MULTIPLE-SCLEROSIS PRESENTING AS A SPINAL-CORD TUMOR

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.