Dl. Braverman et al., MULTIPLE-SCLEROSIS PRESENTING AS A SPINAL-CORD TUMOR, Archives of physical medicine and rehabilitation, 78(11), 1997, pp. 1274-1276
Multiple sclerosis, a disorder of central nervous system demyelination
, is a leading cause of disability in young people. Lesions of the spi
nal cord are usually less than two vertebral body segments long, perip
herally located, and found in the cervical region. A 30-year-old woman
had a 2-month history of back pain, urinary incontinence, and bilater
al lower extremity weakness. Magnetic resonance imaging (MRI) of the s
pine showed an intramedullary spinal cord tumor from T4 to T8 with an
intramedullary cyst from T1 to T4. After thoracic decompressive surger
y, findings from biopsy of the cord lesion a ere consistent with multi
ple sclerosis. Postoperatively, the patient required an intensive reha
bilitation program. This is the first reported case of histopathologic
ally confirmed spinal cord demyelination presenting as an intramedulla
ry thoracic cord tumor. Physiatrists should be alerted that demyelinat
ing disease can mimic a spinal cord tumor, even on MRI, and must be co
nsidered in the differential diagnosis of a symptomatic spinal cord ma
ss. (C) 1997 by the American Congress of Rehabilitation Medicine and t
he American Academy of Physical Medicine and Rehabilitation.