title: Primary spinal oligoastrocytoma mimicking longitudinally extensive transverse myelitis.
abstract: Longitudinally extensive transverse myelitis (LETM) is most commonly associated with neuromyelitis optica spectrum disorders (NMOSD). However, a wide range of etiologies may produce longitudinally extensive spinal cord lesions (LESCLs) on imaging. We highlight the case of a patient with a spinal cord tumor whose imaging showed LESCL and was diagnosed with LETM. He did not respond to immunosuppression and subsequently developed a progressive and protracted clinical course. Thoracic cord biopsy performed 6 years after symptom onset showed primary spinal oligoastrocytoma. We discuss the features that should raise suspicion of a neoplasm in the context of LESCL and serve a reminder that not all LESCLs are inflammatory.
authors.affiliation: Department of Neurology, National Neuroscience Institute, 11 Jalan Tan Tock Seng, 308433 Singapore, Singapore. Electronic address: yeo.tianrong@singhealth.com.sg.
authors.forename: T R
authors.initials: TR
authors.lastname: Yeo
authors.affiliation: Department of Pathology, Tan Tock Seng Hospital, 11 Jalan Tan Tock Seng, 308433 Singapore, Singapore. Electronic address: chin_fong_wong@ttsh.com.sg.
authors.forename: C F
authors.initials: CF
authors.lastname: Wong
authors.affiliation: Department of Medical Oncology, National Cancer Centre Singapore, 11 Hospital Drive, 169610 Singapore, Singapore. Electronic address: joycelyn.lee.j.x@nccs.com.sg.
authors.forename: J J X
authors.initials: JJ
authors.lastname: Lee
authors.affiliation: Department of Neurology, National Neuroscience Institute, 11 Jalan Tan Tock Seng, 308433 Singapore, Singapore. Electronic address: valerie.ng@mohh.com.sg.
authors.forename: V Z Y
authors.initials: VZ
authors.lastname: Ng
authors.affiliation: Department of Neurology, National Neuroscience Institute, 11 Jalan Tan Tock Seng, 308433 Singapore, Singapore. Electronic address: kevin_tan@nni.com.sg.
authors.forename: K
authors.initials: K
authors.lastname: Tan
mesh_terms: D001254:Astrocytoma / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology; D001921:Brain / Q000473:pathology; D003937:Diagnosis, Differential; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009188:Myelitis, Transverse / Q000175:diagnosis*; D060787:Neoplasm Grading; D010166:Palliative Care; D013116:Spinal Cord / Q000473:pathology*; D013120:Spinal Cord Neoplasms / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology; D013904:Thoracic Vertebrae
keywords: Biopsy; Histopathology; Longitudinally extensive spinal cord lesion; Longitudinally extensive transverse myelitis; Spinal cord tumor; Spinal oligoastrocytoma