Abstract
A case of intramedullary spinal cord astrocytoma extending from the second cervical (C2) to sixth thoracic segments (Th6), with successful surgical treatment, is reported.
A 12-year-old boy was admitted with the chief complaints of progressive weakness of all four extremities and neck pain continuing for 2 months. Neurological examination disclosed quadriparesis which was worst in the upper right extremity, hyperreflexia of the bilateral lower and upper right extremities, gait disturbance, limitation of neck movement and neck stiffness. No sensory disturbance, and no bladder and bowel dysfunction was observed. Radiological examination revealed an intramedullary spinal cord tumor involving the segments from C2 to Th6. A cervicothoracic laminectomy and a myelotomy from C2 to Th6 was performed and the tumor was subtotally removed using microsurgical techniques. Histologically, the tumor was diagnosed to be low-grade astrocytoma. Postoperatively, the patient recovered remarkably without any serious complications, and is now attending school, although he has some instability of neck movement and a light kyphosis in the cervicothoracic spine.
Spinal cord astrocytoma extending over 10 vertebrae is extremely rare. The significance of total removal of the tumor using microsurgical techniques in the treatment of an extensive intramedullary spinal cord tumor is emphasized.
