Case Study January 2010

A HIV seropositive 52 year old man presented in June 1997 a Hodgkin’s disease (grade II). He was treated with a MOPP chemotherapy regimen (methylchlorethamine, vincristine, procarbazine, prednisone) followed by a mediastinal radiotherapy with a total dose of 40 Gy at 1.8 Gy per fraction.

He described ten years later in 2007 a two year history of paresthesias in the feet bilaterally. Numbness and tingling gradually progressed, ascending upward to include legs, with disturbance of pain and temperature sensation across his upper abdomen and lower chest.In the weeks preceding his admission, he developed weakness in his lower and upper extremities and bladder sphincter dysfunction. A MRI was performed showing an enlargement of the cervical and upper thoracic spinal cord with an hyperintense signal in T2-weighted image from C3 to T7, with an intramedullary contrast enhancing lesion on C6.

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Proposed by K.Hoang-Xuan, France

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