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MR imaging of neoplasms of the lumbar spine.

MR imaging has evolved as the primary modality for imaging spinal neoplasms; however, neoplasms must be distinguished from unusual appearances of degenerative lesions. This article reviews MR imaging findings of a variety of neoplastic lesions of the lumbar spine. For example, extradural, metastatic tumors are the most common; nerve sheath tumors are the most common intradural extramedullary tumors; and ependymoma accounts for most of the tumors arising from the filum terminale.

Cauda Equina↗

Enlargement of the spinal cord: inflammation or neoplasm?

Intramedullary spinal tumours are uncommon lesions that can cause significant difficulties in the differential diagnosis between inflammatory diseases such as multiple sclerosis and acute disseminated encephalomyelitis, and vascular malformations or neoplasms. We report five cases in which the history and the clinical symptoms suggested an inflammatory process of the spinal cord but the MRI characteristics were those of neoplastic lesions. Both non-neoplastic and neoplastic intramedullary lesion may have very similar symptoms, and even CSF abnormalities, but in every one of our cases, a more detailed history and longer observation of the clinical course would have led to the correct diagnosis; in such problem cases, empirical treatment and a follow-up MRI after a month's observation would be a more prudent approach providing that the patient is not rapidly deteriorating.

Adult↗

[Lymphocytic meningitis with the involvement of the skull in the course of spinal cord neoplasm simulating neuroborreliosis. Case report].

UNLABELLED: We describe a case of 48 year old male patient treated in the Department of Parasitic Diseases and Neuroinfections AMB with suspected neuroborreliosis. CLINICAL SYMPTOMS: lymphocytic meningitis with cranial neuropathies n. VII palsy and radiculitis after numerous tick bites in endemic area--indicated neuroborreliosis. Because there was no effect of antibiotic therapy and lack antibodies against B-burgdorferi in serum and CSF we excluded neuroborreliosis. Developing neuropathies III-XII, increasing cytosis and protein concentration, radiculalgia and difficulties in walking, cachexia made us think of tbc etiology. Patient failed to improve after anti-tbc treatment. CT and MR showed presence of neoplasmatic masses in spinal canal. In cytologic examination "neoplasma malignum male differentiatum probabiliter metastaticum" was found. Primary focus of neoplasmatic process was not found.

Borrelia burgdorferi Group↗

Part I: spinal-cord neoplasms-intradural neoplasms.

Intradural spinal-cord tumours are an uncommon but important consideration in the differential diagnosis of patients with back pain, radicular pain, sensorimotor deficits, or sphincter dysfunction. Intradural spinal tumours can be divided into intramedullary and extramedullary spinal-cord tumours on the basis of their anatomical relation to the spinal parenchyma. The heterogeneous cell composition of the intradural compartment allows the formation of neoplasms, arising from glial cells, neurons, and cells of spinal vasculature. Additionally, developmental tumours, metastases, and intradural extension of extradural tumours are represented. In this Review, we discuss the published work on intradural spinal-cord tumours in terms of epidemiological, radiographic, and histological characteristics. Surgical and adjuvant treatment strategies are also reviewed.

Humans↗

Syringomyelia after removal of benign spinal extramedullary neoplasms.

STUDY DESIGN: This is a case report. OBJECTIVES: Two patients with noncommunicating syringomyelia manifesting symptoms years after the uneventful excision of a benign intradural extramedullary neoplasms are presented. SUMMARY OF BACKGROUND DATA: The association of noncommunicating syringomyelia with benign extramedullary neoplasms as a coexistent or delayed process is a rare event. The pathogenesis of such spinal cord cavitation after tumor removal and the relationship with therapeutic intervention is not well defined. METHODS: The delayed occurrence of neurologic impairment emphasizes the need for considering development of syringomyelia rather than tumor recurrence. RESULTS: The effects of chronic spinal cord compression in the thoracic region may be accelerated by adverse stresses acting on the spinal cord associated with tethering of the spinal cord. CONCLUSION: In defining the pathogenesis of this form of spinal cord cavitation, these cases suggest that therapeutic approaches directed at resolving the process should not only include lyses of adhesions, but shunting procedures, which appear to be most efficacious when these procedures are performed at or cephalad to the level of original tumor removal.

Aged↗

Neoplasms of the spine.

Although the treatment of central nervous system neoplasms generally is unrewarding, some animals with spinal neoplasia may, for a variety of reasons, be successfully managed for extended periods of time. The veterinary profession has greater experience with spinal surgery than with intracranial surgery. As a result, surgeons are more willing to attempt and more successful at removing or debulking spinal neoplasms. Additionally, there are more affordable and accessible diagnostic procedures available to evaluate the spinal cord than there are to evaluate the brain. Finally, the majority of tumors that affect the spinal cord are extramedullary and are therefore amenable to attempts to remove them surgically.

Animals↗

Spinal cord compression in a patient with a pain pump for failed back syndrome: a chalk-like precipitate mimicking a spinal cord neoplasm: case report.

OBJECTIVE AND IMPORTANCE: The use of intrathecal morphine has been effective with few complications for chronic intractable pain of both benign and malignant origins. A rare but serious problem that exists is the formation of an inflammatory mass at the catheter tip of the pain pump. CLINICAL PRESENTATION: We report the case of a 67-year-old female patient with failed back syndrome who presented with sensory complaints and back pain. INTERVENTION: Magnetic resonance imaging revealed impingement on the thoracic cord by a mass. The mass was originally thought to be a spinal cord tumor; however, operation and chemical analysis of the mass showed that it was a bupivacaine precipitate at the tip of the catheter of the pain pump. CONCLUSION: This is the first such case, to our knowledge, of a bupivacaine precipitate mimicking a spinal cord tumor.

Aged↗

Schistosomal myelopathy mimicking spinal cord neoplasm.

We describe a 48-y-old male with chronic progressive myelopathy suggesting thoracic intramedullary neoplasm but in whom laboratory workup disclosed Schistosoma mansoni myelopathy. The case illustrates the need for careful investigation of schistosomiasis in patients from endemic regions with myeloradiculopathy signs.

Animals↗