Rare Cases Of Spinal Cord Tumors: Pitfalls And Complications. Intr-Extra Dural Pseudogout, Intramedullary Neurofibroma And Cervical Sublaxation Due To Neurofibroma

Abstract

Objectives: presenting 3 rare spinal cord tumor cases in order to highlight the importance of correlating the clinical findings from patient’s history and examination with radiological findings for proper patients’ management. Methods: Three cases presentation. Results: First case; young gentleman presented by right SEVERE GIRDLE PAIN followed by right LE weakness and left LE hypoesthesia. MRI and CT scan reported calcified meningioma. On dural opening, thick arachnoid membranes were dissected exposing the tumor. Lesion was opened, extruding cheesy material and the capsule was resected. Post operatively on patient’s recovery, he had same motor power as preoperative that suddenly deteriorated to become ACUTELY PARAPLEGIC ON COUGHING. He was immediately re-operated; an entrapped CSF pocket was found. Dramatic postoperative improvement in motor function ensued. Pathology revealed pseudogout tumor. Second case; 25 years old porter presented by mild quadriparesis due to c3/4 sublaxation. Traction leads to deterioration and further investigations (CT and MRI) revealed extradural neurofibroma managed by tumor resection followed by C3 corpectomy with graft and plating, back to work after 3 months. HE GAVE A PAST HISTORY OF SIMILAR ATTACK THAT RESOLVED SPONTANEOUSLY . Third case; 59 years old patient presented with bilateral foot drop  and GOOD SPHENCTERIC CONTROL. MRI reported conus astrocytoma. Debulking was done with immediate postoperative improvement. He deteriorated neurologically after several hours and reoperated again to find hemorrhagic residual tumor that was found to be neurofibroma on histopathology. Conclusions: critical analysis of history and examination in correlation with imaging is the mainstay to avoid misdiagnosis and prevent complications.