Abstract | BACKGROUND CONTEXT: One hallmark of neurofibromatosis Type 1 (NF1) is the presence of multiple neurofibromas, which are hormonally responsive and may undergo rapid growth during periods of hormonal surge. Although spinal neurofibromas occur in up to 40% of patients with NF1, they rarely cause neurologic sequelae, especially in the young. PURPOSE: To document a unique case of acute postpartum paraparesis in a young woman because of an extradural neurofibroma compressing the conus medullaris and discuss the possible hormonal influences related to rapid growth of this otherwise "benign" nerve sheath tumor. This case demonstrates the importance of closely monitoring patients with known NF1 for neurologic symptoms, especially during pregnancy and the postpartum period. We also seek to describe the management of this patient, which resulted in an excellent outcome. STUDY DESIGN: Case report and literature review. METHODS: Detailed history was obtained from the patient and her family members. All medical records, imaging studies, histopathological findings, and pertinent literature were reviewed. RESULTS: After evaluating a 26-year-old postpartum woman with NF1 for paraparesis, magnetic resonance imaging of the lumbar spine revealed a large heterogeneously enhancing mass at the conus medullaris. She subsequently underwent resection of the mass via laminectomy. Postoperatively, the patient exhibited marked improvement in weakness and was able to ambulate with assistance 2 days later. Histopathological examination of the mass revealed a neurofibroma with strong expression of estrogen and progesterone receptors. CONCLUSIONS:
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Authors | Bhavpreet S Dham, Daniel M Kwa, Joseph V Campellone |
Journal | The spine journal : official journal of the North American Spine Society
(Spine J)
Vol. 12
Issue 7
Pg. e5-8
(Jul 2012)
ISSN: 1878-1632 [Electronic] United States |
PMID | 22939192
(Publication Type: Case Reports, Journal Article, Review)
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Copyright | Copyright © 2012 Elsevier Inc. All rights reserved. |
Topics |
- Adult
- Female
- Humans
- Neurofibroma
(complications, genetics)
- Neurofibromatosis 1
(complications)
- Paraparesis
(etiology)
- Postpartum Period
- Pregnancy
- Pregnancy Complications, Neoplastic
(etiology)
- Spinal Cord Neoplasms
(complications, genetics)
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