J Korean Neurosurg Soc.  2012 Apr;51(4):230-232. 10.3340/jkns.2012.51.4.230.

A Case Report of "Spinal Cord Apoplexy" Elicited by Metastatic Intramedullary Thyroid Carcinoma

• Choi IJ
• Chang JC
• Kim DW
• Choi G

• KMID: 2066917
• DOI: http://doi.org/10.3340/jkns.2012.51.4.230

Abstract

A 31-year-old man presented with acute onset of paraplegia. The patient's history was significant for thyroid carcinoma that had been treated 2 years earlier by thyroidectomy. A magnetic resonance imaging scan showed an enhancing intramedullary lesion at T7-8. Patient underwent surgical treatment and a tumor with hematoma was resected via posterior midline myelotomy. Postoperatively, the patient's motor weakness was improved to grade 3. The lesion showed typical histologic features consistent with papillary thyroid carcinoma. Early diagnosis and microsurgical resection can result in improvement in neurological deficits and quality of life of patients with an ISCM.

Keyword

Intramedullary spinal cord tumor; Metastasis; Thyroid carcinoma; Spinal cord apoplexy

MeSH Terms

Adult
Carcinoma
Early Diagnosis
Hematoma
Humans
Magnetic Resonance Imaging
Neoplasm Metastasis
Paraplegia
Quality of Life
Thyroid Gland
Thyroid Neoplasms
Thyroidectomy
Carcinoma
Thyroid Neoplasms

Figure

• 

  Fig. 1 MRI scan of the thoracic spinal cord : sagittal (A) T1-weighted images, sagittal (B) and axial (C) gadolinium MRI of the thoracic spine showing a solitary mass in the intramedullary spinal cord at T7-8 level. The lesion showed a homogeneous enhancement following intravenous administration of gadolinium contrast.

• 

  Fig. 2 Microscopically, the tumor shows papillary pattern with invasion of the spinal cord (A). The papillae are lined by a layer of cuboidal to low columnar cells, with ground-glass nuclei and longitudinal grooves (B). The tumor cells show positive immunostaining for thyroglobulin (C) and galectin-3 (D).

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