History and Examination
- Neurologically intact
- No significant PMH
- Biopsy: anaplastic astrocytoma
- Patient completed radiation and chemotherapy
- One year follow- up imaging was obtained
- Three months after follow-up imaging he presents with urinary retention and leg weakness for seven days
- MRI findings: enhancing intra/extramedullary mass at T8
- Physical exam:
4/5 Hip flexors/Knee extension, 3/5 Plantar flexion/Dorsiflexion
Decreased light touch in the left lower extremity
1. What is your diagnosis of the T8 enhancing mass?
2. What is your treatment recommendation?
3. What is the maximal single SRS dose that can be safely administered to the spinal cord?
4. What is the maximal total fractionated dose of radiation that can be safely administered to the spinal cord?
5. Which of the following describes you?
6. I practice in one of the following locations.