Supratentorial Glioblastoma With Spinal Cord Intramedullary Metastasis

ABSTRACT:A patient presented with myelopathy due to intramedullary thoracic spinal cord glioblastoma 10 months after treatment for a supratentorial glioblastoma. There was no supratentorial recurrence, and no evidence of gross leptomeningeal dissemination documented by CSF cytology, complete myelography, and MR1 imaging. Gross examination of the spinal cord and arachnoid at the time of exploratory thoracic spinal surgery was normal. However, histological review of thoracic arachnoid demonstrated microscopic deposits of glial fibrillary acidic protein (GFAP) positive tumour consistent with malignant astrocytoma. Intramedullary spinal cord metastasis of cerebral glioblastoma rarely occurs, but may develop in association with leptomeningeal tumour dissemination. As local control of primary tumours improves, distant metastasis is likely to become a more common clinical problem. Leptomeningeal gliomato-sis may be very difficult to document, even when clinically suspected and GFAP staining of a biopsy of arachnoid tissue can play an important role in confirming the diagnosis. This information can be critical to establish prognosis and develop an appropriate treatment strategy.

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Growth of Intramedullary Spinal Cord Dermoid Cyst from a Congenital Thoracic Dermal Sinus Tract after Negative Screening Ultrasound Imaging

Pediatric Neurosurgery ◽

10.1159/000512580 ◽

2021 ◽

pp. 1-6

Author(s):

Liam G. Coulthard ◽

Craig Robert Vonhoff ◽

Ahmad M. Badran ◽

Thomas E. Robertson ◽

Martin J. Wood

Keyword(s):

Spinal Cord ◽

Dermoid Cyst ◽

English Literature ◽

False Negative ◽

Dermal Sinus ◽

Thoracic Spinal Cord ◽

Intramedullary Spinal Cord ◽

First Case ◽

Thoracic Spinal ◽

Screening Ultrasound

Introduction: Intramedullary thoracic dermoid cysts are rare lesions that are associated with dermal sinus tracts (DSTs). Current recommendations advocate for imaging-based screening of suspected DSTs shortly after birth to exclude associated inclusion lesions. Case Presentation: A 6-year-old male child presented with a 2-week history of progressive ataxia, lower limb weakness, and hyperreflexia. He was suspected to have a thoracic DST at birth, though initial screening ultrasound was negative for an inclusion lesion or intradural tract. On representation, MRI demonstrated a 3.9-cm intramedullary thoracic dermoid cyst causing significant spinal cord compression. Intraoperatively, a DST extending intradurally was found. The associated dermoid cyst was removed via intracapsular resection. Conclusions: Whilst dermoid cysts are presumed to progressively develop from DSTs, to our knowledge, this is the first case in English literature documenting a thoracic spinal cord intramedullary dermoid cyst following a negative screening ultrasound for a suspected DST. We use this case to highlight the false-negative rates associated with postnatal screening and advocate for early neurosurgical referral of suspected DSTs, regardless of imaging findings.

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Microsurgical resection of intramedullary spinal cord hemangioblastoma

Neurosurgical FOCUS ◽

10.3171/2014.v3.focus14306 ◽

2014 ◽

Vol 37 (v2supplement) ◽

pp. Video10 ◽

Cited By ~ 1

Author(s):

Paul C. McCormick

Keyword(s):

Spinal Cord ◽

Spinal Cord Tumors ◽

Pia Mater ◽

Thoracic Spinal Cord ◽

Intramedullary Spinal Cord ◽

Glial Tumors ◽

Tumor Margin ◽

Thoracic Spinal ◽

Microsurgical Techniques ◽

Microsurgical Resection

Spinal cord hemangioblastomas account for about 10% of spinal cord tumors. They usually arise from the dorsolateral pia mater and are characterized by their significant vascularity. The principles and techniques of safe resection are different than those employed for the more commonly occurring intramedullary glial tumors (e.g. ependymoma, astrocytoma) and consist of circumferential detachment of the tumor margin from the surrounding normal pia. This video demonstrates the microsurgical techniques of resection of a thoracic spinal cord hemangioblastoma.The video can be found here: http://youtu.be/yT5KLi4VyAo.

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Leptomeningeal spread of intramedullary spinal cord tumors

Journal of Neurosurgery ◽

10.3171/jns.1988.69.2.0295 ◽

1988 ◽

Vol 69 (2) ◽

pp. 295-300 ◽

Cited By ~ 43

Author(s):

William O. Bell ◽

Roger J. Packer ◽

Kathy R. Seigel ◽

Lucy B. Rorke ◽

Leslie N. Sutton ◽

...

Keyword(s):

Spinal Cord ◽

Recent Literature ◽

Cervical Spinal Cord ◽

Spinal Cord Tumors ◽

Thoracic Spinal Cord ◽

Intramedullary Spinal Cord ◽

Content Type ◽

Leptomeningeal Spread ◽

The Past ◽

Thoracic Spinal

✓ Three patients with intramedullary spinal cord tumors and secondary leptomeningeal spread of their tumors are presented. Two patients had astrocytomas and one had a ganglioglioma. Two tumors were located in the cervical spinal cord and one within the thoracic spinal cord. Review of the past and recent literature shows leptomeningeal dissemination of spinal cord tumors to be relatively rare, but it should be suspected and investigated in any patient whose condition deteriorates following removal of a spinal cord neoplasm.

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Nondysraphic pediatric intramedullary spinal cord lipomas

Journal of Neurosurgery Pediatrics ◽

10.3171/2009.9.peds09238 ◽

2010 ◽

Vol 5 (2) ◽

pp. 172-178 ◽

Cited By ~ 10

Author(s):

Karen L. Fleming ◽

Laurence Davidson ◽

Ignacio Gonzalez-Gomez ◽

J. Gordon McComb

Keyword(s):

Spinal Cord ◽

Los Angeles ◽

Retrospective Chart Review ◽

Thoracic Spinal Cord ◽

Intramedullary Spinal Cord ◽

Institutional Review ◽

Thoracic Spinal ◽

Stabilization Procedure

Object Intramedullary spinal cord lipomas not associated with dysraphism are infrequently reported. When present, they typically occur in children and have a predilection for the cervical and thoracic spinal cord. The authors review the presentation, treatment, and disease course in 5 pediatric patients, and compare the outcomes with previously reported cases. Methods With institutional review board approval, a retrospective chart review was undertaken at Childrens Hospital Los Angeles. Results Four patients with intramedullary spinal cord lipomas and 1 patient with a lipoblastoma, none associated with dysraphism, were retrospectively reviewed. There were 2 boys and 3 girls ranging in age from 2 months to 4 years. Four patients underwent a laminectomy or laminoplasty with one or more subtotal resections. One patient initially underwent a decompressive laminoplasty without debulking. The median follow-up was 8 years (range 12 months–11 years). Two patients had regrowth of their lipoma, necessitating a second surgery in one patient and 3 debulking surgeries in the other. Postoperatively, 3 patients developed mild kyphosis, none significant enough to require orthopedic intervention. One patient underwent a stabilization procedure at the time of the initial laminectomy and tumor debulking. No patient received chemotherapy or radiation. At the most recent follow-up visit, patients demonstrated improved neurological function when compared with preoperative status. Conclusions In addition to a decompressive laminectomy, debulking of the lipoma provides the best long-term neurological outcome. Gross-total excision is not warranted and usually is not possible. Long-term follow-up is needed, and repeat debulking of the lipoma is indicated if there is an increase in tumor size due to hyperplasia of residual adipocytes, when tumor growth is associated with neurological deterioration.

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Intramedullary spinal cord ganglioglioma presenting as hyperhidrosis: unique symptoms and magnetic resonance imaging findings

Journal of Neurosurgery Spine ◽

10.3171/2012.11.spine12530 ◽

2013 ◽

Vol 18 (2) ◽

pp. 184-188 ◽

Cited By ~ 5

Author(s):

Tomohiro Murakami ◽

Izumi Koyanagi ◽

Takahisa Kaneko ◽

Akihiro Yoneta ◽

Yoshiko Keira ◽

...

Keyword(s):

Magnetic Resonance Imaging ◽

Spinal Cord ◽

Magnetic Resonance ◽

Lower Extremity ◽

Initial Symptom ◽

Resonance Imaging ◽

Thoracic Spinal Cord ◽

Intramedullary Spinal Cord ◽

Thoracic Spinal ◽

The Right

Hyperhidrosis is caused by a sympathetic dysfunction of the central or peripheral nervous system. Intramedullary spinal cord lesions can be a cause of hyperhidrosis. The authors report a rare case of intramedullary thoracic spinal cord ganglioglioma presenting as hyperhidrosis. This 16-year-old boy presented with abnormal sweating on the right side of the neck, chest, and the right arm that had been occurring for 6 years. Neurological examination revealed mild motor weakness of the right lower extremity and slightly decreased sensation in the left lower extremity. Hyperhidrosis was observed in the right C3–T8 dermatomes. Magnetic resonance imaging showed an intramedullary tumor at the right side of the spinal cord at the T2–3 level. The tumor showed partial enhancement after Gd administration. The patient underwent removal of the tumor via hemilaminectomy of T2–3. Only subtotal resection was achieved because the margins of the tumor were unclear. Histopathological examination revealed ganglioglioma. Hyperhidrosis gradually improved after surgery. Hyperhidrosis is a rare clinical manifestation of intramedullary spinal cord tumors, and only a few cases have been reported in the literature. The location of the tumor origin, around the right gray matter of the lateral spinal cord, may account for the hyperhidrosis as the initial symptom in this patient. Physicians should examine the spinal cord using MRI studies when a patient has hyperhidrosis with some motor or sensory symptoms of the extremities.

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Spontaneous Herniation of the Thoracic Spinal Cord: A Case Report

Journal of the Korean Radiological Society ◽

10.3348/jkrs.2001.45.4.353 ◽

2001 ◽

Vol 45 (4) ◽

pp. 353 ◽

Cited By ~ 1

Author(s):

Sung Chan Jin ◽

Seoung Ro Lee ◽

Dong Woo Park ◽

Kyung Bin Joo

Keyword(s):

Spinal Cord ◽

Case Report ◽

Thoracic Spinal Cord ◽

Thoracic Spinal ◽

Spontaneous Herniation

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Lipomeningocele associated with diplomyelia in a dog

Tierärztliche Praxis Ausgabe K Kleintiere / Heimtiere ◽

10.15654/tpk-170751 ◽

2018 ◽

Vol 46 (05) ◽

pp. 323-329 ◽

Cited By ~ 2

Author(s):

Nele Ondreka ◽

Sara Malberg ◽

Emma Laws ◽

Martin Schmidt ◽

Sabine Schulze

Keyword(s):

Spinal Cord ◽

Neurological Status ◽

Split Cord Malformation ◽

Lumbar Spinal Cord ◽

Histopathological Diagnosis ◽

Type I ◽

Thoracic Spinal Cord ◽

Thoracic Spinal ◽

Subcutaneous Mass ◽

Lumbar Spinal

SummaryA 2-year-old male neutered mixed breed dog with a body weight of 30 kg was presented for evaluation of a soft subcutaneous mass on the dorsal midline at the level of the caudal thoracic spine. A further clinical sign was intermittent pain on palpation of the area of the subcutaneous mass. The owner also described a prolonged phase of urination with repeated interruption and re-initiation of voiding. The findings of the neurological examination were consistent with a lesion localization between the 3rd thoracic and 3rd lumbar spinal cord segments. Magnetic resonance imaging revealed a spina bifida with a lipomeningocele and diplomyelia (split cord malformation type I) at the level of thoracic vertebra 11 and 12 and secondary syringomyelia above the aforementioned defects in the caudal thoracic spinal cord. Surgical resection of the lipomeningocele via a hemilaminectomy was performed. After initial deterioration of the neurological status postsurgery with paraplegia and absent deep pain sensation the dog improved within 2 weeks to non-ambulatory paraparesis with voluntary urination. Six weeks postoperatively the dog was ambulatory, according to the owner. Two years after surgery the owner recorded that the dog showed a normal gait, a normal urination and no pain. Histopathological diagnosis of the biopsied material revealed a lipomeningocele which confirmed the radiological diagnosis.

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Effect of thoracic spinal cord injury on forelimb somatosensory evoked potential

Brain Research Bulletin ◽

10.1016/j.brainresbull.2021.05.005 ◽

2021 ◽

Author(s):

Angelo H. All ◽

Shiyu Luo ◽

Xiaogang Liu ◽

Hasan Al-Nashash

Keyword(s):

Spinal Cord ◽

Spinal Cord Injury ◽

Evoked Potential ◽

Somatosensory Evoked Potential ◽

Thoracic Spinal Cord ◽

Thoracic Spinal ◽

Cord Injury

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The Histopathology of Severe Graded Compression in Lower Thoracic Spinal Cord Segment of Rat, Evaluated at Late Post-injury Phase

Cellular and Molecular Neurobiology ◽

10.1007/s10571-021-01139-7 ◽

2021 ◽

Author(s):

Fedorova Jana ◽

Kellerova Erika ◽

Bimbova Katarina ◽

Pavel Jaroslav

Keyword(s):

Spinal Cord ◽

Spontaneous Recovery ◽

Traumatic Injury ◽

Blue Dye ◽

Post Injury ◽

Thoracic Spinal Cord ◽

Thoracic Spinal ◽

Severe Traumatic Injury ◽

Spinal Cord Segment ◽

Cord Injury

AbstractSpontaneous recovery of lost motor functions is relative fast in rodent models after inducing a very mild/moderate spinal cord injury (SCI), and this may complicate a reliable evaluation of the effectiveness of potential therapy. Therefore, a severe graded (30 g, 40 g and 50 g) weight-compression SCI at the Th9 spinal segment, involving an acute mechanical impact followed by 15 min of persistent compression, was studied in adult female Wistar rats. Functional parameters, such as spontaneous recovery of motor hind limb and bladder emptying function, and the presence of hematuria were evaluated within 28 days of the post-traumatic period. The disruption of the blood-spinal cord barrier, measured by extravasated Evans Blue dye, was examined 24 h after the SCI, when maximum permeability occurs. At the end of the survival period, the degradation of gray and white matter associated with the formation of cystic cavities, and quantitative changes of glial structural proteins, such as GFAP, and integral components of axonal architecture, such as neurofilaments and myelin basic protein, were evaluated in the lesioned area of the spinal cord. Based on these functional and histological parameters, and taking the animal’s welfare into account, the 40 g weight can be considered as an upper limit for severe traumatic injury in this compression model.

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