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PubMed1992

Radiographic evaluation of the degenerative cervical spine.

Despite some claims to the contrary, the use of plain film radiography can be an inexpensive initial means of evaluating the degenerative cervical spine if viewed in the context of the patient's clinical history and physical examination and may serve as a guide for further imaging techniques. This article presents a systematic approach for evaluating cervical spine radiographs for the spectrum of degenerative changes, followed by a brief discussion of differential diagnoses.

Arthritis, Rheumatoid↗
PubMed2006

[Neurological symptoms as the first sign of prostate carcinoma].

Three male patients aged 82, 56 and 60 years presented with cognitive impairment and hemiparesis, weakness of the tongue and facial muscles, and pain and weakness of the left arm, respectively. They were found to have carcinoma of the prostate with cerebral, skull and cervical spine metastases. They were treated with hormonal therapy and local radiotherapy for bone metastases. The first patient died within 2 weeks, the second after 1.5 year, and the third was still alive after 6 years. The diagnostic work-up in men with unexplained neurological symptoms should probably include a rectal exam and assessment of prostate-specific antigen.

Adenocarcinoma↗
PubMedDate not supplied

Benign metastasizing leiomyomatosis with massive brachial plexus involvement mimicking neurofibromatosis type 1.

We report the case of a patient who presented with right arm and shoulder pain due to compression of the infraclavicular brachial plexus due to benign metastasizing leiomyomatosis (BML). She was initially and had been repeatedly misdiagnosed as having neurofibromatosis type 1 (NF 1). The diagnosis of BML was not obvious due to its rare nature, the patient's not detailing the specifics of her gynecologic history of having undergone resection of a large uterine leiomyoma and followed by disseminated pelvic leiomyomatous nodules, histologic misinterpretation of an extrauterine lesion of the spine and the brachial plexus as a neurofibroma and the radiologic diagnosis of lung nodules as being "non-specific" in nature. In addition and importantly, no clinical, radiographic or histologic features of NF 1 were present. Although a rare condition, BML should be considered in the differential diagnosis of NF and in patients having a history of uterine leiomyoma. The remarkable, selective involvement of the brachial plexus in this case is unexplained.

Biomarkers, Tumor↗
PubMed1992

Recognizing an index case of type 1 neurofibromatosis.

Neurofibromatosis is a relatively common autosomal dominant disorder with variable penetrance. The disorder usually presents in childhood. Hallmarks of type 1 neurofibromatosis are café-au-lait macules and neurofibromas. Neurologic complications include mental retardation, learning disabilities and seizures. Tumors of the eighth cranial nerve, as well as other intracranial and spinal neoplasms, are the typical lesions in type 2 neurofibromatosis. Both forms of neurofibromatosis have a highly variable course and may result in progressive neurologic deterioration, disfigurement and impingement syndromes. In the 50 percent of cases that represent new mutations, diagnosis may be delayed if the physician is not familiar with the salient features of the disorder. Thorough initial evaluation, genetic counseling and close follow-up are important aspects of management.

Bone Diseases↗
PubMed1991

Metastatic epidural spinal cord compression.

It is important to remember that ESCC is a complication of systemic malignancy and usually denotes disseminated disease with poor survival rates. Early diagnosis is crucial. The initial symptom is almost always back pain, which is local, radicular, or both. Following neurologic examination and radiography, MRI scanning or myelography/CT is immediately indicated if radiculopathy or myelopathy is present or if the radiographs of the spine are abnormal. In cancer patients with local back pain and normal findings on neurologic examination and radiography of the spine, there is still a probability of 0.1 of significant ESCC. Therefore, urgent CT/MRI scanning is justified. At present, the best treatment for ESCC remains unknown. In the majority of patients, radiotherapy is the most readily available and appropriate option because it is equal in effect to posterior decompressive laminectomy in both radiosensitive and radioresistant tumors. In patients with posterior epidural disease without tissue diagnosis, laminectomy with or without stabilization should be performed. Posterior decompressive laminectomy alone is contraindicated in patients with vertebral collapse. In selected instances of anterior epidural compression without tissue diagnosis or after failure of radiotherapy, an anterior surgical approach or synchronous vertebral decompression with posterior stabilization may be indicated. In the future, after appropriate clinical trials, vertebral body resection may be the optimal approach in de novo selected patients with ESCC with radioresistant tumors and limited systemic spread of the disease.

Combined Modality Therapy↗
PubMed1976

Bone scan patterns of patients with diffuse metastatic carcinoma of the axial skeleton.

Bone scan findings (using 99mTc-stannous pyrophosphate) in five patients with diffuse metastatic carcinoma of the axial skeleton are reviewed. Although there were few visually recognizable asymmetries of tracer localization, the diffuse involvement was diagnosed through abnormally elevated counting rates in the axial skeleton, decreased visualization of the kidneys, and faint or absent visualization of the appendicular skeleton.

Adenocarcinoma↗
PubMed1991

Three-dimensional reconstruction in routine computerized tomography of the skull and spine. Experience based on 161 cases.

Three-dimensional (3D) reconstruction in routine computerized tomography (CT) presupposes that the referring clinicians are motivated, software programs are of good quality, a second working console is available and manipulations are made by experienced persons. Maxillofacial surgery is the main, conventional indication, but the method is also used to plan the surgical treatment of craniofacial malformations and that of injuries and tumours. 3D reconstruction cannot replace a thorough analysis of the acquisition sections since its spatial definition is not as good as theirs. Without competing with pure research-work, a number of applications remain in the realm of speculative imaging, but it cannot be denied that 3D reconstruction has an interesting potential for teaching.

Adult↗
PubMed1991

[Spinal lipomas].

Explore the source record for details and available documents.

Adolescent↗
PubMed1990

[Unusual chordoma of the neck region simulating salivary gland pleomorphic adenoma].

We report a 34-year-old woman with a cervical chordoma consisting of an intraspinal and extraspinal portion. The extraspinal component of the tumor invaded the deeper structures of the left side of the neck, and was subjected to repeated partial removal. It was misinterpreted as pleomorphic adenoma of salivary gland origin, whereas the intraspinal portion was a neurilemmoma with unusual mucous degeneration.

Adenoma↗
PubMed1990

Benign osteoblastoma of vertebral column and skull. Report of two cases.

Osteoblastoma of the spine is a rare but important cause of back pain and the sciatica syndrome in young adults. Osteoblastoma of the skull is rare and the involvement of the orbital roof is very unusual. Clinical complaints and physical examination are not specific enough to provide a lead to the diagnosis. Bone scans and computerized tomography scans should be performed in all cases, to show the extent of vertebrae or calvarium infiltration by the tumor. To prevent recurrence and malignant transformation, the tumor should be completely removed whenever possible. If tumor excision is incomplete, a continuous follow-up is necessary to detect any recurrence or malignant transformation, which normally appears 5-10 years after the first operation (in one of our cases 7 years later).

Adult↗