ABSTRACT
Neural tube defects are a group of birth defects that affect the development of the spinal cord and brain. Myelomeningocele is a type of neural tube defect that results in the protrusion of the spinal cord and meninges through a defect in the vertebral column. While myelomeningocele is a relatively rare condition, cervical myelomeningocele is extremely uncommon. The condition can lead to various neurological problems and atrophies and is typically diagnosed in the first trimester of pregnancy using an ultrasound examination. Surgical intervention is typically recommended to repair the affected vertebral column. In this report, we describe the case of a four-month-old baby boy who was diagnosed with a cervical myelocystocele and successfully treated surgically. The patient had an excellent postoperative status, and this case highlights the importance of early diagnosis and intervention in the management of this rare condition.
ABSTRACT
INTRODUCTION AND IMPORTANCE: Early clinical presentations of spinal processes involving the epidural space are often vague and can mimic other spinal nerve impingements. Patients with NHLs frequently experience neurological problems due to metastatic spinal cord compression (MSCC). CASE PRESENTATION: In this case report, we present a 66-year-old female patient who was diagnosed with diffuse large B-cell lymphoma (DLCBL) of the sacral spine after a recurrence of cauda equine syndrome. The patient initially presented with back discomfort, radicular pain, and muscle weakness, which progressed to weakness in the lower extremities and bladder dysfunction over a few weeks. The patient was treated by surgical decompression and the biopsy result revealed a diagnosis of DLBCL. Further workup proved the tumor is primary and the patient as treated with radio- and chemotherapy. CLINICAL DISCUSSION: The varied distribution of symptoms based on the spinal level of the lesion makes early clinical diagnosis of spinal NHL challenging. In this case, the patient's initial symptoms closely resembled intervertebral disc herniation or other spinal nerve impingements, which delayed the diagnosis of NHL. The abrupt onset and progression of neurological symptoms in the lower extremities and bladder dysfunction raised the suspicion of MSCC. CONCLUSION: NHLs can present as metastatic spinal cord compression, which can cause neurological problems. Early clinical diagnosis of spinal NHLs is challenging due to the vague and varied presentations. A high index of suspicion for MSCC should be maintained in patients with NHLs who present with neurological symptoms.
