A Case Report of Ependymoma in a Pregnant Client With Thoracic and Lumbopelvic Pain

Background: Literature exists for both management of lumbopelvic pain during pregnancy and physical therapy medical screening for cancer. However, little has been written on spinal cord tumors masked by pregnancy-related thoracic or lumbopelvic pain. This case presents management of a client with pregnancy-related back pain complaints and also highlights how a spinal tumor can mimic many common pregnancy symptoms. Case Description: This case describes the physical therapy (PT) management of a pregnant client presenting with thoracic and lumbopelvic pain. Initially, treatment focused on core and pelvic girdle strengthening along with postural retraining and stretching. The client attended a total of 5 PT visits after which point progressive neurological symptoms developed. Medical examination, including imaging, revealed arachnoid cysts secondary to an ependymoma, a rare spinal tumor. Outcomes: The client delivered a viable preterm infant and passed away 2 months after her initial diagnosis secondary to the malignancy. Discussion: This case describes how systemic disease may present as pregnancy-related musculoskeletal dysfunction. Recognition of non–mechanical-based symptom complaints may assist in the detection of occult pathology. There are, however, rare occurrences when red flag signs appear only in the final stages of the disease with irreversible tumor expansion and metastases, ultimately leading to death. Informed Consent: This case is unique as the individual under discussion is deceased and therefore unable to provide consent.