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PubMed1990

[Surgery for backache].

All types of lumbar pain are of course not an indication for surgery. However, an operation may bring relief from lymbodynia in given conditions, owing to the better knowledge of spinal physiopathology and to the evolution of the surgical technique. This is the case for intervertebral disk pathology, lesions of the posterior articular structures, lumbar canal stenosis, vertebral tumors or malunions, as well as for some cases of painful frontal or sagittal deviation of the spine. State-of-the art techniques utilize arthrodesis, often with a plate or CD-material osteosynthesis, but future surgery should be aimed at preserving motion.

Back Pain↗
PubMed1990

[Imaging of malignant lymphoma of muscular sites].

Seventeen cases of muscular lymphoma are reported (5 primary non-Hodgkin lymphoma, 11 secondary NHL, 1 secondary Hodgkin's disease). The psoas or gluteus muscle was involved in 10 cases, and the lower limb was affected in the remaining 7 cases. Nine cases of muscular extension of bone NHL are also reported. On sonograms these lesions were always large and less echogenic than adjacent structures, with no signs of necrosis before treatment. US and CT patterns were comparable for both primary and secondary lesions, regardless of the type of lymphoma or whether or not there was any previous bone lesion. Associated lymphomatous lesions were observed in 14 cases. On angiograms, muscular lymphomatous involvement presented a hypovascular pattern. While ultrasonography is an excellent monitoring technique for soft tissue lymphomas (specially for the lower limbs), a major contribution of CT is the detection and the follow-up of deep or thoracic wall lesions.

Adolescent↗
PubMed1990

[Magnetic resonance in oncology].

The physical and biological background to magnetic resonance imaging (MRI) in patients with neoplasms is reviewed. The clinical indications for this method of diagnosis, staging, and follow-up of malignant neoplasms are discussed on the basis of the guidelines given by the MRI Consensus Conference on April 25-26, 1989, in Berne. MRI is the modality of choice in patients with neoplasms of the central nervous system and the musculoskeletal system. Further emerging indications for MRI are neoplasma of the ENT region, liver, and pelvic organs. Finally, the foreseeable developments in MRI and in magnetic resonance spectroscopy (MRS) are mentioned.

Abdominal Neoplasms↗
PubMed1990

[Chordoma of the mobile spine. Report of 9 cases. Review of the literature].

The authors reported 9 cases of chordomas of the mobile spine: 6 lumbars and 3 cervicals. There are 5 men and 4 women. Mean age at diagnosis is 60 years old. Mean delay between the first clinical manifestations and the diagnosis is 22 months. Clinical findings are not specific. Roentgenologic findings show 2 typicals aspects: a lytic lesion on the lateral side of the vertebrae frequently involving more than one cervical vertebrae, a mixed lesion (lytic and sclerotic) or only sclerotic was detected only at the lumbar spine. Magnetic resonance imaging and computed tomography are the most useful investigations to determine the local extension of the tumor. Certitude of the diagnosis is always microscopic. Evolution is difficult to precise in this kind of embryological tumor. Radical surgery at the earliest time is the best guarantee of a better prognosis which still remain severe.

Adult↗
PubMed1990

Association between number and sites of new bone scan abnormalities and presence of skeletal metastases in patients with breast cancer.

Review of 1,441 bone scans performed on 242 breast cancer patients without known skeletal metastases identified 239 scans with new abnormalities. Findings on 54 of these 239 scans (23%) represented bone metastases. The proportion of scans reflecting metastases, grouped by the number of new abnormalities, was: (1) 20/182 (11%); (2) 9/26 (35%); (3) 4/9 (45%); (4) 1/2 (50%); greater than or equal to 5-20/20 (100%). When metastatic disease presented as a bone scan with 1-4 new abnormalities, the spine was the most common site of involvement (18 of 34 (53%)), followed by the skull (5/34; 15%), extremities and sternum (each 4/34; 12%). Rib lesions were the most common new findings on scans with less than 5 new abnormalities (seen on 76 of 219 scans (35%)) but only infrequently represented metastases (n = 2). Considering as indicative of malignancy only, those bone scans which demonstrated either (a) greater than or equal to 5 new abnormalities, (b) initial radiographic correlation suggestive of metastases, or (c) thoracic spine lesions with normal correlative radiographs, the presence of skeletal metastatic disease could be predicted with a sensitivity of 0.80 and a specificity of 0.94.

Bone Neoplasms↗
PubMed1990

The role of magnetic resonance imaging in an oncology centre.

Magnetic resonance (MR) imaging represents the growth area in radiology at present and for well into the 1990s. It has already established itself as the major emerging technique in neuroradiology. Its apparent risk-free application, noninvasiveness and patient comfort provide wide acceptability. This technique may play an important role in the evaluation of cancer patients. Experience with nearly 2,000 patients over a 32-month period demonstrates MR imaging to allow both a more accurate definition of tumor outline and tumor staging, thanks to its high soft-tissue contrast and multiplanar acquisitions. Moreover, MR imaging proves a valuable procedure for radiation treatment planning. Even though it is beyond realistic expectations to seek complete tissue characterization, MR imaging is likely to be increasingly demanded. With the use of specific paramagnetic contrast agents, this technique will eventually replace computer tomography (CT) in both staging and follow-up of several types of cancer.

Bone Neoplasms↗
PubMed1987

Paravertebral malignant rhabdoid tumor in an adult. A case report with immunocytochemical study.

A case of paravertebral malignant rhabdoid tumor in a 59-year-old man is described. The location of the tumor and age of the patient appear to be unique. The clinical evolution was aggressive and resulted in the death of the patient. The tumor exhibited the light microscopic features of a typical rhabdoid tumor. It was composed of poorly differentiated round or polygonal cells with acidophilic glassy inclusions and vesicular nuclei exhibiting prominent nucleoli. Immunohistochemistry revealed the coexpression of cytokeratin and vimentin in neoplastic cells.

Cell Nucleus↗
PubMed1989

[Medical imaging and chronic backache].

The different procedures for imaging the lumbar spine are presented within a general review of chronic low back pain. Plain films still represent the main procedure: they are sufficient for common backache, the most frequent pattern of chronic low back pain. They help in determining further investigations in symptomatic low back pain, due either to spinal or non spinal conditions.

Arachnoiditis↗
PubMed1989

[Immunotherapy with transfer factor in hormone-resistant metastasized carcinoma of the prostate].

Fifty-six patients with metastatic hormone-resistant carcinoma of prostate (stage D3) were submitted to immunotherapy with a monthly intramuscular injection of predominantly specific transfer factor (TF) produced in vitro. Patient follow-up ranging from 1 to 8 years revealed completed remission was achieved in one patient, partial remission in 6, and there was no progression of the metastatic disease in 14 patients. The mean patient survival was 17 months, higher than the survival rates reported elsewhere. No negative side effects ascribable to the treatment regimen were observed. All the foregoing findings, particularly the absence of side effects, provide encouraging data on this treatment modality.

Bone Neoplasms↗
PubMedDate not supplied

[Auriculotemporal syndrome in patient with prostatic secondaries to the cervical vertebrae and neck lymph nodes].

Auriculotemporal syndrome is characterized by flushing sweating and hypersensitivity in the temporal, parotid and preauricular area during mastication. The syndrome is a rare complication after 1) injuries in this area, 2) parotidectomy, 3) surgery of fractures of the temporomandibular articulation 4) neoplasms of the parotid gland. It usually appears a few days to 1-2 years after the appearance of the above mentioned causes. A case of auriculotemporal syndrome in a 70 year old man with metastatic Ca from the prostate to the cervical vertebrae and neck lymphnodes is reported. On this occasion, the literature is reviewed and emphasis is given in pathogenesis and treatment of the syndrome.

Aged↗
PubMed1989

Transoral stereotactic biopsy of the second cervical vertebral body: case report with technical note.

Although the transoral approach to the atlantoaxial region is generally an open surgical procedure, in patients in whom only tissue diagnosis is required, a needle biopsy can be done. In this paper a patient with a metastatic lesion in the second cervical vertebral body is presented, and the technique for needle biopsy of the second cervical body using stereotactic methods is described.

Adenocarcinoma↗
PubMed1989

Skeletal lymphoma.

The records of forty-two patients with lymphoma of bone [.11 with Hodgkin disease (HD), 31 with non-Hodgkin lymphoma (NHL)] were retrospectively reviewed to correlate histologic type with sites of osseous involvement, radiographic patterns of bone destruction, and prognosis. The vertebral column was the most frequent site of axial involvement and the femur was the commonest site overall. In HD, the most frequent radiographic pattern was vertebral sclerosis, while periosteal reaction was noted in two focal femoral lesions and hypertrophic pulmonary osteoarthropathy in one patient. In NHL, permeative destruction predominated, while unusual layered periosteal reaction and eccentric cortical destruction were each seen in two patients. Radiographic patterns of bone involvement alone cannot be used to predict histologic type or prognosis. Staging remains the most important prognostic indicator. For skeletal lymphoma, instead of the traditional Ann Arbor Staging System, we prefer the more specific Mayo Staging System which relates the temporal appearance of osseous disease to nodal or soft-tissue disease or both.

Adult↗