Esquistossomose medular: forma tumoral. Relato de um caso

Abstract

A case of schistosomiasis of the spinal cord is presented. A 16 years old boy developed a progressive spinal cord compression syndrome suggesting an intramedullary tumor. At the operation a granulomatous mass of the conus and epiconus was found and partially resected. The histopathological examination showed a granulomatous reaction surrounding Schistosoma mansoni eggs. The authors review the various aspects of spinal cord schistosomiasis, particularly the tumoral or granulomatous form. A comprehensive review of the literature is made.

Spinal cord schistosomiasis: a prospective study of 63 cases emphasizing clinical and therapeutic aspects

“…This aspect has also been observed in some reported cases. [12][13][14][15][16][17] Spontaneous stabilization of the manifestations (followed or not by improvement), or development of transitory neurological dysfunction (particularly urinary retention) preceding the definitive installation of the myeloradicular picture were also some of the modalities of disease course observed in some of our patients and reported in the literature. 4;17-24 The proportion of patients who presented pain in the present study was higher than that reported in the review by Ferrari.…”

Esquistossomose cerebelar

“…O cerebelo raramente é acometido 3 . A disseminação mielorradicular é mais freqüente 1,2,7,16,19,20,25,26 , provavelmente devida a fatores anatômicos 25,27,30 . As crianças são acometidas em uma proporção menor que os adultos 23,26 .…”

“…Nosso caso apresentava granulomas envolvendo ovos de Schistosoma mansoni, portanto, com grande reação imunogênica e incluindo-se, assim, na forma pseudotumoral cerebelar 25,27 . De acordo com a literatura consultada, encontramos apenas um caso descrito com comprometimento cerebelar 3 e cujos aspectos cirúrgicos e laboratoriais muito se assemelhavam aos do nosso caso.…”

“…Com relação ao líquido cefalorraquidiano, essa parasitose apresenta, de modo geral, pleocitose leve ou moderada 14 , com predomínio linfomononuclear, eosinofilorraquia e hiperproteinorraquia 7,10,18,22,27 . Nosso paciente apresentava resultado semelhante, porém, com ausência de eosinófilos.…”