Acute Spinal Cord Compression due to Chloroma as the Initial Presenting Feature of Acute Myeloid Leukemia

AbstractChloroma is the deposits in leukemic cells outside the bone marrow and is not common. It is extremely rare to find a chloroma compressing the spinal cord causing paraplegia without any prior symptoms. Only few case reports have been found in the literature till date. We report an interesting case of a 7-year-old boy who presented with acute back pain and paraplegia with a dorsal extradural mass, and with a previous diagnosis of tuberculosis of the dorsal spine, treated with antitubercular drugs without any other signs of systemic illness. After surgical decompression and histopathologic examination of the tissue, it was found to be chloroma. There are only few reported cases of this disease initially presented as paraplegia without any systemic signs of malignancy in the literature, and chloroma presents as a diagnostic challenge to the surgeon. Chloromas are a rare cause of acute spinal cord compression but should be diagnosed and treated promptly to prevent neurologic dysfunction.

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Rosai-Dorfman disease with spinal cord compression: a diagnostic challenge

European Spine Journal ◽

10.1007/s00586-014-3671-6 ◽

2014 ◽

Vol 24 (S4) ◽

pp. 529-535 ◽

Cited By ~ 3

Author(s):

Sara Sciacca ◽

Kostantinos Barkas ◽

Lauren Heptinstall ◽

Christopher McNamara ◽

Rohit Shetty

Keyword(s):

Spinal Cord ◽

Spinal Cord Compression ◽

Cord Compression ◽

Diagnostic Challenge ◽

Rosai Dorfman Disease

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Spinal Cord Compression: A Complication of Silicone-Coated Dacron Dural Grafts. Report of Two Cases

Neurosurgery ◽

10.1227/00006123-198901000-00022 ◽

1989 ◽

Vol 24 (1) ◽

pp. 115-118 ◽

Cited By ~ 14

Author(s):

Heldo Gomez ◽

John R. Little

Keyword(s):

Spinal Cord ◽

Spinal Cord Compression ◽

Cervical Spinal Cord ◽

Case Reports ◽

Cord Compression ◽

Tissue Reaction ◽

Synthetic Graft ◽

Surface Contaminants ◽

Two Factors

Abstract Two case reports of compression of the cervical spinal cord associated with silicone-coated Dacron dural grafts are presented. In both cases, the cervical spinal cord was distorted and compressed by an intense tissue reaction that encapsulated the synthetic graft. At least two factors are thought to play a role in precipitating this reaction: (1) the introduction of surface contaminants into the wound, and (2) repeated motion at the graft site.

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Analysis of a neurosurgical directed acute spinal cord compression pathway at Michigan Medicine, a tertiary referral hospital.

Journal of Clinical Oncology ◽

10.1200/jco.2019.37.15_suppl.e18285 ◽

2019 ◽

Vol 37 (15_suppl) ◽

pp. e18285-e18285

Author(s):

John C. Krauss ◽

Daniel Klarr

Keyword(s):

Decision Making ◽

Spinal Cord ◽

Bone Metastases ◽

Spinal Cord Compression ◽

Radiation Oncology ◽

Medical Oncology ◽

Cord Compression ◽

Imaging Protocol ◽

Presenting Symptoms ◽

Previous Diagnosis

e18285 Background: Spinal cord compression (SCC) is considered an oncologic emergency that is likely to severely impair patients’ quality of life if immediate action is not taken. Clinicians need a high suspicion to diagnose SCC, as the presenting symptoms are variable and nonspecific. To expedite the diagnosis and treatment of SCC, we instituted an emergent spine MRI imaging pathway that was led by the neurosurgeons and involved close collaboration with medical oncology and radiation oncology. Methods: The charts of all patients from July 2015 to June 2018 who underwent the “MR Spine Cord Compression Acute” imaging pathway at Michigan Medicine were reviewed. Electronic time stamps provided the time of the initial order, the time to scan completion, the time to scan reading, and the time to definitive intervention. The charts were reviewed for the initial neurosurgical physical exam, a presentation consistent with recent trauma, a previous diagnosis of malignancy, and a previous diagnosis of bone metastases. The type and timing of therapy, and survival following the imaging protocol were assessed. Results: 319 unique MRI exams were done over the three-year span, 155 of the patients had cancer, and 75 patients had SCC. The time from ordering of exam to performance is 2.91 hours (0 to 25.45), from performance to read 8.31 hours (0 to 75.25 hours). Time from MRI to intervention was 63.14 hours (0 to 432 hours) based on complex decision making around surgical vs. radiation vs. medical therapy. For the majority of patients who were diagnosed with SCC, the cause was secondary to tumor growth from contiguous spinal metastasis, and most had previously identified bone metastases. Degenerative disc extrusion was the most common cause of benign SCC. Conclusions: A neurosurgical directed standard imaging protocol is effective at rapidly diagnosing SCC. Malignant SCC is predominately treated surgically, but complex multi-disciplinary patient centered decision-making involving neurosurgery, radiation oncology, and medical oncology is frequently necessary to arrive at the appropriate treatment.

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Spinal extradural arachnoid cysts

Coluna/Columna ◽

10.1590/s1808-18512013000200004 ◽

2013 ◽

Vol 12 (2) ◽

pp. 112-118 ◽

Cited By ~ 2

Author(s):

Abolfazl Rahimizadeh ◽

Mahmud Kaghazchi ◽

Majid Shariati ◽

Eidi Abdolkhani ◽

Enayatolah Abbasnejad ◽

...

Keyword(s):

Spinal Cord ◽

Spinal Cord Compression ◽

Single Case ◽

Case Reports ◽

Cauda Equina ◽

Cord Compression ◽

Arachnoid Cysts ◽

Imaging Features ◽

Benign Lesions ◽

Characteristic Imaging

OBJECTIVE: Extradural arachnoid cysts (EACs) are rare causes of spinal cord compression and cauda equina. These benign lesions appear in the literature mainly as single case reports. In this article, we present the largest series found in literature, with four new cases of spinal extradural arachnoid cysts. The characteristic imaging features, details of surgical steps and strategies to prevent postoperative kyphosis in this cystic pathology will be discussed.

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Hepatocellular carcinoma presenting as spinal cord compression in Native Americans with controlled hepatitis C: two case reports

Journal of Medical Case Reports ◽

10.1186/s13256-018-1807-8 ◽

2018 ◽

Vol 12 (1) ◽

Author(s):

Maksim Liaukovich ◽

Susan Wu ◽

Sydney Yoon ◽

Jeff Schaffer ◽

Jen C. Wang

Keyword(s):

Hepatocellular Carcinoma ◽

Spinal Cord ◽

Hepatitis C ◽

Native Americans ◽

Spinal Cord Compression ◽

Case Reports ◽

Cord Compression

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An Uncommon Cause of Acute Back Pain: Spinal Subarachnoid Hemorrhage Progressing to Spinal Cord Compression

Journal of Emergency Medicine ◽

10.1016/j.jemermed.2014.11.009 ◽

2015 ◽

Vol 48 (4) ◽

pp. 432-435 ◽

Cited By ~ 2

Author(s):

Shane B. Kappler ◽

Jonathan E. Davis

Keyword(s):

Spinal Cord ◽

Back Pain ◽

Subarachnoid Hemorrhage ◽

Spinal Cord Compression ◽

Cord Compression ◽

Acute Back Pain ◽

Spinal Subarachnoid Hemorrhage

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Late presentation of spinal cord compression in hereditary multiple exostosis: case reports and review of the literature

Journal of Children s Orthopaedics ◽

10.1302/1863-2548.13.180130 ◽

2019 ◽

Vol 13 (5) ◽

pp. 463-470

Author(s):

R. Gigi ◽

B. T. Kurian ◽

A. Cole ◽

J. A. Fernandes

Keyword(s):

Spinal Cord ◽

Spinal Cord Compression ◽

Case Reports ◽

Correct Diagnosis ◽

Cord Compression ◽

Late Presentation ◽

Level Of Evidence ◽

Hereditary Multiple Exostoses ◽

Clear Cut ◽

Cord Injury

Introduction Osteochondromas are usually found in the long bones of patients with hereditary multiple exostoses (HME). The spine is reported to be involved in over 50% of cases, but few of these patients are symptomatic as the result of an existing spinal exostosis. Methods We reviewed the current literature in order to find the right approach to patients with HME-complicated spinal exostosis and describe three paediatric patients that were diagnosed late with spinal cord compression due to cervical exostosis. Results Our three cases were all late presentations with neurology and unfortunately had minimal improvement of neurology after the lesion was surgically removed. There is general agreement that late presentation of spinal cord injury due to osteochondromas involving the cervical spine may cause severe and irreversible neurological sequelae. Our literature review revealed that there are no clear-cut guidelines to develop more comprehensive screening measures for these patients. Conclusions A high index of suspicion is the most important factor for correct diagnosis and appropriate management. Physicians who treat HME should bear in mind that thorough history taking and a neurological examination at follow up are essential for these patients. Clearer guidelines for the development of more comprehensive screening programmes are essential. Level of evidence IV

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Ossification of the posterior longitudinal ligament at the craniocervical junction presenting with Brown-Séquard syndrome: A case report

Surgical Neurology International ◽

10.25259/sni_704_2021 ◽

2021 ◽

Vol 12 ◽

pp. 501

Author(s):

Valérie Nicole Elise Schuermans ◽

Jasper van Aalst ◽

Alida A. Postma ◽

Anouk Y. J. M. Smeets

Keyword(s):

Spinal Cord ◽

Spinal Cord Compression ◽

Case Reports ◽

Posterior Longitudinal Ligament ◽

Cord Compression ◽

Craniocervical Junction ◽

Canal Stenosis ◽

History Of ◽

Lumbar Spinal ◽

Brown Sequard Syndrome

Background: Several case reports about spinal cord compression due to hyperostosis at the craniocervical junction are available. However, compression at C1-C2 solely due to ossification of the posterior longitudinal ligament (OPLL) is rare. Case Description: A 50-year-old Asian male, with a history of lumbar spinal canal stenosis, presented with a progressive quadriparesis within 3 months. Imaging showed central OPLL at the C1-C2 level contributing to severe spinal cord compression. The patient improved neurologically after a C1-C2 laminectomy. Conclusion: A patient presented with a progressive Brown-Séquard syndrome due to OPLL at the craniocervical junction (C1-C2 level) and improved following a decompressive laminectomy.

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Non-Hodgkin’s lymphoma and spinal cord compression: a diagnostic challenge

Italian Journal of Medicine ◽

10.4081/itjm.2015.573 ◽

2015 ◽

Vol 9 (4) ◽

pp. 380

Author(s):

Bilal Bin Abdullah ◽

Nida Nausheen ◽

Nagur Khuda Baksh ◽

Naga Dharma Teja Keerthi

Keyword(s):

Spinal Cord ◽

Spinal Cord Compression ◽

Hodgkin’S Lymphoma ◽

Tertiary Care ◽

Cord Compression ◽

Hodgkin's Lymphoma ◽

Care Hospital ◽

Diagnostic Challenge ◽

Non Hodgkin’S Lymphoma ◽

Non Hodgkin's Lymphoma

We report a 25-year-old lady presenting to the outpatient department of a tertiary care hospital with spinal cord compression. Initially we had a diagnostic difficulty, as its presentation was perplexing. Finally we pointed towards the diagnosis of non- Hodgkin’s lymphoma and proved it. This article carries a message for the clinicians as clinical fallacies were noticed towards pointing this diagnosis. We have clearly explained the shortcomings in evaluating a case making a diagnosis towards non- Hodgkin’s lymphoma and spinal cord compression, as many situations in the setting were simulating and overlapping.

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