An intramedullary mass
BMJ 2021; 374 doi: https://doi.org/10.1136/bmj.n1948 (Published 01 September 2021) Cite this as: BMJ 2021;374:n1948
- Jun-Song Yang, consultant1,
- Lei Chu, attending doctor2,
- Liang Yan, chief physician1,
- Ding-Jun Hao, chief physician,, professor1
- 1Department of spinal surgery, Honghui Hospital, Xi’an Jiaotong University, Xi’an, China
- 2Department of Orthopaedics, the Second Affiliated Hospital Chongqing Medical University, Chongqing, China
- Correspondence to D-J Hao dingjun.hao{at}qq.com
A man in his 30s presented with one month of progressive bilateral numbness and paralysis in the lower extremities. He had a history of pulmonary tuberculosis two years earlier, which resolved after treatment with isoniazid, rifampicin, and ethambutol. Physical examination showed hypoesthesia below the level of T10; grade I strength in the bilateral iliopsoas, quadriceps femoris, and tibialis anterior muscles; and bilateral lower extremity hyperreflexia. Gadolinium enhanced magnetic resonance imaging (MRI) detected a mass in the thoracic canal (fig 1).
Gadolinium enhanced MRI of the thoracic spine (sagittal plane) showing a “target” sign—a ring enhancing intramedullary lesion with a clear border measuring 0.8 cm×3.0 cm×0.8 cm (red arrows) …
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