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At least 289 records · Page 16Linked to original sources
PubMed2006

Implantation of a distractible titanium cage after cervical corpectomy: technical experience in 20 consecutive cases.

BACKGROUND: This prospective observational study was undertaken to investigate the advantages, the safety, and the drawbacks of reconstructing a cervical corpectomy with a distractible corpectomy cage. According to the author's literature search, this is the second clinical report on a distractible cervical corpectomy cage. METHOD: 20 Consecutive patients underwent a single- or multi-level cervical corpectomy for spondylotic myelopathy, traumatic fracture, or tumor. The corpectomy defect was reconstructed by means of a distractible titanium cage, and local bone from the corpectomy was layed around the cage for fusion. An anterior cervical plate and/or a posterior lateral mass or pedicle screw fixation was added in all patients. The average follow-up was 14 months, and all patients had at least 12 months of follow-up. FINDINGS: No hardware failure occurred in any of the patients. Construct stability was achieved in 19 out of 20 patients (95%) at 12 months postoperatively. The mean regional lordosis was 1 degrees preoperatively, 9 degrees postoperatively, and 7 degrees at the follow-up. Mean neck pain on a VAS was 3.9 preoperatively, and 2.6 at 12 months. There were three perioperative complications: transient neurological worsening in one patient, one transient vocal cord paralysis, and persistent dysphagia in one patient. CONCLUSION: A single- or multi-level cervical corpectomy can be safely and effectively reconstructed by a distractible titanium cage and local bone graft in combination with anterior cervical plating and/or posterior lateral mass/pedicle screw fixation. Potential advantages of this technique are an unforced cage insertion in its non-distracted position, press-fitting the cage into the corpectomy defect through cage distraction, correction of kyphosis or preservation of local lordosis through cage distraction, and the absence of donor site morbidity. However, the stability rate in the current series did not exceed the fusion rates of auto- or allografts.

Adult↗
PubMed2003

Measuring of the compensation of a nerve root in a cervical schwannoma: a case report.

A 64-year-old woman experienced numbness and hypesthesia of the right C6 dermatome a year ago. Enhanced magnetic resonance imaging of the cervical spine revealed an enhanced tumor continuing into the foramen from the spinal cord at the C5/6 intervertebral level. It was thought to be an Eden type 2 schwannoma. Right unilateral laminectomy was performed on C5. The tumor was present in the intradural area and arose from the right C6 anterior root. Compound muscle action potentials (CMAPs) from the deltoid, biceps, and extensor carpi radial (ECR) muscles were recorded following electric cervical nerve root stimulation (0.2 ms duration, and 7 mA intensity). CMAPs of large amplitude were obtained from the deltoid, biceps, and ECR muscles following C5 root stimulation, but those following C6 root stimulation were small. As a result it was determined that the right C6 root was not associated with the nerve distribution for these muscles, so it was resected en bloc with the tumor. No apparent loss of motor function was observed. Standard needle electromyography showed no denervation potentials or decrease in motor unit potentials in either the deltoid or biceps muscles. Intraoperative investigation for compensation of nerve root is clinically useful for determining whether resection of a nerve root results in muscle weakness after surgery for a cervical schwannoma.

Action Potentials↗
PubMed2003

Osteochondroma in the lumbar spinal canal causing sciatic pain: report of two cases.

A search of the English-language medical literature found only two cases in which expansion of an osteochondroma into the lumbar spinal canal caused sciatica. We report another two cases of spinal nerve root compression by solitary lumbar spinal canal osteochondromas: in a 56-year-old man and a 55-year-old woman with no history of hereditary multiple exostoses. Osteochondromas compressing the spinal nerve root were seen at the inferior articular processes of the lumbar vertebrae by computed tomography (CT), three-dimensional reconstruction of CT scans, myelography, and magnetic resonance imaging. The symptoms disappeared after surgical removal of the lesions. Histopathologic examination confirmed the diagnosis of benign osteochondroma.

Female↗
PubMed1999

Multiple spinal "miliary" hemangioblastomas in von Hippel-Lindau (vHL) disease without cerebellar involvement. A case report and review of the literature.

We report on a 57-year-old male presenting with radicular pain in the nerve roots of L5 and S1 on the right side and dysuria. Magnetic resonance imaging (MRI) of the lumbar spine showed multiple (up to 20) small, intradural enhancing nodules attached to the cauda equina down to the sacrum, the largest 1 cm in diameter at the level Th12/L1 compressing the conus. Additionally, small nodules in the cervico-thoracal region adjacent to the cord, but no cerebellar or cerebral abnormalities, were detected in a consecutive MRI of the remaining neuroaxis. The histology of a resected lesion at Th12/L1 revealed hemangioblastoma of the reticular type. Together with a history of left eye enucleation performed 17 years ago for angiomatosis of the retina and the immunohistochemical detection of von Hippel-Lindau (vHL) protein within the removed spinal hemangioblastoma, a diagnosis of vHL disease was established. Family history and screening for visceral manifestations of vHL disease were negative. In contrast to cerebellar or solitary spinal hemangioblastomas, multiple spinal hemangioblastomas without cerebellar involvement in vHL represent unusual manifestations. Unlike the case for solitary lesions in non-syndromic patients, a surgical cure does not seem feasible in this case. The role of treatment modalities is discussed.

Biomarkers, Tumor↗
PubMedDate not supplied

Case of optic nerve involvement in metastasis of a gastrointestinal stromal tumor.

BACKGROUND: The gastrointestinal stromal tumor (GIST) belongs to the leiomyosarcoma or leiomyoma group, and metastasis of leiomyosarcoma to the orbit is extremely rare. The most common sign of the metastasis of leiomyosarcoma to the orbit is proptosis; the primary lesion is usually found in skin or soft tissue. CASE: A 60-year-old man, who had a history of multiple metastases of GIST, suffered sudden unilateral blindness. OBSERVATIONS: His history and computed tomographic scans suggested that the lesion was a metastasis of GIST to the cavernous sinus around the root of the optic nerve. CONCLUSION: To the best of our knowledge, this is the first case of metastasis of GIST to the orbit.

Fatal Outcome↗
PubMed2006

Aggressive clinical course of giant cell tumor arising from thoracic vertebra after a long latent period.

We report the aggressive clinical course of a giant cell tumor (GCT) arising from thoracic vertebra after slow growth for 7 years without treatment. GCTs of bone usually have the characteristics of local recurrence and a low potential for distant metastasis. The patient was a 37-year-old man with an unresectable large tumor of the mediastinum. The histopathological diagnosis of a biopsy specimen was GCT. He had received no treatment for 7 years after the initial diagnosis because the growth rate of the tumor was very slow. However, the tumor at the primary site then rapidly increased in size, and numerous multiple bone metastases developed despite radiotherapy for the primary tumor. These aggressive bone metastases with small numerous radiolucent lesions are rare.

Adult↗
PubMed1988

Hepatocellular carcinoma presenting as an oral cavity lesion.

A primary hepatocellular carcinoma associated with underlying hemochromatosis appeared as a metastatic mandibular lesion. A swelling of the retromolar area and mandibular paresthesia were the presenting complaints. Hepatocellular carcinoma rarely metastasizes to the orofacial area. To our knowledge, only 18 cases have been reported. The clinical, radiographic, and histologic features of an additional case of hepatocellular carcinoma metastatic to the left posterior alveolar ridge is reported, and the literature is reviewed.

Aged↗
PubMed1991

Fine-needle aspiration biopsy in the preoperative diagnosis of chordoma: a study of 17 cases with application of electron microscopic, histochemical, and immunocytochemical examination.

The cytologic findings in a series of 17 patients with chordoma (one clivus, three cervical, one lumbar, and 12 sacral tumors), all of whom underwent fine-needle aspiration biopsy (FNAB) in the preoperative investigation, were studied. Cytologically, three main cell types were recognized: large, mononucleated or binucleated physaliferous cells with a vacuolated "bubbly" cytoplasm; small, rounded, uniform cells; and short spindle-shaped cells. The May-Grünwald-Giemsa staining was found superior to Papanicolaou staining in demonstrating the mucoid matrix and the vacuolated cytoplasm of the physaliferous tumor cells. Ultra-structurally, the tumor cells contained prominent bundles of filament of the intermediate type, as well as large vacuoles and lumina often bordered by microvillous projections; the cells were connected to one another by well-developed desmosomes. The resin embedding technique for the light and electron-microscopic examination of FNAB material (eight cases), the histochemical demonstration of sulphated glucosaminoglycans in the matrix (four cases), and the immunocytochemical analysis (four cases) with positivity for cytokeratin, epithelial membrane antigen, vimentin, and S-100 protein and negativity for carcinoembryonic antigen were found to be of value for the cytologic diagnosis of chordoma, and helped in distinguishing it from other chondrogenic tumors and metastatic mucous-producing carcinoma. From this study we conclude that a preoperative diagnosis of chordoma can be reached by FNAB, provided the findings are carefully evaluated in relation to the clinical and roentgenographic findings. Adjunctive histochemical, immunocytochemical, and ultrastructural techniques applied on the FNA material may be helpful in reaching a conclusive diagnosis when differential diagnostic problems occur.

Adult↗
PubMed1984

Contiguous scalp, skull, and epidural Hodgkin's disease.

A patient with Hodgkin's disease of the nodular sclerosing subtype presented with recurrent disease at the site of a previous blunt trauma to the head. The tumor involved the scalp and subjacent skull and epidural space. This particular presentation of Hodgkin's disease is probably unique, and involvement of the skull and cranial cavity by this subtype of Hodgkin's disease is rare.

Adult↗
PubMed1984

Primary osteosarcoma of the cervical spine causing neurological symptoms.

A case of primary osteosarcoma of the C-6 vertebra in a 39-year-old woman is described. The tumor presented with signs and symptoms of radicular involvement, which were successfully treated surgically. Osteosarcomas of the vertebral column are uncommon, and their localization in the cervical region is definitely rare. The literature on the subject is briefly reviewed.

Adult↗
PubMed1992

Association of primary intraspinal meningiomas and subcutaneous meningioma of the cervical region: case report and review of literature.

A report is made of a unique combination of occurrences of primary intraspinal epidural and subdural meningiomas and primary subcutaneous meningioma in the cervical region of a 15-year-old boy. The subcutaneous meningioma was detected at birth. Review of 92 recorded cases of primary dermal meningiomas revealed that they tended to occur in young patients, with an average age of 34 years for both sexes. The female-to-male ratio was 4:5. Most cutaneous meningiomas occurred in the head and neck, and the scalp was the most common site.

Adolescent↗