Longitudinally Extensive Hemorrhagic Myelitis in a Young Adult With Newly Diagnosed Duodenal Adenocarcinoma.
- 1Neurology, The National Hospital Kandy, Kandy, LKA.
Abstract
Longitudinally extensive hemorrhagic myelitis is a rare clinical presentation with a broad differential diagnosis. We report a 20-year-old woman who presented with acute flaccid paraplegia, urinary retention, and a T2 sensory level. Magnetic resonance imaging demonstrated longitudinally extensive intramedullary spinal cord involvement with hemorrhagic features extending from C4 to the conus medullaris. Cerebrospinal fluid showed inflammatory changes and xanthochromia. Aquaporin-4 and myelin oligodendrocyte glycoprotein antibodies, oligoclonal bands, and tumor markers were negative. Further evaluation revealed a circumferential lesion in the second part of the duodenum, with histology confirming adenocarcinoma. No metastatic disease was identified. She received corticosteroids, plasma exchange, and intravenous immunoglobulin, followed by extensive surgical resection of the tumor. Neurological recovery remained poor. In the absence of another clear cause, the clinical and radiological findings raised the possibility of a paraneoplastic inflammatory myelopathy.
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BibTeX
@article{rahmathullah2026longitudinally,
title = {{Longitudinally Extensive Hemorrhagic Myelitis in a Young Adult With Newly Diagnosed Duodenal Adenocarcinoma.}},
author = {Izzathunnisa Rahmathullah and Janaka Peiris and Hemal Hordagoda and Srini Godevithanage and Nipuna Weerasinghe},
journal = {Cureus},
year = {2026},
month = sep,
doi = {10.7759/cureus.116743},
url = {https://europepmc.org/article/MED/42923988},
note = {CC BY},
}
RIS
TY - JOUR
TI - Longitudinally Extensive Hemorrhagic Myelitis in a Young Adult With Newly Diagnosed Duodenal Adenocarcinoma.
AU - Izzathunnisa Rahmathullah
AU - Janaka Peiris
AU - Hemal Hordagoda
AU - Srini Godevithanage
AU - Nipuna Weerasinghe
PY - 2026
DA - 2026/09/22
JO - Cureus
DO - 10.7759/cureus.116743
UR - https://europepmc.org/article/MED/42923988
AB - Longitudinally extensive hemorrhagic myelitis is a rare clinical presentation with a broad differential diagnosis. We report a 20-year-old woman who presented with acute flaccid paraplegia, urinary retention, and a T2 sensory level. Magnetic resonance imaging demonstrated longitudinally extensive intramedullary spinal cord involvement with hemorrhagic features extending from C4 to the conus medullaris. Cerebrospinal fluid showed inflammatory changes and xanthochromia. Aquaporin-4 and myelin oligodendrocyte glycoprotein antibodies, oligoclonal bands, and tumor markers were negative. Further evaluation revealed a circumferential lesion in the second part of the duodenum, with histology confirming adenocarcinoma. No metastatic disease was identified. She received corticosteroids, plasma exchange, and intravenous immunoglobulin, followed by extensive surgical resection of the tumor. Neurological recovery remained poor. In the absence of another clear cause, the clinical and radiological findings raised the possibility of a paraneoplastic inflammatory myelopathy.
SN - 2168-8184
ER -