Intrathecal catheter-tip inflammatory masses: an intraparenchymal granuloma

Abstract

The authors report the case of a 54-year-old woman who presented with an intraparenchymal granuloma in her lower thoracic spinal cord. On imaging studies there was an intramedullary enhancement at the left dorsal aspect of the cord immediately adjacent to the tip of an intrathecal arachnoid catheter used for intraspinal drug therapy. At surgery, it was apparent that once this superficial component of the catheter and inflammatory mass was removed, there was a granulomatous component that extended into the spinal cord. A 5-mm caseating chalklike granuloma was carefully dissected away. To the authors' knowledge, this is the first reported case of an intrathecal catheter-tip granuloma growing inside the spinal cord parenchyma.