Intramedullary thoracic schwannoma.

A case of intramedullary thoracic schwannoma in a 40-year-old woman without signs of von Recklinghausen's disease is reported and the hypotheses as to its origin are discussed. The literature covering 11 other cases is reviewed.     

Intramedullary melanotic schwannoma of the cervicomedullary junction

We report a case of a patient with an intramedullary tumor of the cervicomedullary junction. At operation, the tumor was noted to be highly pigmented, and pathological study demonstrated that the tumor was a melanotic schwannoma. Both intramedullary schwannomas and melanotic schwannomas in any location in the body are exceedingly rare. This is the first reported case of an intramedullary melanotic schwannoma of the central nervous system. The possible origin of this tumor is discussed.     

Intramedullary schwannoma with extradural extension: case report

Intramedullary schwannoma without evidence of von Recklinghausen's disease is extremely rare. Only 23 cases have been reported in the literature. A 42-years-old woman with transverse type myelopathy at the level of Th 6, was referred to our department. Myelography showed diffuse swelling of the thoracic cord. Delayed myelo CT scan revealed the existence of syrinx at C 6 and Th 10 spinal cord level. On NMR spin echo image, high intensity signal with an ovoid shape was visualized in Th 7-8 spinal cord parenchyma and the syrinx was verified below the level of C 5. Based on these findings, she was diagnosed as having Th 7-8 intramedullary spinal cord tumor. Th 6 to Th 9 laminectomy followed by the complete removal of well encapsulated tumor was performed. The rostral and caudal pole of the tumor was found to be located intramedullary. The tumor at the level of Th 7-8, extended not only to the extramedullary space but also to the extradural space. Histopathological examination revealed that the specimen was Antoni A type neurinoma. She showed good recovery. Following hypotheses have been postulated on the cytogenesis of intramedullary schwannoma in the literature: Central displacement of Schwann cells during embryonic development. Schwann cells ensheathing aberrant intramedullary nerve fibers. Schwann cells along the intramedullary perivascular nerve plexus. A critical area where posterior root loose their sheath on entering the pia mater. Transformation of pial cells of neuroectodermal origin into Schwann cells. The cytogenesis of these reported cases may not be identical.(ABSTRACT TRUNCATED AT 250 WORDS)     

Intramedullary schwannoma. A case report

The intramedullary localization of schwannoma is rare, corresponding to 0.3% of all intraspinal tumors. We report a case of intramedullary schwannoma without symptoms suggestive of neurofibromatosis. This patient presented with symptoms of spinal compression. Total removal of the tumor was achieved. The literature is reviewed about of this rare localization of schwannoma.     

Intrasyrinx hemorrhage associated with hemangioblastoma in epiconus

Background contextHemangioblastomas in the central nervous system are highly vascular lesions, but have low risk of hemorrhage. In spinal lesions, there are a few rare cases of intramedullary hemorrhages associated with hemangioblastoma, and their prognoses were very severe.PurposeThis is the first case of an intrasyrinx hemorrhage associated with hemangioblastoma in epiconus. We report this rare case and discuss the clinical manifestations of intrasyrinx hemorrhage caused by hemangioblastoma in epiconus.Study designA case report.MethodsThis case report presents a 45-year-old woman with intrasyrinx hemorrhage caused by hemangioblastoma in epiconus. The patient presented with a sudden onset of burning bilateral leg pain and rectal/bladder dysfunction, indicating conus medullaris syndrome. Initial magnetic resonance imaging revealed an intramedullary nodular lesion in the epiconus and holocord syringomyelia. However, follow-up magnetic resonance imaging showed intramedullary hemorrhage.ResultsThe patient underwent surgery, and an intrasyrinx hematoma was evacuated and the tumor was completely removed. Histological diagnosis was hemangioblastoma. Three months after surgery, the patient recovered from neurological deficits.ConclusionsWe present this rare case, and emphasize hemangioblastoma as the differential diagnosis in hemorrhagic spinal lesion.     

Intramedullary melanotic schwannoma of the cervical spinal cord: report of a case

We present a case report of a patient with an intramedullary tumor of the midcervical cord. At surgery, the lesion was found to be highly pigmented, and pathological analysis revealed a melanotic schwannoma. Intramedullary schwannomas and melanotic schwannomas are exceedingly rare. This is the second reported case of an intramedullary melanotic schwannoma of the central nervous system.     

Intramedullary melanotic schwannoma. Report of a case and review of the literature

A case of an intramedullary melanotic schwannoma located in the spinal cord at the T2-T3 level is described. The lesion occurred in a 44-year-old woman with a 10-year history of weakness and sensory numbness in both legs and feet. At operation the lesion appeared as a well-demarcated grey-brown intramedullary mass. Histologically, it was composed of interlacing bundles of spindle cells showing their cytoplasm filled with melanin. Among spinal cord neoplasms, melanotic schwannomas are rare tumours, which have apparently been reported only in three previous instances. The clinical, diagnostic and pathological features, as well as the possible aetiology of these rare tumours are discussed.     

Intramedullary and extramedullary schwannoma of the cervical spinal cord—Case report

Intramedullary schwannomas and neurofibromas are rare tumors. Only two cases have been reported as having both an intramedullary and extramedullary component.

We have managed the case of a 15-year-old girl with a schwannoma that appeared to track along the sensory nerve root into the spinal cord. The clinical presentation in this case was that of motor weakness and atrophy, sensory abnormalities, and, late in the course, pain.

Magnetic resonance imaging with gadolinium enhancement was better than myelography and computed tomography at delineating the intramedullary extent of the tumor. The tumor was removed microsurgically at two operative sittings. Reports of this unusual pathology are reviewed.     

Intramedullary schwannoma of the spinal cord. A case report and review of the literature

A 9-year-old boy presented with the numbness in both arms and hands, and neck stiffness. On examination, he had a slight quadriparesis and restricted neck movements. There were no signs of von Recklinghausen's disease. Magnetic resonance imaging (MRI) scan disclosed a gadolinium enhanced intramedullary tumor located at C6-T1 associated with syringomyelia. C6-T1 laminectomies were performed and the intramedullary tumor was totally removed by a microsurgical technique. Postoperative course was uneventful. The pathological examination revealed an intramedullary schwannoma. The occurrence of intramedullary schwannoma in a patient without signs of von Recklinghausen's disease is extremely rare. We have been able to find 57 cases of intramedullary schwannoma reported in the literature. Intramedullary schwannomas are usually seen in males. The ages of the patients ranged from 9 to 75 years (mean 40.44 years). Only 4 cases in the pediatric age group have been reported. The duration of symptoms ranged from 3 months to 20 years (mean 31.03 months). Symptoms and signs varied with the location of tumor. The vertebral levels of intramedullary schwannomas were usually cervical (61%). MRI has been the choice of diagnostic tool in the cases reported since 1986. The majority of the cases showed either a partial or complete recovery in the postoperative period.     

Intramedullary spinal schwannoma: case report and review of preoperative magnetic resonance imaging features

Intramedullary schwannomas are rare spinal cord tumours. Correct preoperative diagnosis is essential for proper surgical planning and complete resection. We present a case of cervical intramedullary schwannoma followed by discussion on its preoperative magnetic resonance imaging features and review of the literature.     

Intramedullary limb lengthening with the Intramedullary Skeletal Kinetic Distractor in the lower limb

We report the results of intramedullary leg lengthening conducted between 2002 and 2009 using the Intramedullary Skeletal Kinetic Distractor in 69 unilateral lengthenings involving 58 femora and 11 tibiae. We identified difficulties that occurred during the treatment and assessed whether they were specifically due to the implant or independent of it. Paley's classification for evaluating problems, obstacles and complications with external fixators was adopted, and implant-specific difficulties were continuously noted. There were seven failures requiring premature removal of the device, in four due to nail breakage and three for other reasons, and five unsuccessful outcomes after completion of the lengthening. In all, 116 difficulties were noted in 45 patients, with only 24 having problem-free courses. In addition to the difficulties arising from the use of external fixators, there were almost the same number again of implant-specific difficulties. Nevertheless, successful femoral lengthening was achieved in 52 of the 58 patients (90%). However, successful tibial lengthening was only achieved in five of 11 patients (45%).     

Intramedullary tuberculoma with syringomyelia

Intramedullary tuberculoma with syringomyelia is rare. We treated a woman with back pain and weakness of the left leg that had slowly progressed for more than 30 years. Radiologic evaluation demonstrated a crescent-shaped calcification at the level of the C6 vertebra, and syringomyelia from C7 to T9. Laminectomy and syringosubdural shunt placement were performed, and a tuberculoma was removed. Back pain resolved after the operation, and mobility was facilitated. We recommend surgery for intrathecal tuberculoma with syringomyelia even when the course has been prolonged with no active tuberculous lesion.     

Intramedullary nailing with interlocking

Summary The locked or unlocked intramedullary nail is considered today in most institutions the first choice for stabilisation of the majority of closed diaphyseal fractures of the femur and tibia. In 1st and 2nd degree open fractures of the tibia, the unreamed locked nail may perhaps become the preferred implant. In spite of very favourable results with nailing, not all fracture problems of long bone will be solved with this device. The plate and external fixator will remain indicated in most fractures with meta- and epiphyseal extension as well as in situations in which the intraoperative fluoroscopy is not available. Our experience with the new AO universal femur and tibia nails are being reported.     

Hydatid Cyst of the Rib with Intramedullary Involvement

Osseous localization is uncommon for a hydatid cyst. We present a case of a hydatid cyst with rib involvement spreading through the bone marrow in a 62-year old woman.