Fulminant spinal cord compression caused by postradiation inflammatory pseudotumor with rapid response to steroids: case report

J Neurosurg Spine. 2016 Nov;25(5):660-664. doi: 10.3171/2016.3.SPINE151517. Epub 2016 May 27.

Abstract

Radiation therapy continues to play an extremely valuable role in the treatment of malignancy. The effects of radiation therapy on normal tissue can present in a delayed fashion, resulting in localized damage with pseudomalignant transformation, producing a compressive effect on the spinal cord or exiting nerve roots. Infiltration of inflammatory cells and the subsequent fibrotic response can result in the development of an inflammatory pseudotumor (benign tumor-like lesion) with subsequent mass effect. Herein, the authors present a rare case of inflammatory pseudotumor with fulminant cervicothoracic cord compression, developing 7 years after radiation therapy for breast cancer. The lesion recurred following resection but subsequently displayed complete and rapid resolution following steroid therapy. To the best of the authors' knowledge, no previous studies have reported such an incident.

Keywords: IPT = inflammatory pseudotumor; fulminant cord compression; inflammatory pseudotumor; oncology; radiation effects; steroids.

Publication types

  • Case Reports

MeSH terms

  • Breast Neoplasms / radiotherapy
  • Breast Neoplasms / surgery
  • Carcinoma, Ductal, Breast / radiotherapy
  • Carcinoma, Ductal, Breast / surgery
  • Cervical Vertebrae / diagnostic imaging
  • Diagnosis, Differential
  • Female
  • Granuloma, Plasma Cell / diagnostic imaging
  • Granuloma, Plasma Cell / drug therapy
  • Granuloma, Plasma Cell / etiology*
  • Humans
  • Immunologic Factors / therapeutic use*
  • Middle Aged
  • Radiation Injuries / diagnostic imaging
  • Radiation Injuries / drug therapy*
  • Spinal Cord Compression / diagnostic imaging
  • Spinal Cord Compression / drug therapy
  • Spinal Cord Compression / etiology*
  • Steroids / therapeutic use*
  • Thoracic Vertebrae / diagnostic imaging

Substances

  • Immunologic Factors
  • Steroids