A case of primary malignant lymphoma in lumbar spinal epidural space.

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Primary malignant lymphoma in spinal epidural space is a rare case.We have experienced one patient with primary malignant lymphoma in lumbar epidural space. The patient is a 57 years old male who has bladder and rectal paralysis, left foot numbness and left sciatica. Myelogram demonstrated an epidural compression mass at the left side of L5-S1 vertebrae. A wide laminectomy of L4 and L5 spine was performed and the ossification of ligamentum flavum at the L4-5 level, compressing the cauda equina from left side, was removed. The neurological symptoms improved remarkably soon after operation, but the plantar numbness remained. About six months after the laminectomy, he complained of left gluteal and foot pain. Seven months after the operation, he was unable to pass urine on his own. Myelogram revealed an epidural tumor at the level of L5-S1 spine, compressing from the left posterolateral side. Dura and left L5 nerve root were decompressed completely by the operation.The tumor was diagnosed at the malignant lymphoma (non-Hodgkin's type), diffuse and large cell type by histological examination.Three months after the resection of the tumor, scintigram discovered the bone bone metastasis at the sacrum and the right temporal bone.He was given radiotherapy and chemotherapy with a combination of VEMP.
西日本整形・災害外科学会の論文