Dear Sirs,A 63-year-old man was admitted with bilateral sensory loss up to thoracic level TH 8, progressive spastic paraparesis of legs, urinary incontinence, and fecal obstipation. Symptoms had begun 3 weeks earlier. Spinal MRI showed a contrast-enhancing mass with perifocal edema in the spinal cord at TH 6-7, and brain MRT was unsuspicious (Fig. la). Cerebral spinal fluid (CSF) revealed leukocytosis (19 cells/ul), elevated lactate (4.9 mmol/1), and protein (65.8 mg/dl) without neoplastic cells. Suspecting an auto-nomic inflammatory disease, steroids were applied, leading only to temporary improvement.
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