biostudies-literatureUnknown16Lee SJ<h4>Background</h4>Spinal subdural empyema rarely involves the spinal cord and may result in devastating neurological deficits. These lesions typically require prompt diagnosis, surgical evacuation, and antibiotic therapy. Here, we present the clinical course, imaging, and narrated operative video of a thoracic spinal subdural empyema initially diagnosed as an intramedullary neoplasm.<h4>Case description</h4>A 73-year-old female presented with a 6-month history of worsening thoracic myelopathy; over the last few weeks, she rapidly developed paraplegia. She was initially diagnosed with an enlarging thoracic intramedullary mass. A spinal biopsy was performed for the presumptive diagnosis of primary intramedullary central nervous system lymphoma. However, at surgery, the thoracic lesion proveSurgical neurology international95https://www.ebi.ac.uk/biostudies/studies/S-EPMC11980745biostudies-literatureSpinal subdural empyema: A two-dimensional illustrative operative video.PMC11980745Sandhu SLee SJEdgar MAPatel SGendreau JLBrown NJMichaelides LChen SClifton WfalseSpinal subdural empyema: A two-dimensional illustrative operative video.<h4>Background</h4>Spinal subdural empyema rarely involves the spinal cord and may result in devastating neurological deficits. These lesions typically require prompt diagnosis, surgical evacuation, and antibiotic therapy. Here, we present the clinical course, imaging, and narrated operative video of a thoracic spinal subdural empyema initially diagnosed as an intramedullary neoplasm.<h4>Case description</h4>A 73-year-old female presented with a 6-month history of worsening thoracic myelopathy; over the last few weeks, she rapidly developed paraplegia. She was initially diagnosed with an enlarging thoracic intramedullary mass. A spinal biopsy was performed for the presumptive diagnosis of primary intramedullary central nervous system lymphoma. However, at surgery, the thoracic lesion prove2025-01-01T00:00:00Z20252025-07-13T03:06:16.264Z2025-07-13T03:06:16.264ZS-EPMC119807454020676410.25259/SNI_141_2025