Abstract
Intercostal neuralgia caused by thoracic radiculopathy is difficult to diagnose unless accompanied by myelopathy. As compared with cervical or lumbar radiculopathy, neurological findings are rarely observed except sensory loss. Diagnosis of thoracic spinal legion without recognition of intercostal neuralgia is most difficult. We report two cases of spinal tumor whose initial symptoms were chest pain only. In case 1 (46-year-old, female), she complained of right linear chest pain, and was first diagnosed as intercostal neuralgia, but its cause remained unknown. In case 2 (36-yearold, male), his complaint was nocturnal pain of right chest without apparent margin. He first took various examinations of internal medicine including Holter ECG, abdominal echogram, CT and GIF. Both cases were finally diagnosed as spinal tumor by Magnetic Resonance Imaging (MRI). The former was small (6mm in diameter) arachnoid cyst which selectively compressed right 9th thoracic nerve root. The latter was schwannoma arised from axillar portion of 6th nerve root, which located dorsal aspect of spinal column at Th4 level and severely compressed spinal cord. In both cases pain disappeared after surgical removal of the tumor. MRI was quite successful to make diagnosis in both cases.
