LONGITUDINALLY EXTENSIVE TRANSVERSE MYELITIS ASSOCIATED WITH OVARIAN SARCOMA: CASE REPORT

Öz

Neoplasm associated longitudinally extensive transverse myelitis (LETM) is mainly associated with solid tumors, especially lung and breast. This disease may present with different clinical, radiological and pathological features. It has severe disability and high mortality. A 44-year-old female patient presented with weakness in the lower extremities and urinary incontinence for 2 months. Paraparesis (right lower extremity 2/5 and left lower extremity4/5) was noted on the neurological examination. Hypoesthesia was detected under the T9 dermatomal level. Spinal magnetic resonance imaging showed hyperintensity consistent with long-segment myelitis of thoracic and lumbar spinal cord. On the second day of treatment, widespread abdominal pain started. It has been learned that these pain have been repeated for one year. Abdominal computed tomography revealed a 9x7.5 cm mass in the right ovary, aortic vascular invasion, hepatosplenomegaly and diffuse ascites. The result of salpingooferectomy was shown to be ovarian sarcoma with undifferentiated tumor. Spinal cord lesions resulting from neoplasm may present with different clinical symptoms. The most important prognostic factor is the type of primary tumor and metastasis. Therefore, early detection of the tumor is very important. The sensitivity of the screening tests is low. For this reason, clinical symptoms should be evaluated in detail.

Anahtar Kelimeler

• Transverse myelitis,ovarian tumor,undifferentiated sarcoma

OVARİAN SARKOM İLİŞKİLİ LONGİTUDİNAL EKSTENSİF TRANSVERS MİYELİT: OLGU SUNUMU

Öz

Tümör ilişki longitudinal ekstensif transvers miyelit (LETM), başta akciğer ve meme olmak üzere özellikle solid tümörler ile ilişkilidir. Bu hastalık farklı klinik, radyolojik ve patolojik bulgular ile ortaya çıkabilir. Ciddi dizabilite ve yüksek mortaliteye sahiptir. 44 yaşında kadın hasta, 2 aydır olan alt ekstremitelerde güçsüzlük ve idrar inkontinansı nedeni ile başvurdu. Nörolojik muayenede paraparezi (sağ alt ekstremitede 2/5 ve sol alt ekstremitede 4/5) belirlendi. T9 dermatomal seviyenin altında hipoestezi saptandı. Spinal manyetik rezonans görüntülemede; torakal ve lomber spinal kord uzun segment, miyelit ile uyumlu hiperintensite mevcuttu. Tedavinin 2. günü yaygın karın ağrısı başladı. Bu ağrıların son 1 yıldır ara ara tekrarladığı öğrenildi. Abdomen bilgisayarlı tomografide; sağ overde 9x7.5 cm kitle, aortik vasküler invazyon, hepatosplenomegali ve yaygın asit belirlendi. Salpingooferektomi neticesinde elde edilen kitlenin indiferansiye ovarian sarkom olduğu anlaşıldı. Neoplazi sonucu oluşan spinal kord lezyonları farklı klinik bulgular ile ortaya çıkabilir. En önemli prognostik unsur, primer tümöral yapının tipi ve metastaz durumudur. Bu nedenle tümörün erken dönemde tespit edilmesi oldukça önemlidir. Tarama testlerinin duyarlılığı düşüktür. Bu nedenle klinik semptomlar ayrıntılı olarak değerlendirilmelidir.

Anahtar Kelimeler

• Transvers miyelit,ovarian tümör,indiferansiye sarkom

Kaynakça

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