Intradural cervical inflammatory pseudotumor mimicking epidural hematoma in a pregnant woman: case report and review of the literature

Surg Neurol. 2008 Mar;69(3):302-5. doi: 10.1016/j.surneu.2006.12.056. Epub 2007 Sep 4.

Abstract

Background: Inflammatory pseudotumors usually affect the lung and the orbit. They occur extremely rarely in the spine. We encountered a case of intradural extramedullary IPT of the cervical spine in a pregnant woman that initially presented as an epidural hematoma in MRI.

Case description: This is a case of a 30-year-old, HIV-negative, full-term pregnant lady presenting with 2-month history of progressive quadriparesis with rapid worsening of power in all 4 limbs for 3 days. Magnetic resonance imaging scanning revealed cervical extramedullary compressive lesion likely to be epidural bleed from its imaging characteristics. Intraoperatively, intradural extramedullary granulomatous lesion was found with dural thickening. Gross total excision was accomplished; histopathologic study assessed an IPT. The patient improved after surgery excision and is doing well at 6-month follow-up with remarkable neurological recovery.

Conclusion: Cervical intradural IPT is a very rare issue in the spine. Diagnosis can be confused with a neoplastic lesion like an "en plaque meningioma" or as epidural bleed like in the present case.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adult
  • Diagnosis, Differential
  • Female
  • Granuloma, Plasma Cell / complications
  • Granuloma, Plasma Cell / pathology*
  • Granuloma, Plasma Cell / surgery
  • Hematoma, Epidural, Spinal / diagnosis*
  • Humans
  • Magnetic Resonance Imaging
  • Neck
  • Neurosurgical Procedures / methods
  • Pregnancy
  • Quadriplegia / diagnosis
  • Spinal Cord Neoplasms / complications
  • Spinal Cord Neoplasms / pathology*
  • Spinal Cord Neoplasms / surgery