Successful treatment of paraneoplastic longitudinally extensive transverse myelitis (LETM): A 16-month clinical-spinal MRI follow-up.

Longitudinally extensive transverse myelitis (LETM) is defined as a spinal cord lesion that extends over three or more vertebrae. LETM very rarely occurs in patients with the systemic malignancy. We report a 38-year old woman with adenocarcinoma of the cervix and LETM. Cervical and thoracic spine MRI showed hyperintense signal on T2W involving predominantly central spinal cord from the C4 level distally, including conus medullaris. In this patient corticosteroid therapy and therapeutic plasma exchange (TPE) courses were performed. On discharge, five weeks after TPE initiation, patient could walk with bilateral assistance. After a 16-month follow-up, her neurological finding was almost normal and MRI lesions disappeared. Thus, we present our patient as one of the rare cases of paraneoplastic LETM with excellent treatment response.