In this paper,a 41-year-old female with previous history of ependymoma is reported.The patient underwent gross-total resection of the tumor and ventriculo-peritoneal shunt placement,followed by radiotherapy to the pos...In this paper,a 41-year-old female with previous history of ependymoma is reported.The patient underwent gross-total resection of the tumor and ventriculo-peritoneal shunt placement,followed by radiotherapy to the posterior fossa and the upper-cervical spinal cord region.Three years later she developed numbness in her right arm,body and leg.Magnetic resonance imaging(MRI)of the entire neuraxis revealed no evidence of tumor recurrence,while a small enhancing area was noted in the left anterolateral spinal cord at the level of the C1-C2 vertebrae and a left posterior-lateral herniated disk in the C5-C6 level which was not present in the earlier MRI at initial diagnosis.Lumbar punctures were negative for malignant cells.The patient’s symptoms were first attributed to radiation-induced effect.Follow-up results of brain and the cervical spine MRI were performed which showed disappearance of the small abnormality in the left C2 spinal cord area but persistence of the herniated C5-C6 disk.Thus,the current diagnosis of right-sided numbness due to pressure of the left anterolateral spinothalamic tracts from the herniated C5-C6 disk was made.This is a unique case,in which herniated disk pressuring effects needed to be differentiated from both radiation-induced treatment effect and tumor recurrence.展开更多
文摘In this paper,a 41-year-old female with previous history of ependymoma is reported.The patient underwent gross-total resection of the tumor and ventriculo-peritoneal shunt placement,followed by radiotherapy to the posterior fossa and the upper-cervical spinal cord region.Three years later she developed numbness in her right arm,body and leg.Magnetic resonance imaging(MRI)of the entire neuraxis revealed no evidence of tumor recurrence,while a small enhancing area was noted in the left anterolateral spinal cord at the level of the C1-C2 vertebrae and a left posterior-lateral herniated disk in the C5-C6 level which was not present in the earlier MRI at initial diagnosis.Lumbar punctures were negative for malignant cells.The patient’s symptoms were first attributed to radiation-induced effect.Follow-up results of brain and the cervical spine MRI were performed which showed disappearance of the small abnormality in the left C2 spinal cord area but persistence of the herniated C5-C6 disk.Thus,the current diagnosis of right-sided numbness due to pressure of the left anterolateral spinothalamic tracts from the herniated C5-C6 disk was made.This is a unique case,in which herniated disk pressuring effects needed to be differentiated from both radiation-induced treatment effect and tumor recurrence.
