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At least 145 records · Page 8Linked to original sources
PubMed2006

CyberKnife radiosurgery for benign intradural extramedullary spinal tumors.

OBJECTIVE: Microsurgical resection of benign intradural extramedullary spinal tumors is generally safe and successful, but patients with neurofibromatosis, recurrent tumors, multiple lesions, or medical problems that place them at higher surgical risk may benefit from alternatives to surgery. In this prospective study, we analyzed our preliminary experience with image-guided radiosurgical ablation of selected benign spinal neoplasms. METHODS: Since 1999, CyberKnife (Accuray, Inc., Sunnyvale, CA) radiosurgery was used to manage 51 patients (median age, 46 yr; range, 12-86 yr) with 55 benign spinal tumors (30 schwannomas, nine neurofibromas, 16 meningiomas) at Stanford University Medical Center. Total treatment doses ranged from 1600 to 3000 cGy delivered in consecutive daily sessions (1-5) to tumor volumes that varied from 0.136 to 24.6 cm. RESULTS: Less than 1 year postradiosurgery, three of the 51 patients in this series (one meningioma, one schwannoma, and one neurofibroma) required surgical resection of their tumor because of persistent or worsening symptoms; only one of these lesions was larger radiographically. However, 28 of the 51 patients now have greater than 24 months clinical and radiographic follow-up. After a mean follow-up of 36 months, all of these later lesions were either stable (61%) or smaller (39%). Two patients died from unrelated causes. Radiation-induced myelopathy appeared 8 months postradiosurgery in one patient. CONCLUSION: Although more patients studied over an even longer follow-up period are needed to determine the long-term efficacy of spinal radiosurgery for benign extra-axial neoplasms, short-term clinical benefits were observed in this prospective analysis. The present study demonstrates that CyberKnife radiosurgical ablation of such tumors is technically feasible and associated with low morbidity.

Adolescent↗
PubMed2001

[Mechanical pathology of the spinal cord].

Syringomyelia is a cyst within the spinal cord, associated with numerous causes, most frequently combined with the Chiari abnormality. Many other causes of craniovertebral junction anomalies are described. In those cases the syringomyelia is so-called hind-brain related syringomyelia. Other dysraphic states and spinal causes of syringomyelia are spina bifida cystica, lumbar lipomas, diastematomyelia or split notochord syndrome. Mechanical causes of spinal cord compression are mostly of tumoral origin. The vast majority of spinal metastases occur extradurally and originate from carcinomas of the breast, prostate and lung. Intradural extramedullary tumours of the spine constitute two thirds of all spinal neoplasm: schwannomas and meningiomas make up approximately 90% of the total and occur in equal numbers.

Biomechanical Phenomena↗
PubMed1997

Imaging and pathological features of primary malignant rhabdoid tumours of the brain and spine.

In this article two cases of primary malignant extrarenal rhabdoid tumour are described. In the affected children the brain and the spinal cord were the primary sites of origin of the tumour. The imaging findings are presented and the pathology discussed. Although the imaging features are non-specific, rhabdoid tumour should be included in the differential diagnosis of childhood intracranial and spinal neoplasms.

Acquired Immunodeficiency Syndrome↗
PubMed2000

SHORT PAPER - extensive spinal meningioma in a young dog.

The meningioma is one of the most common intradural spinal neoplasms in dogs. Such tumours are usually solitary, well-defined masses that tend to occur in mature and aged dogs. Several variants have been described in the medical and veterinary literature. This paper records a case of a spinal meningioma that extended from the cervical to the lumbosacral spine, with concurrent hydrocephalus, in a 5-month-old male Rhodesian Ridgeback. The tumour appeared to be a meningothelial meningioma with focal mineralization.

Animals↗
PubMed2000

Review of 36 cases of spinal cord meningioma.

STUDY DESIGN: Thirty-six consecutive patients with histologically confirmed spinal cord meningioma were presented to evaluate clinical, diagnostic, therapeutic options and to correlate treatment methods and outcome. OBJECTIVE: To present the incidence, clinical presentation, localization, techniques, and long term results of surgically treated spinal meningiomas. SUMMARY OF BACKGROUND DATA: Meningiomas are common tumors of spinal neoplasm. They are generally benign and slow-growing. Advanced in radiologic and surgical techniques have brought about better surgical results. The goal of surgical treatment must be total resection if possible. However, spinal meningiomas may recur, especially as a result of incomplete resection. METHODS: Thirty-six consecutive patients with histologically confirmed spinal meningiomas were treated from 1980 to 1997. Neuroradiological diagnosis was made through myelogram in 20 patients, CT scan in 15 patients, and MRI in 16 patients. All patients were operated on via the posterior approach and using microsurgical technique and when necessary Cooper-Ultrasonic surgical aspirator (CUSA) and CO2 laser were also applied. The patients were followed for 2 to 15 years (mean 9 years). Radiotherapy was not undertaken except in recurrent tumors. RESULTS: The most frequent site of spinal meningiomas was in the thoracic region. In 30 (83%) patients tumors were found to be completely intradural extramedullary during surgery. Total tumor resection was achieved in 35 (97%) of patients. In the follow-up period, 30 cases (83%) improved when compared to their preoperative conditions. There was one operative mortality (3%). A 66-year-old women died of pulmonary emboli. CONCLUSIONS: Magnetic resonance imaging is the best imaging technique for diagnosis. Total tumor resection improved the surgical results of spinal meningiomas. If total removal of the tumor cannot be achieved, or in the case of early recurrence followed by total resection, radiotherapy should be performed in adjuvant therapy.

Adult↗
PubMed1993

The plated bayonet: a new instrument to facilitate surgery for intra-axial neoplasms of the spinal cord and brain stem. Technical note.

A new instrument for use in surgically treating intra-axial neoplasms of the spinal cord and brain stem is described. The plated bayonet allows neoplastic tissue in the spinal cord to be separated from functioning neural elements without perforating the adjacent spinal cord. In addition, the plated bayonet facilitates exposure through the very small incision necessary to remove tumors of the brain stem without damaging cranial nerves or other vital structures.

Brain Neoplasms↗
PubMed2006

Non-enhancing pilocytic astrocytoma of the spinal cord.

Pilocytic astrocytomas are among the most common intramedullary spinal cord tumors in the pediatric age group. The presence of contrast enhancement is a major factor used to distinguish these tumors from other spinal cord lesions. We present a case of histologically proved non-enhancing intramedullary spinal cord pilocytic astrocytoma in a 12-year-old girl. This case represents an exception to the conventional wisdom that pediatric spinal neoplasms enhance with administration of intravenous contrast material.

Arm↗
PubMed2001

Intraoperative diagnosis of tanycytic ependymoma: pitfalls and differential diagnosis.

Smear preparations have become increasingly popular in the intraoperative assessment of central nervous system pathology. The cytological features of a histologically proven tanycytic ependymoma are presented with the pitfalls and differential diagnosis. The smear preparation showed a glial neoplasm composed of cells with long, bipolar glial processes and oval to spindle-shaped nuclei resembling those seen in pilocytic astrocytoma smears. The smear characteristics of an ependymoma usually show remarkably uniform round-to-oval nuclei, fluffy glial processes, and a perivascular nuclear-free zone (pseudorosetting). None of these features were present in our case. The accompanying frozen section showed a fascicular spindle-cell tumor that resembled a schwanomma, a commonly reported misinterpretation of the histology of tanycytic ependymomas on frozen sections. Careful attention to the radiological findings, the surgeon's impression, and the intraoperative smear preparation details should allow one to include this uncommon entity in the differential diagnosis of spinal neoplasms.

Adult↗
PubMed1995

Spinal dermoid cysts originating intracranial fat drops causing obstructive hydrocephalus: case reports.

The authors report two cases of spinal dermoid cysts whose rupture originated the migration of free fat drops into the ventricles and intracranial subarachnoid spaces. In both cases the fat drops caused obstructive hydrocephalus, which represents a quite exceptional complication. Moreover, one of the cases is unique, since the finding of intracranial fat causing hydrocephalus considerably preceded the discovery of the spinal neoplasm. The authors suggest that the finding of intracranial fat in the absence of a local source makes the search for a intraspinal dermoid or epidermoid tumor mandatory.

Cerebral Ventricles↗
PubMed1980

[Ependymoma of the cauda equina presenting as raised intracranial pressure without ventricular dilatation. One case (author's transl)].

Intracranial hypertension is a rare phenomenon in the development of intra-spinal neoplasm. In the present case, it occurred without ventricular dilatation raising the problem of the underlying mechanism. Perturbations in the CSF reabsorption would appear less likely than an increase in brain volume, where cerebral edema may play an important role.

Adult↗