Invasive myxopapillary ependymoma of the lumbar spine: A case report

BACKGROUND Myxopapillary ependymomas are rare spinal tumours.Although histologically benign,they have a tendency for local recurrence.CASE SUMMARY We describe a patient suffering from extra-and intradural myxopapillary ependymoma with perisacral spreading.He was treated with subtotal resection and postoperative radiation therapy.After treatment,he experienced slight sphincter disorders and lumboischialgic pain with no motor or sensory disturbances.Eight months later,a tumour regression was documented.The patient is still followed-up regularly.CONCLUSION Lumbar myxopapillary ependymomas may present with lumbar or radicular pain,similar to more trivial lesions.Magnetic resonance imaging(MRI)is the primary modality for diagnosis.The treatment aim is to minimize both tumour and therapy-related morbidity and to involve different treatment modalities.     

Follicular carcinoma of the thyroid with a single metastatic lesion in the lumbar spine: A case report

BACKGROUNDThe bone is the second most common site of thyroid cancer metastasis, after the lung. Treatment options for bone metastasis of thyroid cancer include surgery, radioiodine therapy (RAIT), external radiation therapy, thyroid-stimulating hormone (TSH) inhibition, bisphosphonates, and small-molecule targeted therapies. In most cases, thyroid carcinoma is found in the thyroid tissue; reports of follicular thyroid carcinoma with a single metastasis to the lumbar spine are rare.CASE SUMMARYWe report a case of bone metastasis as the only clinical manifestation of thyroid cancer. The patient was a 67-year-old woman with lumbar pain for 7 years and aggravation with intermittent claudication who had previously undergone partial thyroidectomy of a benign thyroid lesion. No abnormal nodules were found in the bilateral thyroid glands. However, imaging studies were consistent with a spinal tumor, and the lesion was diagnosed as a metastatic follicular carcinoma of thyroid origin. We adopted a multidisciplinary collaboration and comprehensive treatment approach. The patient underwent lumbar spine surgery, total resection of the thyroid, postoperative TSH suppression therapy, and RAIT. There were no complications associated with the operation, and the patient had good postoperative recovery. She has experienced no recurrence.CONCLUSIONFollicular thyroid carcinoma is associated with early hematogenous metastasis, and the bone is a typical site of metastasis. Single bone metastasis is not a contraindication to medical procedures, and providing the appropriate therapy can result in better outcomes and quality of life for these patients.     

Tenosynovial giant cell tumor involving the cervical spine: A case report

BACKGROUNDTenosynovial giant cell tumors (TGCTs) are a frequent benign proliferative disease originating from the synovial membrane. However, TGCTs rarely occur in the spine. The purpose of this paper is to report a case of TGCT occurring in the cervical spine. Although the disease is rare, it is essential to consider the possibility of TGCT in axial skeletal lesions. Awareness of spinal TGCTs is important because their characteristics are similar to common spinal tumor lesions.CASE SUMMARYA 49-year-old man with a 2-year history of neck pain and weakness in both lower extremities was referred to our ward. Imaging revealed a mass extending from the left epidural space to the C4-5 paravertebral muscles with uneven enhancement. The tumor originated in the synovium of the C4-5 lesser joint and eroded mainly the C4-5 vertebral arch and spine. Puncture biopsy was suggestive of a giant cell-rich lesion. The patient had pulmonary tuberculosis, and we first administered anti-tuberculosis treatment. After the preoperative requirements of the anti-tuberculosis treatment were met, we used a posterior cervical approach to completely remove the mass after fixation with eight pedicle screws. The mass was identified as a TGCT by postoperative immunohistochemical analysis. Recurrence was not detected after 1 year of follow-up.CONCLUSIONSpinal TGCTs are often misdiagnosed. The radiological changes are not specific. The ideal treatment comprises complete excision with proper internal fixation, which can significantly reduce postoperative recurrence.     

Hemolymphangioma with multiple hemangiomas in liver of elderly woman with history of gynecological malignancy: A case report

BACKGROUNDHepatic hemolymphangioma is an extremely rare benign congenital malformation composed of cystically dilated lymphatic and blood vessels, and they have nonspecific clinical symptoms and laboratory results. In this study, hepatic hemolymphangioma with multiple hemangiomas in an elderly woman was initially reported and analyzed.CASE SUMMARYA 61-year-old female patient, with a history of hysterectomy and bilateral adnexectomy, was referred to the hepatobiliary surgery department with the complaint of multiple hepatic hemangiomas that had been diagnosed 2 years prior in a preoperative contrast-enhanced computed tomography (CECT) examination. Upon entering our hospital, no abnormal physical examination and laboratory data were found. The latest CECT revealed a new 7.0 cm × 6.2 cm cystic-solid lesion with multiple internal divisions in segment II of the liver, with delayed CECT enhancement characteristics that presented as solid parts with internal division. On the positron emission tomography (PET)/CT, no significant uptake of ¹⁸F-fluorodeoxyglucse was observed. Finally, hepatic hemolymphangioma was confirmed based on the pathological and immunohistochemical results after surgery. At 1-year follow-up, her posthepatectomy evaluation was uneventful, and she had recovered full activity. In addition, no postoperative recurrent or residual lesion was found on CECT imaging.CONCLUSIONHepatic hemolymphangioma with multiple hemangiomas was reported and observed by CECT and PET/CT imaging.     

Multiple gastric angiolipomas: A case report

BACKGROUND Angiolipoma is a benign tumor and is generally found in subcutaneous tissues.Angiolipomas are rare in the gastrointestinal tract,including the stomach.Preoperative diagnosis of the tumor is difficult,although there are several radiological examinations such as computed tomography and endoscopic ultrasound.CASE SUMMARY We report a 24-year-old Chinese man with multiple gastric angiolipomas,with a positive stool occult blood examination. Endoscopic biopsy only showed nonspecific inflammation. Histological examination of the specimen by endoscopic snare resection showed that the tumor consisted of adipose tissues and blood vessels. We also performed a literature review. After the use of proton pump inhibitor,the fecal occult blood test was negative. Due to the difficulty of resecting multiple lesions in the stomach completely and the benign characteristics of angiolipoma,we chose to have regular upper gastrointestinal endoscopy evaluation of the lesion. No evidence of significant change in lesion size was detected after 3-years follow-up.CONCLUSION Gastric angiolipoma is rare,and benign neoplasm should be considered when lesions occur submucosally in the gastrointestinal tract.     

Chondromyxoid fibroma of the cervical spine: A case report

BACKGROUNDChondromyxoid fibroma (CMF) is an unusual benign tumour of cartilaginous tissues that may be confused with other malignant tumours. It is rarely seen in the cervical spine.CASE SUMMARYA 24-year-old young woman was admitted to the hospital because of neck and shoulder pain. Computed tomography, magnetic resonance imaging, X-ray and other imaging examinations of the cervical spine and laboratory-related indicators combined with intraoperative pathology revealed that the patient had cervical CMF. We performed total resection of the vertebral body and intervertebral disc, and internal fixation was performed to simultaneously maintain the stability of the entire spine. The clinical results from extensive resection were satisfactory. At the 2-year follow-up, the patient''s symptoms had not recurred.CONCLUSIONCMF is a benign primary bone tumour that is rarely located in the vertebral bone. Accurate initial diagnosis of these tumours is important for appropriate treatment. En bloc surgical resection of the tumour is the cornerstone of treatment.     

Computed tomography diagnosed left ovarian venous thrombophlebitis after vaginal delivery: A case report

BACKGROUNDPostpartum ovarian vein thrombophlebitis (POVT) is a rare but serious postpartum complication that affects mostly postpartum women. A high index of suspicion is required when faced with sudden postpartum abdominal pain.CASE SUMMARYA 25-year-old healthy woman who accepted a vaginal delivery procedure suffered fever (temperature 39.6℃) one day after delivery, accompanied with left lower abdominal pain. Physical examination indicated mild tenderness in the left lower abdomen, accompanied with rebound pain. The patient was confirmed to have left ovarian venous thrombosis with inflammation after receiving a multi-detector row computed tomography scan.CONCLUSIONPOVT is a rare and dangerous postpartum complication. A high index of suspicion is required for the occurrence of ovarian venous thrombosis when faced with postpartum abdominal pain and fever. Early application of Doppler ultrasound, computed tomography, magnetic resonance imaging and other auxiliary examinations is conducive to timely and accurate diagnosis of POVT, thus reducing maternal mortality.     

Retroperitoneal bronchogenic cyst in suprarenal region treated by laparoscopic resection: A case report

BACKGROUNDBronchogenic cysts (BCs) are benign congenital foregut malformations that are mostly present in the mediastinum and pulmonary parenchyma but rarely seen in the retroperitoneum. CASE SUMMARYWe report the case of 17-year-old girl who complained of epigastric pain. A cystic lesion was found in the left suprarenal region on spectral computed tomography. The ovoid, well-defined, and homogeneous cystic lesion revealed slightly enhancement on conventional imaging but no enhancement on 40 KeV virtual mono-energetic images. The iodine density value of the lesion was 0.001 mg/mL and the Z-effective value was 7.25, which were close to those of fluid material in in vitro experiments. Magnetic resonance imaging revealed a cystic mass of intermediate signal intensity on T1-weighted imaging and high signal intensity on T2-weighted imaging. A laparoscopic surgery was carried out. Intraoperatively, a cystic lesion with a smooth surface was found in the left retroperitoneum. And the cystic wall was completely resected after intracystic fluid was suctioned. The histopathological examination findings of the lesion were compatible with BC. The patient recovered uneventfully without sighs of recurrence during a 10-mo follow-up period.CONCLUSIONRadiological examinations play a significant role in the diagnosis of suprarenal BCs and spectral images offer additional spectral parameters. Accurate preoperative diagnoses of retroperitoneal BCs based on thorough imaging examinations are beneficial to the operation of laparoscopic resection.