J Korean Neurosurg Soc.  2013 May;53(5):316-319. 10.3340/jkns.2013.53.5.316.

Neuromyelitis Optica Mimicking Intramedullary Tumor

• Oh SH
• Yoon KW
• Kim YJ
• Lee SK

• KMID: 1426204
• DOI: http://doi.org/10.3340/jkns.2013.53.5.316

Abstract

Neuromyelitis optica (NMO) is considered to be a rarer autoimmune disease than multiple sclerosis. It is very difficult to make a diagnosis of MNO for doctors who are not familiar with its clinical features and diagnostic criteria. We report a case of a young female patient who had been suffering motor weakness and radiating pain in both upper extremities. Cervical MRI showed tumorous lesion in spinal cord and performed surgery to remove lesion. We could not find a tumor mass in operation field and final diagnosis was NMO. NMO must be included in the differential diagnosis of lesions to rescue the patient from invasive surgical interventions. More specific diagnostic tools may be necessary for early diagnosis and proper treatment.

Keyword

Neuromyelitis optica; Autoimmune disease; Spinal tumor

MeSH Terms

Autoimmune Diseases
Diagnosis, Differential
Early Diagnosis
Female
Humans
Multiple Sclerosis
Neuromyelitis Optica
Spinal Cord
Stress, Psychological
Upper Extremity

Figure

• 

  Fig. 1 Initial cervical MRI sagittal images show heterogenous enhancement of elongated shaped mass like lesion mimics tumorous condition from C1 to C6 levels. A : T1 weighted image. B : T2 weighted image. C : T1 weighted enhanced image.

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  Fig. 2 Cervical MRI which was performed after neurologic deterioration shows newly appeared enhancing lesion in the anterior aspect of spinal cord from C2 to C4 level. A : T1 weighted image. B : T2 weighted image. C : T1 weighted enhanced image.

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  Fig. 3 Intraoperative picture shows no definite lesion which is suspected as tumorous condition except a mild edema.

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  Fig. 4 Postoperative cervical MRI (after 3 months from surgery) shows improvement of cord swelling and remaining focal high signal foci on T2 weighted image. A : T1 weighted image. B : T2 weighted image. C : T1 weighted enhanced image.

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