AI Article Synopsis

  • Spinal cord compression is a critical neurosurgical emergency with symptoms like back pain, difficulty walking, and incontinence, warranting imaging if neurological deficits are present.
  • A unique case of a 31-year-old male with chronic back pain and neurological issues raised concerns for a neoplastic cause, but further testing revealed a non-neoplastic condition potentially linked to Langerhans cell histiocytosis or an infection.
  • This case highlights the need to consider both neoplastic and non-neoplastic causes in diagnosing spinal cord compression, which can help improve patient outcomes.

Article Abstract

Spinal cord compression is a neurosurgical emergency. Symptoms of this disorder are highlighted as back pain, ambulatory difficulties, and bladder/bowel incontinence. Diagnostic imaging is not indicated in many circumstances of nonspecific back pain; however, the addition of neurologic deficits in the setting of back pain justifies radiologic imaging. Various pathologies can cause constriction of the spinal cord due to the delicate nature of spinal cord anatomy. Etiologies may include trauma, neoplasms, and infections. In this report, we present an unusual case of a 31-year-old male who presented to the emergency department with a history of chronic back pain accompanied by neurological deficits, ataxia, and bladder dysfunction. Contrast-enhanced MRI imaging heightened the suspicion of a neoplastic etiology; however, neuropathology revealed a non-neoplastic nature with abnormal lymphohistiocytic infiltrate suspicious for Langerhans cell histiocytosis or infectious etiology. A second opinion was provided by Mayo Clinic Laboratories, resulting in the definitive conclusion that the mass was non-neoplastic and tested negative for SD1a and Langerhin, biomarkers used to diagnose Langerhans cell histiocytosis. This unusual non-neoplastic lesion exemplifies one of many diverse and multifaceted pathologies that can precipitate spinal cord compression. Additionally, these findings underscore the importance of considering both neoplastic and non-neoplastic causes in the differential diagnosis of spinal cord compression, thereby enhancing clinical vigilance and improving patient outcomes for underlying spinal conditions.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11166180PMC
http://dx.doi.org/10.7759/cureus.60141DOI Listing

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