11/325. Congenital intramedullary tumor with neonatal manifestations.The authors report on a 45-day-old boy with a congenital intramedullary tumor with clinical manifestations since birth. neurologic examination disclosed severe bilateral lower-limb hypotonia and diplegia, with exacerbated deep tendon reflexes and clonus associated with severe pain at manipulation. Further evaluation of this patient included screening for infections, computed tomographic scan, myelography, and somatosensory evoked potentials. The definite diagnosis was a solid holocord astrocytoma. This report discusses a rare disorder in the neonatal period and makes other medical practitioners aware of this diagnosis. Previously published literature is also reviewed.- - - - - - - - - - ranking = 1keywords = pain (Clic here for more details about this article) |
12/325. Granulocytic sarcoma of the spine.OBJECTIVE: Granulocytic sarcomas (chloromas) are tumors consisting of primitive myeloid cells. They are rare manifestations of acute and chronic leukemias and can occasionally precede the development of systemic disease by weeks to years. Spinal complications of chloromas, such as cord compression secondary to epidural tumor or cauda equina syndrome, have been described but are uncommon. methods: We present eight new cases of spinal chloroma. Three patients displayed significant motor deficit in the form of paraparesis or paraplegia. All patients complained of lower back pain, with other complaints including generalized pain, abdominal pain, numbness and pain in the lower extremities and perianal region, and poor appetite. The average age of the patients was 37 years. Treatment strategies included surgery, chemotherapy, and radiotherapy. Three patients underwent surgical decompression. Six patients received chemotherapy, and six patients received radiotherapy at doses of 2000 to 3000 cGy in up to 30 fractions. RESULTS: Patient survival ranged from 18 days to 9.5 years after diagnosis. A review of the previously reported cases of granulocytic sarcoma in addition to our new cases reveals that the most effective treatment is multimodality therapy coupled with early diagnosis. CONCLUSION: Increased awareness of this entity will facilitate early diagnosis and minimize potentially preventable neurological morbidity.- - - - - - - - - - ranking = 17.670997040092keywords = back pain, pain, back, abdominal pain (Clic here for more details about this article) |
13/325. Dermal sinus with dermoid cyst in the upper cervical spine: case note.We describe a 5 year-old girl who had a skin dimple of the back of her upper neck. MRI showed a dermal sinus tract in the upper cervical spine, associated with an intramedullary dermoid cyst at C 2-3, and spina bifida. A laminectomy was performed, the dermoid cyst and the sinus tract were completely removed. This congenital complex is very rare.- - - - - - - - - - ranking = 1.2564724723882keywords = back, upper (Clic here for more details about this article) |
14/325. Metastatic spinal intramedullary germinoma with elevated cerebrospinal fluid chorionic gonadotropin: a case report.We treated a patient whose unusual recurrent germinoma illustrates the diagnostic value of measuring human chorionic gonadotropin beta subunit (HCG-beta) in cerebrospinal fluid (CSF) and serum. A 25-year-old man with a suprasellar germinoma and ventricular dissemination was treated successfully with systemic chemotherapy and cranial irradiation. Six years later he developed progressive numbness and weakness in both upper extremities. magnetic resonance imaging (MRI) disclosed an intramedullary spinal cord tumor in the cervical region. The CSF concentration of HCG-beta was elevated and exceeded that in serum. After completion of systemic chemotherapy and spinal irradiation, symptoms subsided and the tumor was no longer evident on MRI. Based on the patient's history and the rapid response of the tumor to treatment, the spinal cord tumor was considered a metastatic intramedullary spinal germinoma representing CSF dissemination via the central canal.- - - - - - - - - - ranking = 0.082898208156814keywords = upper (Clic here for more details about this article) |
15/325. Pain-relieving posterior rod fixation with segmental sublaminar wiring for Pancoast tumor invading the vertebrae.We describe the case of a 44-year-old male patient with Pancoast lung cancer invading the vertebrae. Because irradiation did not relieve his symptoms, we conducted tumor resection with posterior rod fixation with segmental sublaminar wiring of the vertebrae. This enabled the patient to walk and to discontinue morphine immediately after surgery. Although the tumor recurred within the region of the fixation 4 months after surgery, the patient complained of no pain until his death. Although Pancoast lung cancer with extensive vertebral invasion cannot be cured surgically, posterior rod fixation with segmental sublaminar wiring with tumor resection can improve a patient's quality of life by providing immediate, long-term pain relief.- - - - - - - - - - ranking = 2keywords = pain (Clic here for more details about this article) |
16/325. Paroxysmal atrial fibrillation and insidious neck pain.Paroxysmal atrial fibrillation (AF) is an arrhythmia usually secondary to autonomic imbalance, and it may occur in the absence of any structural heart disease. The case of a patient with paroxysmal AF, in whom the arrhythmia may have been a presenting symptom of a later diagnosed cervical schwannoma, is reported.- - - - - - - - - - ranking = 4keywords = pain (Clic here for more details about this article) |
17/325. Solitary fibrous tumor of the thoracic spine. Case report and review of the literature.Solitary fibrous tumor (SFT) is a neoplasm first described as a tumor of mesenchymal origin involving soft tissues. The authors provide a review of the literature with detailed pathological analysis and radiological description of SFTs involving the central nervous system. The authors report a rare case of a SFT of the thoracic spine in an adult man presenting with myelopathy. magnetic resonance imaging revealed a well-circumscribed, intradural, extramedullary mass at the T2-3 level. Histological examination demonstrated a proliferation of predominantly spindle-shaped cells with a collagen-matrix background. Immunohistochemical staining was positive for vimentin and CD34 and negative for S-100 and epithelial membrane antigen with an MIB-1 labeling index of 2.6%. review of the literature revealed 10 cases in which this tumor, frequently found in the pleura, was involved in the central nervous system. Although rare and their clinical significance as yet unknown, SFTs may be considered in the differential diagnosis of intradural spinal cord lesions. The natural history is also unknown, but these tumors appear to be biologically benign.- - - - - - - - - - ranking = 0.75908322344733keywords = back (Clic here for more details about this article) |
18/325. Neurocutaneous vascular hamartomas mimicking Cobb syndrome. Case report.The authors report the rare case of a patient with neurocutaneous vascular hamartomas mimicking Cobb syndrome. An 8-year-old boy was admitted to the authors' hospital with progressive urinary disturbance and upper back pain. Multiple skin nevi had been noted at the child's birth. Radiological examination revealed multiple cavernous angiomas in the spinal cord in the same metamere in which the skin nevi had been observed and also in the left cerebral hemisphere. His symptoms gradually improved without surgical intervention. Four years later he was readmitted because of a cerebral hemorrhage involving the left cerebral peduncle. Nonsurgical treatment was chosen because his symptoms promptly improved. To the best of the authors' knowledge, this is the first case of multiple cavernous angiomas in the brain and spinal cord associated with skin nevi. The authors discuss this clinical entity and the significance of the disease.- - - - - - - - - - ranking = 14.646122590691keywords = back pain, pain, back, upper (Clic here for more details about this article) |
19/325. Fine-needle aspiration diagnosis of psammomatous melanotic schwannoma.A 51-yr-old male presented with an 8-mo history of lower back pain. Computerized axial tomography (CT) and magnetic resonance imaging (MRI) studies showed a 3.5 X 3.0 cm sacral mass within the spinal canal in the region of the left S2 nerve root. A fine-needle aspirate biopsy (FNAB) was performed under CT guidance. The cytologic findings included a spindle-cell population with a fibrillary background arranged in a vaguely streaming pattern, wavy nuclei with mild atypia, wispy cytoplasm, rare intranuclear inclusions, and dilated vascular spaces. Some cells contained a nonrefractile granular brown pigment consistent with melanin. Also identified were calcified concentric laminations typical of psammoma bodies. Immunohistochemically, the neoplastic cells were strongly immunoreactive for S-100 protein and HMB-45. A diagnosis of psammomatous melanotic schwannoma was rendered. No stigmata of Carney's complex were identified on physical examination. The patient has declined the recommendation of surgical excision of the mass. We herein describe a case unequivocally diagnosed as psammomatous melanotic schwannoma by FNAB.- - - - - - - - - - ranking = 15.322307605982keywords = back pain, pain, back (Clic here for more details about this article) |
20/325. Recurrent lumbar ependymoma presenting as headache and communicating hydrocephalus.We describe a patient with a recurrent spinal cord ependymoma who initially presented with symptoms of increased intracranial pressure rather than symptoms directly relating to involvement of the conus medullaris. brain magnetic resonance imaging with gadolinium showed communicating hydrocephalus. magnetic resonance imaging of the entire spinal cord with gadolinium revealed recurrent tumor. Postoperatively, a permanent ventriculoperitoneal shunt was placed. Recognition of the association between spinal cord ependymoma and hydrocephalus is important in the evaluation of patients with headache.- - - - - - - - - - ranking = 0.53285649823715keywords = headache (Clic here for more details about this article) |
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