Thoracic spinal Pantopaque cyst and associated syrinx resulting in progressive spastic paraparesis: case report.

Abstract

OBJECTIVE AND IMPORTANCE:

We describe a unique presentation of a thoracic spinal Pantopaque cyst. Although Pantopaque is no longer used, sequelae of its long-term use may continue to surface.

CLINICAL PRESENTATION:

Our patient presented to the emergency room with 4 months of progressive lower extremity numbness, spasticity, and incontinence and a 2-day history of left upper extremity dysesthesias. Magnetic resonance imaging at admission revealed a C7-T10 syrinx and an intrathecal extramedullary mass to the right of the spinal cord at T10-T11.

INTERVENTION:

Radiographic evidence led to the initial diagnosis of hemangioblastoma. The results of a critical analysis of the preoperative studies caused us to suspect a Pantopaque cyst. This suspicion was confirmed at the time of surgery, when a cyst filled with contrast medium was revealed. T9-T11 laminectomies were performed, allowing for a 5-cm dural opening. The cyst was aspirated and excised, and then the syrinx was decompressed.

CONCLUSION:

Our patient experienced significant sensory and motor improvement postoperatively. We present a previously undescribed complication of one of the most commonly used contrast media, Pantopaque. Despite its replacement with newer agents, it may continue to play a significant role in the pathological presentation of patients in whom it was previously used.

• Authors: E N Tabor, U Batzdorf
• Journal: Neurosurgery (Neurosurgery) Vol. 39 Issue 5 Pg. 1040-2 (Nov 1996) ISSN: 0148-396X [Print] United States
• PMID: 8905763 (Publication Type: Case Reports, Journal Article)

Chemical References

• Contrast Media
• Iophendylate

Topics

• Adult
• Angiography
• Contrast Media (adverse effects)
• Cysts (chemically induced, diagnosis, surgery)
• Humans
• Iophendylate (adverse effects)
• Magnetic Resonance Imaging
• Male
• Paraparesis, Tropical Spastic (chemically induced, diagnosis, surgery)
• Spinal Diseases (chemically induced, diagnosis, surgery)
• Syringomyelia (chemically induced, diagnosis, surgery)
• Thorax