[Intramedullary spinal cord metastasis and leptomeningeal involvement in Hodgkin's disease. Case report and review of the literature]. / Atteinte de la moelle épinière et envahissement méningé lors d'une maladie de Hodgkin. A propos d'un cas et revue de la littérature.

ABSTRACT

INTRODUCTION: Central nervous system, especially spinal cord involvement, is unusual in Hodgkin's disease. We report the case of a patient with refractory Hodgkin's disease who presented with intramedullary involvement. EXEGESIS A 36-year-old woman presented with weakness of the right lower extremity and sphincter dysfunction 13 years after initial diagnosis of Hodgkin's disease. Magnetic resonance imaging showed intraspinal tumor with contrast enhancement extending from C7 to D1. Cerebrospinal fluid examination revealed the presence of Reed-Sternberg cells. Specific intramedullary spinal cord metastasis and leptomeningeal involvement were confirmed. Despite intrathecal chemotherapy the neurologic deficit progressed to paraplegia and the patient died 2 months later. CONCLUSION: Intramedullary spinal cord metastases rarely occur in the course of Hodgkin's disease. Except for the initial presentation, their prognosis is poor despite early diagnosis with magnetic resonance imaging. Other causes such as epidural cord compression, paraneoplasic myelopathy, granulomatous angiitis and radiation myelopathy are still delated.