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At least 523 records · Page 29Linked to original sources
PubMed1988

Epidural lipomatosis.

The authors report six new cases of epidural lipomatosis--a rarely described entity characterized by increased extradural fat within the spinal canal causing compression of the spinal cord and neurologic deficits. Five of the six patients had a history of chronic steroid use. Myelography of the thoracic spine, followed by computed tomography (CT), was performed in five patients, and magnetic resonance (MR) imaging was done in three. Myelographic findings were abnormal in three patients and normal in two, compared with those of postmyelography CT, which revealed increased accumulation of extradural fat in all five patients. In the three patients in whom it was performed, MR imaging also showed the increased spinal canal fat. Four patients underwent surgery, which revealed an increased amount of histologically normal, unencapsulated fat in all cases. The diagnosis of epidural lipomatosis should be based on a combination of clinical, imaging, surgical, and histologic findings. If the clinical suspicion is high, even if results of myelography are normal, further evaluation with post-myelography CT or MR imaging should be considered.

Adult↗
PubMed1990

Bone scans with one or two new abnormalities in cancer patients with no known metastases: frequency and serial scintigraphic behavior of benign and malignant lesions.

Scintigraphic, radiologic, and clinical follow-up findings were reviewed in cases in which bone scans (n = 301) showed one or two new abnormalities in patients with malignancy but no known metastases. Metastatic disease was confirmed for 25 of 231 scans (11%) with one new abnormality and for 17 of 70 scans (24%) with two new abnormalities. The prevalence of metastases was 0.06 to 0.13 for lesions in all regions of the skeleton, except the sternum (three of six) and the pelvis (10 of 32). On follow-up scans, in the absence of an interval change in therapy, 19 of 21 metastases became more intense, whereas most benign abnormalities either remained unchanged (47%) or resolved (41%). Benign lesions in the ribs, extremities, and pelvis generally resolved within 12-24 months, while most benign skull and spine abnormalities were still apparent after 35-58 months of follow-up.

Bone Neoplasms↗
PubMed2000

Symptomatic vertebral hemangiomas: treatment by means of direct intralesional injection of ethanol.

PURPOSE: To describe the technique and results of injecting ethanol directly into symptomatic vertebral hemangiomas. MATERIALS AND METHODS: Eleven patients with paraplegia (n = 6) or radiculopathy (n = 5) due to vertebral hemangioma were treated by means of injecting ethanol (5-50 mL) directly into the lesion with computed tomographic (CT) guidance. CT angiograms were essential prior to treatment to identify functional vascular spaces of the hemangioma and direct needle placement. RESULTS: All hemangiomas were obliterated completely at follow-up angiography and gadolinium-enhanced magnetic resonance imaging. Five of six patients with paraplegia recovered completely: One who was treated recently was walking with assistance. Four of five patients with radiculopathy improved. No immediate complications were associated with ethanol injection. The two patients who received the largest volumes of ethanol, 42 and 50 mL, developed pathologic fractures of the involved vertebrae 4 and 16 weeks after treatment. CONCLUSION: Direct injection of ethanol into symptomatic vertebral hemangioma is an effective and safe treatment, provided the dose is less than 15 mL.

Adult↗
PubMedDate not supplied

Hemangioma from head to toe: MR imaging with pathologic correlation.

Hemangioma is a common benign vascular neoplasm that closely resembles normal vessels and can be found in all organs of the human body. Vascular lesions can be classified as infantile hemangiomas or vascular malformations on the basis of their natural history, location, cellular turnover, and histologic characteristics. The magnetic resonance (MR) imaging features of vascular malformations of the central nervous system depend on the pathologic subtype. Soft-tissue vascular malformations can be categorized with combined MR imaging and MR angiography as either high- or low-flow. Osseous vascular malformations commonly demonstrate a high-signal-intensity trabecular pattern at both T1- and T2-weighted MR imaging. A group of more aggressive vascular neoplasms, including hemangioendothelioma, hemangiopericytoma, and glomus tumor, have a nonspecific appearance at MR imaging. In the liver and spleen, hemangiomas are typically hyperintense at T2-weighted MR imaging, with a centripetal filling pattern after administration of gadopentetate dimeglumine. Vascular lesions can involve several organs or systems in angiomatous syndromes. MR imaging allows characterization of a hemangioma with typical features, which vary depending on anatomic location. Familiarity with these features facilitates diagnosis and management of these anomalies.

Angiomatosis↗
PubMedDate not supplied

Pediatric presacral masses.

Various types of masses may affect the presacral area in children. A presacral mass may be congenital or developmental or may arise from inflammation. The mass may have neural, vascular, lymphatic, or mesenchymal origins and may be primary (as in focal disease) or systemic (as in multifocal disease). Because the clinical manifestations of presacral masses are often nonspecific, imaging plays an important role in the detection and differentiation of these masses. Information obtained from imaging is also critical for management, especially for surgical planning. For these reasons, it is important that radiologists be familiar with the anatomy of the presacral region and with the imaging features of the various lesions that may occur in this region in children. For the accurate interpretation of findings, radiologists also must know the specific advantages and limitations of each of the imaging modalities used to evaluate this category of abnormalities.

Child↗
PubMedDate not supplied

New interdisciplinary approach for removing large clivus and upper cervical spine tumors.

We have developed a new interdisciplinary approach for removing large clivus and upper cervical spine tumors. This approach is a combination of the Le Fort I osteotomy, midfacial degloving, and median labiomandibular glossotomy. Our approach gives an excellent, wide surgical field from the nasopharynx, including the base of the skull, to the base of the tongue and permits sufficiently safe extirpation of clivus and upper cervical spine tumors that may not be removed by transoral or transcervical approaches. Our approach not only incorporates the merits of each approach but also creates a larger surgical field that may be modified or expanded to accommodate the removal of more bulky tumors in this region. This novel approach will facilitate more successful resection of tumors arising between the nasopharynx, including the skull base, and the retropharyngeal area.

Adult↗
PubMed2003

Influence of growth hormone therapy on pituitary and lumbar spine astrocytomas. A clinical observation.

We report on a male patient with an inactive pituitary and lumbar astrocytoma. He presented with panhypopituitarism at the age of 16 and received growth hormone replacement therapy for one year. During this period the pituitary mass increased substantially and showed subsequently a consistent shrinkage once treatment was stopped. The lumbar lesion stayed stable for the whole period of observation. The presumable rGH related change of the pituitary astrocytoma underlines the importance of careful follow-up of children with growth hormone deficiency secondary to treatment for brain tumors. Substitution therapy with rGH requires further and longer studies before it can be recommended with absolute reassurance in children with subtotal resection of a pituitary astrocytoma.

Adolescent↗
PubMed2003

A rare case of lymphangiomatosis of the craniocervical spine in conjunction with a Chiari I malformation.

Lymphangiomatosis of the bone is rare. The axial as well as appendicular skeleton may be affected. Neurosurgical consultation may be called for several reasons: (1) lesions involving the calvarium and/or spine; (2) nondiagnostic biopsies from more accessible and less morbid locations, and (3) persistent CSF leak and/or recurrent meningitis. Thus, it is important for the neurosurgeon to be familiar with this disease entity and consider it in the differential diagnoses of multifocal lytic lesions of the axial skeleton. We present a case report of a 4-year-old girl with lymphangiomatosis of the skull base and upper cervical spine with concurrent Chiari I malformation and briefly review the literature.

Angiomatosis↗
PubMed1991

[Operative therapy in tumor involvement of the spine].

We report on 56 patients, who underwent operative treatment of tumorous lesions of the spine. We indicated dorsal instrumentation in 14 cases, ventral tumorectomy in 11 cases and a combined dorsal and ventral instrumentation in 31 cases. The median survival time was 14.8 months. Reduction of pain and the improvement of the preexisting neurological symptoms were the most important postoperative factors. According to our follow-up study, the combined dorsal and ventral instrumentation seems to be the best method for an operative treatment of tumorous spine lesions.

Bone Transplantation↗
PubMed1975

Batson's theory of vertebral venous metastasis: a review.

In 1940, Batson (6) ushered in a new era with the theory that metastasis occurs through the vertebral veins. It was based on the premises that metastatic tumors may show typical peculiar distributions, that such patterns have not been adequately explained by orthodox theories, and that cadaver and animal injection experiments reveal the existence of a network of vertebral veins whose vast interconnections explain the puzzling patterns seen in metastases. Undoubtedly, Batson's theory has been widely acclaimed. However, several criticisms are on record. The prevailing controversy needs to be resolved. The prospects are that this can be achieved by further research in this important field.

Animals↗
PubMed1993

Chordoma with multiple skin metastases.

We report a case of sacral chordoma with numerous skin metastases. Histologically they show the typical 'physaliform cells' expressing simultaneously cytokeratin, S-100 protein, epithelial membrane antigen and vimentin immunoreactivity.

Chordoma↗
PubMedDate not supplied

Chordoma. Cytomorphologic findings in 14 cases diagnosed by fine needle aspiration.

OBJECTIVE: To review the clinical and cytomorphologic features of 14 chordomas diagnosed by fine needle aspiration biopsy (FNAB) at our institution. STUDY DESIGN: The cytology files from January 1985 to February 2000 at Mayo Clinic, Rochester, Minnesota, U.S.A., were searched for all cases diagnosed as chordoma by FNAB. Clinical, radiographic and cytomorphologic findings of each case were reviewed. RESULTS: Ten males and four females (mean age, 55 years; range, 14-78) had tumors involving the sacrum (8), clivus (3) and vertebrae (lumbar, 2; cervical, 1). Pain was the presenting symptom in 11 patients. Most smears (82%) were cellular with a fibrillary background. Chondroid matrix was recognized in nine cases. Small, epitheliallike cells constituted the predominant cellular component in nine cases. Cells with clear, vacuolated cytoplasm were seen in almost 'every case; however, true physaliferous cells were rare. Mitotic figures were seen in four cases, binucleation in six and multinucleated giant cells in seven. Needle biopsies contained diagnostic material in all cases. Of the nine patients with follow-up (mean, 57 months; range, 3-184 months), three patients were alive and free of disease, five were alive with disease, and one was dead of disease at this writing. CONCLUSION: Because various cytologic presentations and overlapping cytologic features occur between chordoma, chondrosarcoma and metastatic clear cell carcinoma, it is important to recognize the various appearances of chordoma in FNAB.

Adolescent↗
PubMed1984

Chordomas of the skull base.

The results are presented of a retrospective study of 7 cases of chordoma affecting the spheno-occipital region and one sited in the upper cervical spine. Follow up data were available on 6 patients. Of these 2 are dead but the rest are alive and well, one of them after more than ten years. The mean survival time of the group so far is 5.2 years. The presentation, treatment and course of these lesions is discussed.

Adolescent↗
PubMed1985

Erythema ab igne in cancer patients.

Five cancer patients were observed to have the skin change erythema ab igne (EAI) associated with painful underlying lesions, for which they had been applying local heating with hot-water bottles. In 4 cases the pain was produced by metastases and in one by the primary tumour. The EAI may be seen directly over the lesion or in an area of pain referral. In cancer patients it may be a helpful localizing sign, and in all patients (apart from the anterior lower legs of old people) it is very suggestive of a serious underlying cause.

Adult↗