston.
authors.forename: John H
authors.initials: JH
authors.lastname: Shin
authors.affiliation: Department of Neurology, Harvard Medical School, Boston, Massachusetts4Department of Pathology, Massachusetts General Hospital, Boston.
authors.forename: Matthew P
authors.initials: MP
authors.lastname: Frosch
authors.affiliation: Department of Neurology, Brigham and Women's Hospital, Boston, Massachusetts3Department of Neurology, Harvard Medical School, Boston, Massachusetts.
authors.forename: Aaron L
authors.initials: AL
authors.lastname: Berkowitz
authors.affiliation: Department of Neurology, Massachusetts General Hospital, Boston3Department of Neurology, Harvard Medical School, Boston, Massachusetts6Division of Neuro-Oncology, Massachusetts General Hospital, Boston.
authors.forename: Jorg
authors.initials: J
authors.lastname: Dietrich
mesh_terms: D001416:Back Pain / Q000175:diagnosis* / Q000209:etiology / Q000601:surgery; D002574:Cervical Vertebrae / Q000473:pathology / Q000601:surgery; D006801:Humans; D035002:Lower Extremity / Q000473:pathology*; D008159:Lumbar Vertebrae / Q000473:pathology / Q000601:surgery; D008297:Male; D018908:Muscle Weakness / Q000175:diagnosis* / Q000209:etiology / Q000601:surgery; D013120:Spinal Cord Neoplasms / Q000150:complications / Q000175:diagnosis* / Q000601:surgery; D013904:Thoracic Vertebrae / Q000473:pathology / Q000601:surgery; D055815:Young Adult