Multicystic spinal chord mass

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Record number: 
Adverse Occurrence type: 
Estimated frequency: 
This is the first report of a spinal cord mass complicating spinal cord cell transplantation and neural stem cell therapy in a human patient.
Time to detection: 
8 years
Alerting signals, symptoms, evidence of occurrence: 
This is a case of an 18-year-old woman who sustained a complete spinal cord injury at T10-11. Three years after injury, she remained paraplegic and underwent olfactory mucosal cell autograft implantation at the site of injury. Patient developed back pain 8 years later, and imaging revealed an intramedullary spinal cord mass at the site of cell implantation, which required resection. Imaging revealed a 3.9 × 1.2 cm expansile cystic and heterogeneously enhancing intramedullary mass at the level of the spinal cord injury (T10–11). Intraoperative findings revealed an expanded spinal cord with a multicystic mass containing large amounts of thick mucus-like material.
Demonstration of imputability or root cause: 
Histological examination and immunohistochemical staining revealed that the mass was composed mostly of cysts lined by respiratory epithelium, submucosal glands with goblet cells, and intervening nerve twigs.
Imputability grade: 
2 Probable
Groups audience: 
Suggest new keywords: 
autologous, autograft
"Mucosal cells, spinal cord, multicystic mass, histology, immunochemistry, goblet cells, cysts, epithelium, back pain,"
Reference attachment: 
Suggest references: 
Dloughy B.J., Awe, O., Rao, R.C., Kirby, P.A. and Hitchon, P.W. (2014). Autograft-derived spinal cord mass following olfactory mucosal cell transplantation in a spinal cord injury patient. J Neurosurg Spine 21(4):618-622.
OK once the voice olfactory mucosal cells is added in the MPHO taxonomy (Evi)
Expert comments for publication: 
Given the prolonged time to presentation, safety monitoring of all patients treated with cell transplantation and neural stem cell implantation should be maintained for many years.