Mass: The Conundrum in Spine
| Autor: | P D Rath, Sunil Katoch, Abhijeet Kumar Agrawal, Swetal Chouhan, H N Bajaj, Rahul Bisaralli |
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| Rok vydání: | 2023 |
| Předmět: | |
| Zdroj: | Journal of Orthopaedic Case Reports. 13:37-40 |
| ISSN: | 2321-3817 2250-0685 |
| DOI: | 10.13107/jocr.2023.v13.i04.3606 |
| Popis: | Introduction: Immunoglobulin (Ig)G4-related disease belongs to a rare compilation of conditions in rheumatology and may involve a multitude of organs. Amidst the central nervous system (CNS) presentation, involvement of spinal cord is rarer still. Case Report: A 50-year-old male came with chief complaints of tingling sensation over both soles since 2 months associated with lower back ache and gait disturbance in the form of spastic gait. X-rays of spine were suggestive of a growth at the level of D10–D12 compressing the spinal cord with no focal sclerotic/lytic lesions, and MRI dorsolumbar spine showed dural tail sign. The patient underwent excision of dural mass, and histopathology revealed majority of plasma cells positive for IgG4. Case 2: A 65-year-old female came with complaints of cough, shortness of breath, and fever on and off since 2 months. No history of hemoptysis, purulent sputum, weight loss. On examination: There were bilateral rhonchi in the left upper zone. MRI spine showed focal erosion with soft-tissue thickening at the right paravertebral region extending from D5-9. The patient underwent surgery (fusion D6-8 and ostectomy D7 posterior rib resection D7 right side) with the right pleural biopsy and transpendicular intracorporal biopsy D7. Histopathology was compatible with findings of IgG4 disease. Discussion: IgG4 tumors presenting in CNS itself is rare and rarer in spinal cord. Histopathological examination is central to diagnose and prognosticate the disease further as IgG4-related disease manifestations may recur without proper treatment. Keywords: IgG4, spinal mass, central nervous system, pleura. |
| Databáze: | OpenAIRE |
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