Title: Medular compression sindrome as a presentation of a spinal epidural lynphoma.

Biography:

Graduated as a Doctor of Medicine from the University of Medical Sciences of Matanzas in July 2016. In September of that same year, I began my residency in the specialty of Neurosurgery at the Faustino Perez University Hospital in Matanzas, Cuba. After 2 years of work as a resident doctor at that hospital, I was accepted as a resident doctor of neurosurgery at the Institute of Neurology and Neurosurgery of Cuba, where I graduated as a General Neurosurgeon on January 28, 2021. Now I work as a General Neurosurgeon at the Matanzas province treating adults and children with neurosurgical pathologies.

Abstract

Introduction: Lymphomas are solid tumours of the immune system. Spinal cord compression by this tumors is a late manefestation and not always present in all of patients. Sometimes, lynphomas can be present only in the spinal epidural space but this is a very reare condition.

Case report: This is a 23 years old patient who 6 month ago started with dorsal pain after a sudden movement. With time, the pain got worse in intensity and frecuency. Four month after his first manifestation noted a progressive loss of weight and weaknes in both lower limbs.

Discussion: In the CT and MRI studies, we found images suggestive of lymphadenopathy in the mediastinum and abdominal cavity, as well as in the dorsal spine an intra-spinal extradural image that enhancement with contrast. Thinking in a paraparesis caused by a extradural lynphoma, the patient was taken to the operating room and a three- space laminectomy was performed with a gross total ressection of the tumor. Histopathological examination revealed a Hodgkin lynphoma and 5 days after surgery the patient presented improvement in the muscular strength of the lower limbs. He was transferred to the oncology service to begin with adjuvant chemotherapy and radiotherapy treatment.

Conclussion: Despite the low incidence of lymphomas with spinal epidural presentation, it is a diagnosis to bear in mind when differentiating intra-spinal extradural tumors. Surgery in patients with signs of medullary compression that are clinically expressed with progressive neurological deterioration should be performed as soon as possible to achieve an adequate improvement of the neurological picture.