May 2001: 32 year old female with dural mass encircling cervical spinal cord

Brain Pathol. 2001 Oct;11(4):483-4, 487. doi: 10.1111/j.1750-3639.2001.tb01090.x.

Abstract

The May COM. A 32-year-old woman with a history of previous mastoid surgery presented with bilateral extremity weakness and ambulatory instability. MRI revealed a dural-based mass completely encircling the upper cervical spinal cord. Workup was significant for an abnormally elevated c-ANCA, positive at a dilution of 1:128. A portion of the lesion was removed by a posterior surgical approach to decompress the cervical cord. Histologic examination of the dura showed a dense granulomatous infiltrate with vasculitis and giant cells; coupled with the positive c-ANCA, the process was felt to be most consistent with Wegener's granulomatosis. Wegener's granulomatosis infrequently involves the dura or meninges and has not previously been reported to affect dura of the cervical cord. Symptomatic improvement followed surgical decompression and high-dose corticosteroid therapy, with resultant resolution of an elevated c-ANCA titer.

Publication types

  • Case Reports

MeSH terms

  • Adrenal Cortex Hormones / therapeutic use
  • Adult
  • Cervical Vertebrae
  • Decompression, Surgical
  • Dura Mater / pathology*
  • Dura Mater / physiopathology
  • Dura Mater / surgery
  • Female
  • Granulomatosis with Polyangiitis / complications*
  • Granulomatosis with Polyangiitis / pathology
  • Granulomatosis with Polyangiitis / physiopathology
  • Humans
  • Mastoiditis / complications
  • Mastoiditis / etiology
  • Mastoiditis / physiopathology
  • Meningeal Neoplasms / etiology*
  • Meningeal Neoplasms / pathology*
  • Meningeal Neoplasms / therapy
  • Spinal Cord / pathology*
  • Spinal Cord / physiopathology
  • Spinal Cord Compression / etiology*
  • Spinal Cord Compression / pathology*
  • Spinal Cord Compression / therapy
  • Treatment Outcome

Substances

  • Adrenal Cortex Hormones