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World Neurosurg. 2019 Mar 20. pii: S1878-8750(19)30793-4. doi: 10.1016/j.wneu.2019.03.115. [Epub ahead of print]

Intramedullary Spinal Cord Ganglioglioma Presenting as Hyperhidrosis: A Rare Case Report and literature Review.

Author information

1
Departments of Neurosurgery, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China.
2
Departments of Radiology, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China.
3
Departments of Pathology, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China.
4
Department of Pathology, General Navy Hospital of PLA, Beijing, China.
5
Department of Intensive Care Unit, Beijing Jishuitan Hospital, Beijing, China.
6
Departments of Neurosurgery, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China. Electronic address: wyvern1230@163.com.

Abstract

BACKGROUND:

Hyperhidrosis is caused by sympathetic dysfunction of the central or peripheral nervous system. However, intramedullary spinal cord tumors presenting with hyperhidrosis as an initial symptom had been rarely reported in the literature.

CASE DESCRIPTION:

This case involves an 18-year-old man who presented with abnormal enhanced sweating and flushing on the bilateral side of his face and neck that had persisted for 6 years. Magnetic resonance (MR) images revealed that, at the C7-T2 levels of the spinal cord, a large intramedullary tumor was involved in the cervico-thoracic region. The patient underwent gross total resection (GTR) of the tumor via the fluorescein-guided technique and intraoperative neurophysiological monitoring. The histopathological diagnosis revealed ganglioglioma. The symptoms gradually improved after the surgery, and the patient presented virtually complete remission at the end of an 18 months follow-up.

CONCLUSIONS:

Few cases of intramedullary spinal cord tumors presenting as hyperhidrosis in clinical manifestation have been reported in the literature. Sympathetic irritation by the tumor, particularly in the location around the gray matter of the lateral spinal cord, may account for the hyperhidrosis as the initial symptom in present patient. Therefore, if a patient has autonomic dysfunction, the spine cord should be additionally examined using MR imaging.

KEYWORDS:

fluorescein; ganglioglioma; hyperhidrosis; intramedullary spinal cord tumor

PMID:
30904797
DOI:
10.1016/j.wneu.2019.03.115

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