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KMID : 0388720170240020109
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Journal of Korean Society of Spine Surgery
2017 Volume.24 No. 2 p.109 ~ p.114
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A Long, Solitary, Rosary-Shaped Spinal Neurofibroma
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Choi Sung-Woo
Lee Jae-Chul
Chun Dong-Il
Kim Jin-Hyeung
Shin Byung-Joon
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Abstract
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Study Design: Case report.
Objectives: We report the case of a long, solitary, rosary-shaped neurofibroma that was misdiagnosed as another disease due to the patient's surgical history involving repetitive procedures and its abnormal appearance.
Summary of Literature Review: Neurofibroma is an intradural-extramedullary spinal tumor. It is generally not difficult to diagnose due to its frequent occurrence and specific magnetic resonance imaging (MRI) findings. However, to date, neurofibromatosis stigmata and long, solitary, rosary-shaped neurofibromas have rarely been reported.
Materials and Methods: A 60-year-old woman was admitted to our hospital due to persistent pain, despite previous surgery and repetitive procedures. On physical examination, vision loss, hearing loss, skin discoloration, or subcutaneous nodules were not observed. A neurologic examination revealed normal motor and sensory function and voiding sensation. No pathologic reflexes such as the Babinski sign were observed. Previous sequential MRIs revealed intradural lesions that progressed from the thoracic vertebra 11 to the lumbar vertebra 3. She had no signs of neurofibromatosis stigmata, and the neurologic examination was unremarkable. The initial diagnosis was based on serial MRIs, which revealed a parasite infestation, a spinal cord tumor (myxopapillary-type ependymoma with hemorrhage), arachnoiditis, and vascular malformations. Total mass excision was performed, and the final diagnosis was neurofibroma.
Results: There were no signs of a tumor remnants or local recurrence in a 1-year follow-up MRI study.
Conclusions: Although intradural spinal tumors are very rare, their clinical features are nonspecific and resemble other degenerative spinal diseases, including spinal stenosis and disc herniation. These diseases may easily be overlooked by physicians.
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KEYWORD
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Neurofibroma, Spinal cord neoplasms, Parasites, Diagnostic errors
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