1/42. Ganglion-cell tumor of the filum terminale: immunohistochemical characterization.A case of an unusual spinal neuronal tumor is described in a 36-year-old woman presenting with a buttock pain. The spinal tumor was fully characterized by neuroradiological means, and in particular MRI was of significant value in delineating the extension of the tumor within the spinal canal and its exophitic growth pattern. Pathologically, a well circumscribed tumor originating from the intradural filum terminale characteristically comprised both large and small cells, resembling mature and immature neuronal cells, respectively. In addition, two neuronal markers, i.e., chromogranin a (CGA) and neuron-specific enolase (NSE), and other markers such as glial fibrilary acidic protein (GFAP), S-100 protein, HNK-1, tyrosine hydroxylase and beta 2-microgloblin were investigated immunohistochemically. We found that both neuronal cells expressed immunoreactivity for CGA and NSE, and small neuronal cells showed more intense CGA immunoreactivity, indicating an earlier stage of neuronal differentiation. Weakly positive immunoreactivity for HNK-1 was also demonstrated in small neuronal cells, consistent with evidence of maturation along a neuronal differentiation. From these findings a pathological diagnosis of ganglioneuroma was made. This unique group of ganglion-cell spinal tumors is reviewed in the literature and differential diagnosis and immunohistochemical features are discussed.- - - - - - - - - - ranking = 1keywords = spinal (Clic here for more details about this article) |
2/42. Mild gait abnormality and leg discomfort in a child secondary to extradural ganglioneuroma.Ganglioneuromas are benign and slow-growing tumors that most commonly originate from the sympathetic trunk. Ganglioneuromas often decrease in size and rarely require reoperation. Changes in gait or the onset of limb pain without a discernible local cause are indications for investigation of patients for possible intraspinal pathology. We report the case of a 5-year-old boy who presented with seemingly static symptoms, while the slow-growing tumor had enveloped nerve roots and caused bone destruction of the vertebrae.- - - - - - - - - - ranking = 0.25keywords = spinal (Clic here for more details about this article) |
3/42. Combined laminectomy and thoracoscopic resection of dumbbell-type thoracic cord tumor.STUDY DESIGN: A study of five patients whose dumbbell or paraspinal tumors of the thoracic spine were managed by using thoracoscopic surgery is reported. OBJECTIVES: To report on the use of combined laminectomy and thoracoscopic resection for the management of dumbbell-type thoracic cord tumor. SUMMARY OF BACKGROUND DATA: Some posterior mediastinal tumors can be resected safely with video-assisted thoracic surgery. However, there are few reports on thoracoscopic resection of dumbbell and paraspinal tumors of the thoracic spine. methods: Five patients who received treatment for thoracic spine dumbbell tumors and paraspinal tumors were studied retrospectively. Three patients had dumbbell tumors, and two had paraspinal tumors of the thoracic spine. Preoperative evaluation of each patient included plain chest radiography, magnetic resonance imaging, and computed tomography. All patients underwent total resection by means of a combined posteroanterior approach, with thoracoscopic surgery for dumbbell tumors and thoracoscopic surgery alone for paraspinal tumors. In all patients, a gross total resection was achieved with this approach. All patients were observed for a minimum of 3 years. RESULTS: All patients regained their ability to walk 2 days after surgery, except for one patient who had a hemothorax. A gross total tumor resection, documented by magnetic resonance imaging, was performed on all patients. Follow-up imaging at 6 weeks, 1 year, 2 years, and 3 years after surgery did not show residual tumor or recurrence in any patient. To date, spinal instability has not developed in any patient. CONCLUSIONS: Combined laminectomy and thoracoscopic surgery may be a good alternative method for managing thoracic dumbbell tumors.- - - - - - - - - - ranking = 1.5keywords = spinal (Clic here for more details about this article) |
4/42. Spinal ganglioneuroma presenting as a highly vascular lesion with hypertrophic venous drainage.We present the case of a 33-year-old man with a highly vascular spinal ganglioneuroma associated with hypertrophic draining veins mimicking arteriovenous malformation. Ganglioneuromas are classically known as avascular and association with hypertrohic venous drainage has not been previously reported. The magnetic resonance imaging and digital subtraction angiography features of this benign tumor were strongly suspicious for malignancy because of the high vascularity caused by intratumoral arteriovenous shunts. This case emphasizes the importance of including ganglioneuroma in the differential diagnosis of vascular spinal tumors and recalls that hypertrophic draining veins may be associated with spinal tumors.- - - - - - - - - - ranking = 0.75keywords = spinal (Clic here for more details about this article) |
5/42. Gangliocytoma of the spinal cord: a case report.We present a case of intramedullary spinal gangliocytoma in a 7-year-old girl who presented with scoliosis and progressive weakness of both legs. The tumour involved the whole spinal cord and medulla oblongata and was composed of inner cystic and outer solid components. On MRI, the solid portion of the lesion showed strong enhancement at the thoracolumbar level and mild enhancement at the cervical and medullary levels. Histological examination of the surgical specimen showed neoplastic ganglion cells arranged irregularly in benign normocellular glial background, which made a diagnosis of gangliocytoma.- - - - - - - - - - ranking = 1.5keywords = spinal (Clic here for more details about this article) |
6/42. ganglioneuroma masquerading as spinal pain.OBJECTIVE: To discuss the clinical features of ganglioneuroma and to propose it as a differential diagnosis for a young patient suffering from chronic back pain. CLINICAL FEATURES: A 25-year-old patient suffered from chronic mid-thoracic pain and a history of scoliosis. The physical examination result was unremarkable; thus radiographs were obtained. A posteroanterior and lateral chest radiograph demonstrated a well-defined opacity extending from the region of the left hilum to below the diaphragm. A differential diagnosis of a posterior mediastinal mass was advanced. Computed tomography revealed a homogenous, nonenhancing left posterior mediastinal mass with adjacent posterior rib deformity. Computed tomography (CT)-guided biopsy subsequently defined the mass as a ganglioneuroma. INTERVENTION AND OUTCOME: The mass was surgically resected. Although the patient experienced some postsurgical discomfort, she has fared well. CONCLUSION: Twenty percent of mediastinal tumors are neurogenic, and 10% of neurogenic tumors are ganglioneuromas. In spite of the rarity of this tumor, ganglioneuroma should be considered in the differential diagnosis of young patients suffering from back pain. The diagnosis is important to ascertain because surgical resection is curative and can relieve the symptoms.- - - - - - - - - - ranking = 1keywords = spinal (Clic here for more details about this article) |
7/42. Videothoracoscopic resection of intrathoracic neurogenic tumors: report of two cases.Two cases of intrathoracic neurogenic tumors are discussed. The benign neoplasms were located in the posterior mediastinum and caused no clinical symptoms. In both cases, complete resection of the lesion was achieved by video-assisted thoracic surgery (VATS). There were no intraoperative complications. Postoperatively, one patient presented with Claude Bernard-horner syndrome, which resolved spontaneously after 1 week. Although the great majority of mediastinal neurogenic neoplasms are benign, resection is necessary to prevent malignant transformation and intraspinal extension.- - - - - - - - - - ranking = 0.25keywords = spinal (Clic here for more details about this article) |
8/42. Symmetric dumbbell ganglioneuromas of bilateral C2 and C3 roots with intradural extension associated with von Recklinghausen's disease: case report.BACKGROUND: Ganglioneuromas are rare benign tumors arising most commonly from the sympathetic nervous system. They occasionally grow in a dumbbell fashion extending into the spinal canal extradurally. However, ganglioneuromas of the cervical spine with intradural extension or multiple locations or in association with von Recklinghausen's disease are rare. CASE DESCRIPTION: A 35-year-old man with von Recklinghausen's disease presented with tetraparesis and respiratory dysfunction. Preoperative neuroimaging revealed an intradural mass extending from the foramen magnum to the C4 vertebral level, as well as bilateral extravertebral extension connecting it with bilateral paraspinal lesions in a dumbbell fashion. Four intradural tumors associated with the bilateral C2 and C3 nerves and located ventrally were removed, leaving the intraforaminal and extradural portion intact. The procedure resulted in postoperative symptomatic improvement. Second, extravertebral tumors of the left neck, which were not related to the cervical sympathetic nerve, were removed. The pathologic diagnosis of the tumors of both the intradural space and cervical neck was ganglioneuroma. CONCLUSION: We present an extremely rare case in an adult with von Recklinghausen's disease who had bilateral, symmetric and multiple dumbbell ganglioneuromas with intradural extension, and also multiple bilateral ganglioneuromas at the neck. The intradural ganglioneuromas were suspected to have originated from the posterior root ganglions of the bilateral C2 and C3 nerves and to have extended ventrally to the spinal cord involving not only sensory but also motor rootlets; the ganglioneuroma of the neck was suspected to have originated from the cervical nerve itself.- - - - - - - - - - ranking = 0.75keywords = spinal (Clic here for more details about this article) |
9/42. Intradural extramedullary ganglioneuroma: case report and review of the literature.The authors present a unique case of an intradural extramedullary ganglioneuroma in the thoracic spine of an adult. Intraspinal ganglioneuromas are rare, benign tumors of sympathetic nervous tissue origin, but exclusively intradural ganglioneuromas have not been reported.- - - - - - - - - - ranking = 0.25keywords = spinal (Clic here for more details about this article) |
10/42. scoliosis associated with ganglioneuroblastoma: a case report with 17-year follow-up.We describe the case of a 12-year-old boy with scoliosis due to a malignant ganglioneuroblastoma. He had a successful outcome, as was noted by 17-year follow-up of tumor resection and spinal fusion.- - - - - - - - - - ranking = 0.25keywords = spinal (Clic here for more details about this article) |
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