Intramedullary spinal schistosomiasis in a child with acute myelopathy: A case report

BACKGROUND: Neuroschistosomiasis is defined as an infection of the nervous system caused by Schistosoma mansoni. Neuroschistosomiasis is an important differential diagnostic consideration in pediatric patients presenting with myelopathy. Surgical excision combined with antiparasitic drugs typically provides a satisfactory outcome and often results in neurological recovery. CASE DESCRIPTION: A 4-year-old child presented with acute and progressive myelopathy. A thoracolumbar magnetic resonance image revealed a T12-L2 conus medullaris mass that was isointense on T1 and hyperintense on T2 (with an extensive syringomyelia at the thoracic spinal cord) and showed enhanced heterogeneity with gadolinium. The lesion was excised through T12-L2 laminotomy. Intraoperatively, the tumor appeared reddish and infiltrative. The frozen section suggested a granulomatous process, while the final pathology confirmed conus medullaris schistosomiasis. CONCLUSION: Schistosomal myeloradiculopathy should be considered among the different diagnosis in children presenting with lower thoracic region, conus medullaris, and/or cauda equina infiltrative spinal masses.