Spinal Pain: From Neoplastic to Parasitic
- Author:
Junno Angelo M. Sexcion
1
Author Information
1. Department of Pathology and Laboratories, Davao Regional Medical Center
- Publication Type:Other Types
- Keywords:
Conus medullaris
- MeSH:
Schistosomiasis;
Spinal Cord Diseases
- From:
Philippine Journal of Pathology
2026;(75th PSP Research Competition Abstracts):1-
- CountryPhilippines
- Language:English
-
Abstract:
Introduction:Spinal cord schistosomiasis can masquerade as an intramedullary tumor when it involves the conus medullaris or lower thoracic cord.
Eggs transported via the valveless vertebral (Batson) venous plexus provoke a
granulomatous inflammatory response, producing mass-like lesions on MRI.
Because clinical presentation overlaps with neoplastic or inflammatory spinal
diseases, the diagnosis often requires histopathologic confirmation.
Case Description:A 26-year-old male experienced sudden severe back pain
initially thought to be due to a manifestation of symptoms from a bad fall from
when the patient was just 5 years old. The patient was assessed through MRI with
contrast yielding a 1 x 1.6 x 4.1 cm mass at the distal lumbar area involving the
conus medullaris. Histopathological examination revealed the spinal tumor to
be schistosomiasis with chronic inflammation.
Discussion:Spinal neuroschistosomiasis, overall, is rare with a 1-4%
incidence among people with systemic schistosomiasis. Even among medullary
schistosomiasis, 0.7% were lumbosacral and not necessarily involving the conus
medullaris. Spinal cord schistosomiasis is most commonly due to Schistosoma
mansoni or haematobium and can masquerade as an intramedullary tumor but
epidemiological and microscopic data point toward Schistosoma japonicum to be
the more likely causative agent for this case. The clinical presentation of spinal
neuroschistosomiasis of the conus medullaris is non-specific and may overlap
with more common spinal pathologies presenting as a subacute myelopathy,
clinically.
Conclusion:The case highlights the necessity of heightened suspicion for
spinal tumors among patients from schistosoma-endemic areas, advocating early
diagnosis and management.
- Full text:2026090216242810912PJ Pathology Abstract 9.pdf
