1/229. Increased intracranial pressure associated with spinal cord tumours.Two cases of spinal cord tumour associated with increased intracranial pressure are reported and the 44 cases described in the literature are reviewed. The different hypotheses produced to explain the pathogenic mechanism of this syndrome are discussed. We think that several factors working together, rather than an isolated mechanism, take part in the production of this syndrome.- - - - - - - - - - ranking = 1keywords = tumour (Clic here for more details about this article) |
2/229. Paragangliomas of the spinal canal.We report the clinical MRI and histopathological features of five consecutive cases of spinal paraganglioma. Three intradural tumours were found in the typical location (two at the L4, one at the S2 level); one intradural extramedullary tumour arose at an unusual level, from the ventral C2 root, and one extradural tumour growing along the L5 nerve root sheath had an aggressive growth pattern with early, local paraspinal recurrence and, eventually, intradural metastatic spread. This type of growth pattern has not been described previously. Paragangliomas of the spinal canal are more common than previously thought and can be located anywhere along the spine, although the lumbosacral level is the most common. Their appearance on MRI can not distinguish them from other tumours in the spinal canal. Even though paragangliomas in general are benign and slowly growing their growth pattern can vary and be more aggressive, to the point of metastatic spread.- - - - - - - - - - ranking = 0.8keywords = tumour (Clic here for more details about this article) |
3/229. 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.- - - - - - - - - - ranking = 0.4keywords = tumour (Clic here for more details about this article) |
4/229. Spinal lesions, paraplegia and the surgeon.Thirty-six patients with spinal cord lesions and varying degrees of paraplegia were seen by the surgical team at the Angau Memorial Hospital, Lae, over a thirty month period. Because the continued presence of a spinal lesion may lead to progressive cord destruction and ischaemic myelopathy, prompt treatment is advocated. The depressing results that have followed treatment of fracture dislocations of the cervical spine and secondary neoplasm with paraplegia is recorded and some suggestions are made that may improve the outlook in future cases. Early and major surgery is advocated in the treatment of spinal abscesses, tumours, Pott's paraplegia and unstable fracture dislocations of the lumbar spine.- - - - - - - - - - ranking = 0.2keywords = tumour (Clic here for more details about this article) |
5/229. Isolated eccentric syrinx of the conus medullaris simulating a tumour.There are many reasons for the formation of cavities in the spinal cord. A focal cavitation is distinguished from syringomyclia by the absence of an ependymal lining in the former as opposed to the latter. The authors report a case of an isolated eccentrically placed syringomyelia of the conus medullaris, which caused a cauda equina syndrome and resembled a tumour on MRI.- - - - - - - - - - ranking = 1keywords = tumour (Clic here for more details about this article) |
6/229. Angiotropic large B-cell lymphoma with clinical features resembling subacute combined degeneration of the cord.Angiotropic large cell lymphoma is a rare neoplastic disorder associated with a high mortality. The hallmark of the disease is lymphoid proliferation confined to the intravascular compartment without local tissue or vessel wall infiltration [1]. This feature is so striking that the disease was originally thought to arise from endothelial tissue and early cases were described as malignant angioendotheliomatosis. However, application of immunohistochemical methods for detection of lymphoid markers such as the CD45 and CD20 cell surface markers has confirmed its lymphoid origin, usually of B-cell lineage [2]. Clinical manifestations of the disease are protean and are due to multifocal medium and small vessel occlusion by tumour cells [3]. Characteristic sites of involvement are skin and central nervous system and although an ante-mortem diagnosis can be made from a biopsy specimen, it is often unsuspected [4]. We present a case of angiotropic large B-cell lymphoma in a 74-year-old man who presented with urinary symptoms and had a neurological picture resembling subacute combined degeneration of the cord.- - - - - - - - - - ranking = 0.2keywords = tumour (Clic here for more details about this article) |
7/229. An arachnoid cyst presenting as an intramedullary tumour.A case of thoracic intradural extramedullary arachnoid cyst is presented in which an intramedullary low grade glioma was suspected preoperatively. The cyst was widely fenestrated and postoperatively, the patient experienced considerable improvement in her symptoms. As postoperative MRI studies also showed resolution of the intramedullary changes we regard the intramedullary changes as a result of the cyst, without the existence of primary medullary pathology. To our knowledge an arachnoid cyst, to date, has not been described as the cause of syringomyelia. As radiological findings can be misleading, extramedullary pathology, located more cranially, should be ruled out when treating cystic medullary changes.- - - - - - - - - - ranking = 0.8keywords = tumour (Clic here for more details about this article) |
8/229. Late intramedullary spinal cord metastasis in a patient with lymphoblastic lymphoma: case report.Late intramedullary spinal cord metastasis of lymphoblastic lymphoma (LBL) is unreported in the literature. The central nervous system (CNS) sites of metastasis previously documented include the spinal leptomeninges causing epidural spinal cord compression or brain praenchymal sites within a year of primary diagnosis. This report represents the first case of intramedullary spinal cord LBL as a late recurrence. The method consists of a case study of one patient with retrospective analysis of tumour tissues from biopsies at ages 5, 9 and 26. The results show that late spinal cord recurrence was microneurosurgically subtotally debulked and later treated with radiotherapy with improvement in neurological deficit. Investigations revealed no evidence of systemic disease and this recurrence appears to be an isolated sanctuary site tumour. A medline search (1966 - present) of the literature failed to reveal similar reported cases and the authors believe this to be the first late intramedullary spinal cord metastasis in a patient with LBL.- - - - - - - - - - ranking = 0.4keywords = tumour (Clic here for more details about this article) |
9/229. Spinal cord gliomas: management and outcome with reference to adjuvant therapy.The authors review their experience with 19 consecutive cases with either astrocytic tumour (glioblastoma multiforme one, anaplastic astrocytoma one, astrocytoma 4, pilocytic astrocytoma 4) or ependymoma (10 tumours in 9 patients) of the spinal cord who were treated during the period from 1982 to 1996. The patients included 10 male and 9 female patients with a median age of 38 years. The main tumour locations included the cervicomedullary region 5 the cervical cord (8), the thoracic cord (5) and one each in the thoracolumbar region and conus medullaris. While a total removal of the tumour was achieved in 8 out of 10 ependymomas, the initial treatment for astrocytic tumours was a partial resection in 5, and biopsy in the remaining 5. As adjuvant treatment, 8 patients received radiation therapy and 2 received chemotherapy. Two patients with an astrocytic tumour received chemotherapy only, while the remaining 9 received neither radiation therapy nor chemotherapy initially. After these treatments, 6 out of the 8 patients with low grade astrocytoma have remained alive for 1.3-12.6 years, while 2 patients with high grade astrocytic tumours died within 15 months following surgery. Eight out of 9 patients with an ependymoma have remained alive for 3.0-12.3 years, while one committed suicide 2 years after surgery. As a result, 14 patients are still alive; half of them are accompanied by a mild neurological dysfunction, while the remaining one has a moderate deficit. The postoperative results and the rationale for surgery is discussed, and an approach for utilising adjuvant therapy for high grade tumours is also suggested.- - - - - - - - - - ranking = 1.6keywords = tumour (Clic here for more details about this article) |
10/229. Malignant spread of haemangioblastoma: report on two cases.Two cases are described in which, after successful removal of a cerebellar haemangioblastoma followed by several years of freedom from symptoms, there developed a progressive spinal cord compression, leading to death. At necropsy the spinal cords in both cases and the brainstem in one case, were irregularly plastered with haemangioblastoma. Although there was no doubt that malignant spread had occurred from one or more primary tumours, the histology of the tumour tissue was in no way different from that of conventional haemangioblastoma.- - - - - - - - - - ranking = 0.4keywords = tumour (Clic here for more details about this article) |
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