Thoracolumbar Spinal Cord Astrocytoma with Intense Calcification: Case Report

A case of thoracolumbar spinal cord astrocytoma (grade 2) with intense calcification detected by computed tomography (CT) scan is reported with its radiological and pathological findings. A 28-year-old female with a 6-year history of very mild weakness of bilateral lower extremities was admitted a day after a sudden onset of severe headache associated with nausea and vomiting. CT scans for the head revealed subarachnoid hemorrhage and hydrocephalus. Cerebral angiograms showed no intracranial vascular lesions. Neurological findings suggested a spinal cord lesion and CT scans for the spine showed marked calcification in the spinal canal from the 9th to the 12th thoracic vertebral levels. A myelogram showed swelling of the spinal cord and partial block at the level of 9th thoracic vertebra with filling defects, suggesting the presence of abnormal vessels. A selective spinal angiography showed a tumor blush and draining veins corresponding to the filling defects in the myelogram. An intramedullary spinal cord tumor was diagnosed. The patient underwent laminectomy and biopsy alone because the tumor showed no plane of cleavage even with the aid of the operative microscope. The histology of the tumor was astrocytoma grade 2 with numerous psammoma bodies. Radiological and histological findings of the spinal cord astrocytoma and the therapy are discussed with a review of the literature.