-
Orestes López Piloto
1*
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Yurledys Jhohana Linares Benavides
2
-
Mercedes Rita Salinas Olivares
3
1 Neurosurgeon Professor. Neurology and Neurosurgery Institute, Cuba
2 Second year Neurosurgery Resident Neurology and Neurosurgery Institute, Cuba
3 Pathology Professor. Neurology and Neurosurgery Institute, Cuba.
*Corresponding Author: Orestes López Piloto, Neurosurgeon Professor. Neurology and Neurosurgery Institute, Cuba
Citation: Orestes López Piloto, Yurledys Jhohana Linares Benavides, Mercedes Rita Salinas Olivares (2020) Spinal Amiloydoma Mimic an Intradural Neoplasm. Case report and literature analysis. J Clinical Research and Reports, 3(1); DOI:10.31579/2690-1919/029
Copyright: © pez Piloto. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Received: 27 January 2020 | Accepted: 14 February 2020 | Published: 19 February 2020
Keywords: amyloidosis; spinal amyloidoma; surgical resection
Abstract
Introduction: Amyloidosis represents an alteration secondary to the extracellular deposit of low molecular weight protein with an fibrillar structure. Intradural spinal amyloidoma is unusual, with only two cases previously reported.
Case report: A female 53 years old patient with story of progressive paraparesis and successfully operated of an intradural extramedullary amyloidoma is presented.
Conclusions: Although extremely unusual, the spinal amyloidoma should be considered in the differential diagnosis of any patient with an intradural extramedullary tumor. In this scenario, the laminectomy constitutes a good therapeutic modality which not only afford to stablish the positive diagnosis, also helps to improve the neurological condition of the patient.
Clinical case
A 53-year-old female patient is presented, of rural origin, white race, with a history of previous good health and a history of progressive decrease in muscle strength in both lower limbs of 3 years of evolution, associated with stiffness.
The neurological examination confirmed a spastic paraparesis with ASIA 3/5 in the lower right limb and 4/5 in the lower left limb, as well as patellar hyperreflexia and bilateral aquilea with increased reflexogenic area and bilateral Babinski sign. Hypoaesthesia was also observed for thermoalgesic sensitivity, apalestesia and abarognosis, with a sensitive level in D4. The rest of the physical exam was negative.
Simple x-rays of the cervical and lumbar spine showed moderate signs of spondylosis without other alterations. In the Magnetic Resonance Imaging (MRI) study, a hypointense posterior intradural lesion was observed in the well-defined sequence in T1 and T2 of well-defined limits that compressed the spinal cord at the level of D4 with a maximum cephalocaudal diameter of 38 mm (image 1A and B).
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