[The importance of a complete diagnostic workup in patients with nontraumatic (partial) paraplegia]

Ned Tijdschr Geneeskd. 2003 Dec 27;147(52):2565-9.
[Article in Dutch]

Abstract

In two women, aged 86 and 56 years, respectively, who suffered from back pain and loss of strength, and in a 55-year-old man who lost sensation and strength in his left leg, spinal-cord compression in connection with vertebral destruction was seen on radiological examination. When spinal-cord compression is the result of a local malignant tumour, the therapy often entails emergency radiotherapy. In the first two patients, histological examination revealed a solitary plasmocytoma and curative high-dose radiotherapy was applied. The third patient also had a lung tumour and received low-dose palliative radiotherapy to the vertebrae, as a metastasis was suspected. Later, however, histopathologic examination of the vertebral lesion revealed osteomyelitis due to Listeria monocytogenes and the lung tumour was diagnosed as a pT2N0M0 broncho-alveolar carcinoma which was surgically removed. When a patient is referred with a nontraumatic spinal-cord injury, it is important to complete the radiological and histological examinations before starting emergency radiotherapy in order to prevent an inadequate or even incorrect treatment.

Publication types

  • Case Reports
  • English Abstract

MeSH terms

  • Adenocarcinoma, Bronchiolo-Alveolar / diagnosis
  • Adenocarcinoma, Bronchiolo-Alveolar / pathology
  • Adenocarcinoma, Bronchiolo-Alveolar / surgery
  • Aged
  • Aged, 80 and over
  • Diagnosis, Differential
  • Female
  • Humans
  • Listeriosis / complications
  • Listeriosis / diagnosis*
  • Lung Neoplasms / diagnosis
  • Lung Neoplasms / pathology
  • Lung Neoplasms / surgery
  • Male
  • Middle Aged
  • Osteomyelitis / complications
  • Osteomyelitis / diagnosis*
  • Paraplegia / diagnosis*
  • Paraplegia / etiology
  • Paraplegia / therapy
  • Plasmacytoma / complications
  • Plasmacytoma / diagnosis*
  • Plasmacytoma / radiotherapy
  • Spinal Cord Compression / complications
  • Spinal Cord Compression / diagnosis*
  • Spinal Cord Compression / etiology
  • Spinal Cord Neoplasms / complications
  • Spinal Cord Neoplasms / diagnosis*
  • Spinal Cord Neoplasms / radiotherapy
  • Spinal Cord Neoplasms / secondary