Background: Disseminated histoplasmosis involving the central nervous system occurs in 5–10% of cases. However, intramedullary spinal cord lesions are extremely rare. Here, 45-year-old female with a T8–9 intramedullary lesion did well following surgical extirpation. Case Description: For 2 weeks, a 45-year-old female experienced progressive lower back pain, paresthesias, and paraparesis. The magnetic resonance imaging showed an intramedullary expansive lesion at the T8–T9 level that markedly enhanced with contrast. Surgery, consisting of T8–T10 laminectomies performed using neuronavigation, an operating microscope, and intraoperative monitoring, revealed a well-demarcated lesion that proved to be a focus of histoplasmosis; it was readily completely excised. Conclusion: Surgery is the gold standard for treating spinal cord compression attributed to intramedullary histoplasmosis unresponsive to medical management.

Background: Spinal cord hemangioblastomas (HBs) account for 2–15% of all spinal cord neoplasms. They are the third most common primary intramedullary tumor (1–5%). Here, 72-year-old female presented with a thoracic intramedullary spinal HB that responded well to surgery. Case Description: A 72-year-old female presented with a 3–4 years of progressive paresthesias and paraparesis. On examination, she exhibited diffuse distal weakness of the lower extremities. The magnetic resonance scan showed an intramedullary expansive lesion at the T1–T2 level that markedly enhanced with contrast with both proximal and distal hydromyelia. Surgery included a C7 partial and T1–T2 total laminectomies performed under microscope visualization with intraoperative monitoring. At surgery, there was a well-documented cleavage plane between the tumor and the cord; excision was facilitated using the cavitron ultrasonic surgical aspirator device. Conclusion: Surgery is the gold standard treatment for treating/resecting HBs and should include utilization of an operating microscope and intraoperative monitoring.