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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.
The tumor relationship is associated with longitudinal extensive transversal myelitis (LETM), primarily with solid tumors, including the lungs and breast. This disease can occur with different clinical, radiological and pathological findings. He has severe disability and high mortality. A 44-year-old woman has been treated with weakness in the lower limbs and urine incontinence for 2 months. Paraparesis was identified in the neurological examination (2/5 in the lower right and 4/5) in the lower left. Hypoesthesia is found below the dermatomal level of T9. In spinal magnetic resonance imaging; the long segment of the spinal cord of the throat and lombard was present with hypertension compatible with myelite. On the 2nd day of treatment, a common stomach pain began. This pain has repeatedly occurred over the last year. In the computer tomography of the abdominal; the right overde has a mass of 9x7.5 cm, aortic vascular invasion, hepatosplenomegali and common acid. The mass obtained as a result of salpingooferectomy was found to be ovarian sarcoma to indifference. Spinal cord injury resulting from neoplasm may occur with different clinical findings. The most important prognostic element is the type and state of metastasis of the primary tumor structure. It is therefore very important that the tumor be detected in the early period. The sensitivity of screening tests is low. Therefore, clinical symptoms should be evaluated in detail.
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.
Alan : Sağlık Bilimleri
Dergi Türü : Ulusal
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