Intramedullary spinal cord metastasis. A case report

This 54-year-old patient with a breast carcinoma of one year's evolution presented a progressive paraparesis and sphincter disregulation of a week evolution; MRI image showed a tumor in the medullary conus. She improved after removal of the conus mass. The histologic diagnosis was metastasis of adenocarcinoma. Metastasis at this level is infrequent and represents less than 1% of all spinal metastases. When the patients' general condition is good, surgery can relieve the neurologic deficit produced by the medullary mass.     

Intramedullary abscess associated with a spinal cord ependymoma: case report.

Intramedullary spinal cord abscesses are relatively uncommon. We report the first case of an intramedullary spinal cord abscess in a preexisting spinal cord ependymoma. The clinical features and pathogenesis are discussed. Salient features of the management of intramedullary spinal cord abscesses are outlined.     

Intramedullary spinal cord astrolipoma: case report

OBJECTIVE AND IMPORTANCE: Reported is a case of a thoracic intramedullary astrocytoma with a lipomatous component, a so-called astrolipoma. This is the only known case of a single intraspinal astrolipoma in an otherwise healthy patient. CLINICAL PRESENTATION: The patient was a 36-year-old woman with dorsal thoracic pain of more than 1 month's duration, mild lower extremity weakness, and incomplete sensory loss to the T10 level. INTERVENTION: Magnetic resonance imaging of the thoracolumbar spine revealed a fusiform mass at the T9-T11 level. The patient underwent T9-T11 laminectomies and complete resection of the tumor. In the initial postoperative period, the patient's symptoms worsened. However, 3 months after surgery, the patient was clinically improved and was able to walk without assistance. Twelve months after surgery, imaging revealed no evidence of tumor. CONCLUSION: The current treatment plan and recommendation, assuming this tumor will behave like a low-grade glioma or lipoma, is continued radiographic surveillance after gross total resection. Reresection is recommended for tumor recurrence or significant regrowth. The long-term prognosis for astrolipoma is unknown.     

Intramedullary spinal cord germinoma: case report

A case of intramedullary spinal cord germinoma within the conus medullaris, with lumbago and pain in the lower extremities, is presented. The intramedullary spinal cord germinoma was determined by a biopsy specimen. After local irradiation of 50 Gy, the tumor markedly decreased in size and clinical symptoms disappeared.     

Intramedullary spinal cord metastasis

Intramedullary spinal cord metastases are rarely the presenting manifestation of a previously undiagnosed neoplasms. We report such a case in which a subacutely progressive motor and sensory spinal cord syndrome was the initial problem. The differential diagnosis and the difficulties in distinguishing intramedullary from extramedullary mass lesions are discussed. The special features of tumors of the lung and their predilection for metastasis to the central nervous system are considered.     

Intramedullary spinal cord metastasis treated with radiation therapy: report of 3 cases

OBJECTIVES: Intramedurally spinal cord metastasis (ISCM) tends to be seen in the end period of the malignant tumor, so it is important to choose a therapeutic method regarding the QOL (quality of life) of the patient. In this study, we reported three cases of ISCM treated by radiation therapy alone, and demonstrated the utility of this therapeutic procedure. PATIENTS AND METHODS: From 2005 to 2006, 3 cases of ISCM underwent radiotherapy in our institution. The mean age of the patients was 64.0 years old, and all patients were men, having lung carcinoma as their primary lesions. The lesions were located at the cervical cord in one case and the conus medullaris in the other two cases. They were treated by radiotherapy at the department of radiology in our institute. RESULTS: The tumor size and intramedullary high signal area on MR images after the radiotherapy were reduced in all patients. During the clinical course, neurological symptoms were improved in two patients, and progression of the symptoms was stopped in one patient. All of the patients obtained a better ADL due to the radiotherapy. CONCLUSIONS: Radiotherapy has an advantage over surgical treatment in that it involves less invasion. The treatment brought improvements of clinical symptoms and radiological findings in the patients with ISCM. So, radiotherapy could be used as one of the major treatments for patients with ISCM who desire a better QOL after treatment.     

Intramedullary spinal cord metastasis: two case reports and literature review

Intramedullary spinal cord metastasis was thought to be rare, but the advent of MR imaging and treatment for malignancy have revealed that it is more frequent than we previously thought. We report two cases of intramedullary spinal cord metastasis from lung and rectal colon carcinoma. Their symptoms were aggravated rapidly. We performed surgical treatment in both cases; one was grosstotal and the other was subtotal resection. After the operation, symptoms improved mildly in one patient and worsened in the other patient. Both died 3 months after surgery, because of respiratory disturbance due to brain stem compression and lung metastasis. In conclusion, MRI is highly useful for making a diagnosis of intramedullary spinal metastatic tumors. However, it is still difficult to treat such a patient by surgery alone. Further postoperative adjuvant therapy will be necessary to improve the prognosis of such patients.     

脊髓髓内孤立性纤维性肿瘤1例报道

正孤立性纤维性肿瘤(solitary fibrous tumors,SFT)是一种临床罕见的来源于间叶组织的梭形细胞肿瘤,1931年Klemperer和Rabin首次将其描述为一种来源于间叶细胞的纤维增殖性肿瘤~([1])。其主要发生在脏层胸膜,也可发生在全身各处~([2、3])。多数表现为良性,一般无明显临床症状~([4])。近期我院收治了1例脊髓髓内SFT,报告如下。患者女,62岁,因"左下肢无力11月余"于2016年     

Intramedullary subependymoma of the cervical spinal cord: case report

The third case of intramedullary subependymoma of the cervical spinal cord is reported. This is the first such case for which intraoperative views are available. It was possible to remove most of this lesion with the aid of the operating microscope, the carbon dioxide laser, and the use of somatosensory evoked potentials. The diagnosis was clouded by the coexistence of Holmes-Adie pupils and absent reflexes in the lower extremities. All three reported intramedullary subependymomas have been found in the cervical spinal cord of middle-aged patients. Tumors in this clinical setting should not be assumed to be unresectable astrocytomas without careful histopathological and intraoperative evaluation.     

Intramedullary spinal tuberculoma: a case report

STUDY DESIGN: A case report showing an intramedullary thoracic spinal tuberculoma secondary to pulmonary tuberculosis in a 16-year-old patient with findings of subacute spinal cord compression. OBJECTIVES: The significance and the use of magnetic resonance imaging in the diagnosis of intramedullary tuberculoma, and the treatment of the patient that involves surgically the excision of intramedullary lesion followed by appropriate antituberculous therapy. SUMMARY OF BACKGROUND DATA: Tuberculomas of spinal cord are rare entities. The possibility of intramedullary tuberculoma should be seriously considered when an intraspinal mass is found, provided that pulmonary tuberculosis is present in the history of the patient. METHOD: Th4-Th5 laminectomy was performed. Intramedullary tuberculoma was excised through a myelotomy. Antituberculous treatment was applied after the surgery. RESULTS: Excellent clinical outcome was obtained with a combination of both medical and surgical treatments. CONCLUSION: The intramedullary spinal tuberculoma, although a rare entity, must be considered in the differential diagnosis of the spinal cord compression in patients with a history of tuberculosis, human immunodeficiency virus, and those who have a bad socioeconomic condition and bad nutrition habit. When confronted with a progressing neurologic deficit, a combination of microsurgical resection and antituberculous chemotherapy with the avoidance of steroids should be the choice of treatment for intramedullary tuberculomas.     

Intramedullary spinal cord metastasis: a rare and devastating complication of cancer--two case reports

Two cases of very rare intramedullary spinal cord metastasis from colon carcinoma and renal carcinoma were treated primarily by microsurgical excision. A 44-year-old female presented with colon carcinoma metastasis manifesting as complete neurological deficit. She had undergone colon resection 2 years previously for colon carcinoma. The tumor was excised by microsurgery with megadose steroid therapy but she remained paraplegic. A 43-year-old man presented with renal carcinoma metastasis manifesting as incomplete neurological deficits. He had undergone nephrectomy one year previously for renal carcinoma. The tumor was removed by microsurgery. He made a remarkable neurological recovery and became ambulatory after physical therapy.     

Intramedullary ossified cavernous angioma of the spinal cord: case report

A case of a heavily ossified cavernous angioma of the spinal cord along with its histological features and surgical implications is reported. The unusually dense calcification and even bone formation along with the unique eggshell-like cyst formation posed problems in diagnosis and surgical excision. This calcified vascular lesion was treated by subtotal excision.     

Intramedullary spinal cord gangliocytoma: case report and a review of the literature

We present a case of intramedullary spinal gangliocytoma in a 19-year-old woman who presented with a long history of hyperhidrosis of the face and neck areas and intermittent pain of the hands. The tumor involved the cervico-thoracic region of the spinal cord from C7-T3. The patient underwent debulking of the lesion and remains neurologically stable at two years follow-up. A discussion of this case is followed by a review of the literature surrounding this rare clinicopathological entity.     

Intramedullary lipoma of the cervicodorsal spinal cord with intracranial extension: case report

BACKGROUND: An unusual case of an extensive intramedullary lipoma of the cervicodorsal spinal cord with intracranial extension causing compression of spinal cord and brainstem is described. CASE DESCRIPTION: A 3-year-old child with lack of limb movement since birth, the cause of which had remained obscure, developed opisthotonos and episodes of severe respiratory difficulty with brief periods of apnea. Craniospinal computed tomography and magnetic resonance imaging (MRI) were diagnostic of lipoma. Urgent occipitocervical decompression and subtotal removal of the posterior fossa and cervical spinal cord lipoma resulted in lasting resolution of symptoms. CONCLUSIONS: Extensive spinal cord lipomas with intracranial extension can present with alarming spinal cord/medullary compression and respiratory symptoms. Computed tomographic scan and MRI are diagnostic. Total removal is not feasible, or necessary, because subtotal removal and decompression give long-lasting resolution of symptoms.     

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 spinal cord metastasis of ovarian tumor

STUDY DESIGN: Case report. OBJECTIVES: To report a case of a thoracic intramedullary spinal cord metastasis of ovarian tumor in a 59-year-old woman. SETTING: Shiga, Japan. CASE REPORT: A case of a thoracic intramedullary spinal cord metastasis of ovarian tumor in a 59-year-old woman is reported. She received abdominal ovariectomy for the ovarian adenocarcinoma 4 years before she suffered from back pain and showed neurological symptoms. The thoracic intramedullary lesion was confirmed by preoperative magnetic resonance imaging. She showed complete paralysis before operation. The excision of the tumor was achieved through the posterior approach. Histologically, the diagnosis of metastasis of adenocarcinoma was made. CONCLUSION: Although she did not show any postoperative neurologic recovery, her general condition was good and there was no evidence of recurrence 24 months after surgery.     

Intramedullary epidermoid cyst of the cervical spinal cord associated with an extraspinal neuroenteric cyst: case report.

A 4-year-old girl presented with an intramedullary epidermoid cyst of the cervical spinal cord. The clinical, radiological, and surgical features and a brief critical review of the literature are included in this report. The cyst contents were removed totally in two operations. The child had a coexisting neuroenteric cyst in the posterior mediastinum. To our knowledge, this coexistence has not been previously reported. Contemporary imaging modes and prospects of the surgical treatment are discussed.     

Intramedullary neurofibroma in the cervical spinal cord; a case report]

A 62-year-old woman was admitted complaining of clumsiness in both hands. On neurological examination, bilateral hand muscles were weak, both legs were spastic and hyperreflexic, all the extremities were hypoesthetic. Urological examination revealed detruser sphincter dyssynergia. Spinal CT scan demonstrated an iso density mass lesion in the cervical spinal cord, and it was markedly enhanced. On MRI, it was also markedly enhanced by Gd-DTPA. The operative finding was that an oval shaped tumor was buried in the spinal cord and was totally removed. Its histological diagnosis was neurofibroma. Intramedullary neurofibroma is rare and only 18 cases have been reported. In this case the tumor seemed to have arisen at the root entry zone and to have grown sub-pially.