Spinal cord compression in hodgkin's disease: A review of 10 cases

Abstract

pulmonary metastases is described. Radio-active REFERENCES iodine tracer studies were of diagnostic value in the initial location of the carcinoma in the thyroid. The histology of the tumour and its metastases showed features in keeping with a carcinoma of relatively slow growth.

Acute Cauda Equina Compression Revealing Hodgkin’s Disease

“…The contiguous spread of a paraspinal mediastinal or retroperitoneal lymphatic tissue through the intervertebral foramens has been suspected to be the general route of spread to the epidural space. 1,8,12 The presence of interaortocaval lymphadenopathies and MRI aspects suggest that this was the mechanism by which it spread to the epidural space in our patient. Hematogenous dissemination from nodal sites has been suspected in isolated spinal epidural space involvement 6,11 in a fashion similar to the intracranial infiltration.…”

“…In addition to a good functional outcome, the overall prognosis was relatively favorable in patients with HD of the spinal epidural space, especially patients with primary spinal involvement. 1,2,4,8,9,12,15 These data should support an initial aggressive management in such cases of severe deficit to rapidly give the patients a painfree spine and a return of function of neurologic tissue.…”

“…1,7 The thoracic segment was the most common site of spinal epidural infiltration in patients with HD. 1,4,6,8,9 This special localization seems to reflect the frequent involvement of mediastinal lymph nodes, 9 and like in non-Hodgkin's lymphoma, 10 it may expose the patients to a poorer neurologic functional outcome than in other areas of the spinal canal because of the susceptibility of the neurologic tissue to ischemic injury in this region. Isolated primary HD affecting epidural space of the spine is extremely rare and has been presented in a handful of case reports.…”

“…Whatever the mechanism, the dura offer a firm resistance to invasion by lymphadenomatous tissue, and infiltration of the subdural space and cord elements occurs rarely. 8 Based on a spinal epidural infiltration without any invasion of the nervous system, clinical manifestations in our case report were explained by the physical mass effect of the tumoral tissue on nervous structures, and then sustained the principle of surgery in the context of an undiagnosed disease. But there are practical limitations to such a surgical approach, and the role of surgery must be individualized.…”

“…14 These rests may give rise to a malignant transformation to produce isolated primary spinal epidural lymphoma. 8 But this latter hypothesis is still debated. Whatever the mechanism, the dura offer a firm resistance to invasion by lymphadenomatous tissue, and infiltration of the subdural space and cord elements occurs rarely.…”