RESUMO
We report a 66-year-old woman who developed sudden-onset bilateral sensorineural deafness due to leptomeningeal carcinomatosis involving the vestibulocochlear nerves. The clinical and diagnostic features of leptomeningeal carcinomatosis are discussed.
Assuntos
Carcinoma/complicações , Perda Auditiva Bilateral/etiologia , Perda Auditiva Súbita/etiologia , Neoplasias Meníngeas/complicações , Idoso , Carcinoma/patologia , Feminino , Perda Auditiva Bilateral/patologia , Perda Auditiva Súbita/patologia , Humanos , Imageamento por Ressonância Magnética/métodos , Neoplasias Meníngeas/patologiaRESUMO
A 17-year-old male presented with acute onset paraparesis in the lower limbs. Urinary retention was present and the patient required catheterisation. Clinical examination confirmed severe bilateral lower limb weakness and a sensory level at T8. Magnetic resonance imaging (MRI) revealed a haemorrhagic intramedullary tumour extending from T8 to the conus. Microsurgical excision of the tumour was performed and the patient made a good functional recovery. The histology of the tumour demonstrated a ganglioglioma of the spinal cord. Acute paraparesis has not previously been reported with a spinal cord ganglioglioma. We discuss the clinical, diagnostic and pathological features of spinal cord gangliogliomas.
Assuntos
Ganglioglioma/complicações , Ganglioglioma/patologia , Paraparesia/diagnóstico , Paraparesia/etiologia , Neoplasias da Medula Espinal/complicações , Neoplasias da Medula Espinal/patologia , Doença Aguda , Adolescente , Anti-Inflamatórios/uso terapêutico , Dexametasona/uso terapêutico , Diagnóstico Diferencial , Ganglioglioma/cirurgia , Humanos , Injeções Intravenosas , Imageamento por Ressonância Magnética , Masculino , Estadiamento de Neoplasias , Procedimentos Neurocirúrgicos , Paraparesia/tratamento farmacológico , Índice de Gravidade de Doença , Neoplasias da Medula Espinal/cirurgiaRESUMO
OBJECTIVE AND IMPORTANCE: Paragangliomas of the thoracic spine are rare. Previously described cases involved nonfunctioning tumors. This report documents the diagnosis and surgical treatment for a patient who presented with a functioning thoracic paraganglioma. CLINICAL PRESENTATION: A 53-year-old woman presented with a 10-month history of headaches, facial flushing, and palpitations associated with hypertension. Urinary catecholamine levels were markedly elevated. Magnetic resonance imaging and m-[(123)I]iodobenzylguanidine scans demonstrated an extradural tumor located within the T12 vertebra, with a significant paraspinal component. The neurological examination revealed mild hypesthesia in the right T12 dermatome. INTERVENTION: The patient underwent resection of the tumor after alpha-adrenergic receptor blockade. Grossly complete excision was achieved without neurological complications. Postoperatively, the patient was normotensive and exhibited catecholamine levels within the normal range. CONCLUSION: Functioning paragangliomas of the thoracic spine are rare lesions that are difficult to treat. Successful treatment requires careful surgical planning and expert pharmacological manipulation.