24 yo male with cervical intramedullary tumor Options

[waelkh]

Dear Henry,

It is a case of cervical intramedullary tumor in 24 years old man with minimal neurological deficits.

What to do?

Yours,

Igor Kurilets

[waelkh]

Ideally he needs a contrast-enhanced scan to see how much of the abnormality on the scan is solid tumour and how much is simply cyst. If he has minimal deficit and is not getting worse I would not operate, at the moment. However, it must be very probabley that he will need an operation one day in the future because he will start to get worse. The tumour is high cervical and would therefore be quite dangerous to remove - even in the UK I would not operate yet and instead would simply watch him with follow-up scans. I will try to telephone you tomorrow.

Henry Marsh
Wimbledon, England

[pablo cox]

Obviously it is a intramedullary tumor of high cervical segment,with two cavities in both sides.The tumor present low intensity signal in T1 images,has relative clear border and uniformal intensity.It is more like a ependymoma,and astrocytoma grade 2 can not be excluded too.No matter what it is,the tumor will grow.If the patient suffer a cervical spinal injury,sometimes just a sudden extreme flexion or extension,or there is a unexpected hemorrhage in the tumor,the patient may loss breath.So a recent operation is my suggestion.Prognosis of intramedullary ependymoma is not too bad.