2022 Volume 13 Issue 4 Pages 720-725
Introduction: Methotrexate-associated lymphoproliferative disorder (MTX-LPD) has been reported as a lymphoma developing in a patient with methotrexate administration. Here we report a rare case of MTX-LPD growing in the thoracic spine.
Case Report: The patient was a 37-year-old female who showed paraplegia while receiving MTX therapy for 10 years for rheumatoid arthritis (RA). The sensation distal to the bilateral inguinal regions was disappeared except around the anus, and no muscle contraction was observed in both lower extremities. Magnetic resonance imaging (MRI) demonstrated occupied lesion which progressed into the spinal canal at the level of Th11 vertebra. We emergently performed Th10-11 laminectomy and tumor resection because she showed progressive paraplegia. The pathological examination indicated malignant lymphoma, suggesting MTX-LPD. The remaining legion showed spontaneous remission 2 weeks after MTX withdrawal, however, it subsequently recurred in 4 weeks.
Conclusions: Because MTX-LPD can be developed in tissues other than lymph nodes, such as in bones and joints, we need to take MTX-LPD into a candidate when we diagnose spinal tumor in patients with MTX treatment.
