A 7-year-old girl presented with progressive weakness and paresthesias of both legs for 1 week. Sagittal spinal MRI showed a large epidural hematoma at T3-T8 with intralesional septations (figure 1). On axial images, the mass extended through the left intervertebral foramen to the paravertebral region and was confluent with the thickened left pleura (figure 2). Multiple pulmonary nodules were observed on MRI. The patient had high blood eosinophil count and a positive serologic test for Paragonimus-specific antibody. The patient underwent a complete resection and then was given praziquantel therapy. The symptoms showed progressive improvement. Pathology confirmed the diagnosis of paragonimiasis.
(A) Sagittal T1-weighted and (B) sagittal T2-weighted images show a huge hyperintensity epidural mass at T3-T8 with intralesional septations. The spinal cord is severely compressed.
(A) Axial T1-weighted and (B) axial T2-weighted images show a hyperintense dorsal mass. The mass extends through the left intervertebral foramen to the paravertebral region and is confluent with the thickened pleura (white open arrows). Multiple pulmonary nodules can be observed.
Author contributions
All authors were involved in clinical care and investigative workup of the patient. Mengmeng Wang and Yan Ju provided pictures of the patient and drafted and revised the manuscript. Xueyou Liu, Liang Lv, and Zeming Wang performed the patient follow-up and drafted and revised the manuscript. Shu Jiang was responsible for the study concept and revised the manuscript for intellectual content.
Study funding
No targeted funding reported.
Disclosure
The authors report no disclosures relevant to the manuscript. Go to Neurology.org/N for full disclosures.
Footnotes
↵* These authors contributed equally to this work.
- © 2018 American Academy of Neurology
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