Lymphocytic meningitis with the involvement of the skull in the course of spinal cord neoplasm simulating neuroborreliosis. Case report

UNLABELLED: We describe a case of 48 year old male patient treated in the Department of Parasitic Diseases and Neuroinfections AMB with suspected neuroborreliosis. CLINICAL SYMPTOMS: lymphocytic meningitis with cranial neuropathies n. VII palsy and radiculitis after numerous tick bites in endemic area--indicated neuroborreliosis. Because there was no effect of antibiotic therapy and lack antibodies against B-burgdorferi in serum and CSF we excluded neuroborreliosis. Developing neuropathies III-XII, increasing cytosis and protein concentration, radiculalgia and difficulties in walking, cachexia made us think of tbc etiology. Patient failed to improve after anti-tbc treatment. CT and MR showed presence of neoplasmatic masses in spinal canal. In cytologic examination "neoplasma malignum male differentiatum probabiliter metastaticum" was found. Primary focus of neoplasmatic process was not found.