scholarly journals Intradural Disk Herniation Mimicking a Spinal Tumor: Radiologic Imaging, Pathogenesis, and Operative Management

2018 ◽  
Vol 2018 ◽  
pp. 1-6
Author(s):  
Daisuke Tateiwa ◽  
Ryoji Yamasaki ◽  
Rinsei Tei ◽  
Yasushi Shin ◽  
Kenta Ariga ◽  
...  
Keyword(s):  
Imaging Techniques ◽  
Rare Condition ◽  
Spinal Tumor ◽  
Operative Management ◽  
Spinal Tumors ◽  
Dural Defect ◽  
Disk Herniation ◽  
Computed Tomographic ◽  
Surgical Microscope ◽  
Computed Tomographic Myelography

Intradural disk herniation (IDH) is a rare condition, occurring more often at the L4-5 level. We examined a case of an IDH at the L1-2 level mimicking an intradural spinal tumor. A 71-year-old woman with a long history of backache and pain radiating down the left leg was admitted to our hospital with the worsening of these symptoms. Magnetic resonance imaging and computed tomographic myelography demonstrated an intradural mass at the L1-2 level. Given the radiologic findings and the location of the mass, the preoperative differential diagnosis centered on intradural spinal tumors. Dural incision was performed using a surgical microscope to resect the mass. Contrary to our expectation, the diagnosis made during the surgery was IDH. Despite advances in imaging techniques, IDH could not be definitively diagnosed preoperatively. The pathogenesis of IDH remains unclear. In our patient, the ventral dural defect was smooth and round, and the dural tissue around the defect was thickened. These intraoperative findings suggested that the patient’s IDH resulted not from an acute new event but from a chronic process. We recommend dural incision using a surgical microscope for treating IDH because it provides a clear visual field.

Rare cause of subarachnoid hemorrhage: spinal meningeal carcinomatosis

2005 ◽  
Vol 2 (1) ◽  
pp. 79-82 ◽  
Author(s):  
Servet Inci ◽  
Gokhan Bozkurt ◽  
Salih Gulsen ◽  
Pinar Firat ◽  
Tuncalp Ozgen
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Vascular Malformations ◽  
Spinal Metastases ◽  
Rare Condition ◽  
Spinal Tumor ◽  
Meningeal Carcinomatosis ◽  
Spinal Tumors ◽  
Content Type ◽  
Metastatic Spinal Tumor ◽  
Fine Print

✓Subarachnoid hemorrhage (SAH) of spinal origin is a rare entity accounting for approximately 1% of all cases of SAH. Its most frequent causes are trauma and vascular malformations. Although primary spinal tumors, especially ependymomas, are also relatively common causes, SAH secondary to a metastatic spinal tumor arising from outside the central nervous system is an extremely rare condition; only one case has been reported in the literature. The authors present a case of spinal meningeal carcinomatosis secondary to cutaneous malignant melanoma in which the patient presented with only symptoms of SAH. Although very rare, this case underscores several factors. 1) Spinal SAH due to spinal metastases should be considered in the differential diagnosis of patients with previously known malignancy. 2) Spinal SAH may manifest without paraparesis or sensory deficit. 3) Magnetic resonance imaging of the spinal cord may be important to determine the source of SAH in patients in whom four-vessel cerebral angiography demonstrates no abnormal findings.

Chemical Meningitis: Unusual Presentation of a Cerebellar Astrocytoma: Case Report and Review of the Literature

Neurosurgery ◽  
1989 ◽  
Vol 25 (2) ◽  
pp. 264-270 ◽  
Author(s):  
Pierpaolo Lunardi ◽  
Paolo Missori ◽  
Bernardo Fraioli
Keyword(s):  
Case Report ◽  
Signs And Symptoms ◽  
Spinal Tumor ◽  
Spinal Tumors ◽  
Cystic Tumor ◽  
Review Of The Literature ◽  
Cerebellar Astrocytoma ◽  
Computed Tomographic ◽  
Computed Tomographic Scan ◽  
Chemical Meningitis

Abstract Chemical meningitis resulting from the spillage of the contents of a cystic tumor rarely constitutes the sole manifestation of a cranial or spinal tumor. The case of a man who initially had signs and symptoms of meningitis that on computed tomographic scan was shown to be a space-occupying cerebellar lesion is reported. Thirty-five cases of cranial and spinal tumors in which the presenting symptom was chemical meningitis are also reviewed.

Diagnostic workup and endovascular treatment of popliteal artery trauma

VASA ◽  
2019 ◽  
Vol 48 (1) ◽  
pp. 65-71 ◽  
Author(s):  
Cheong J. Lee ◽  
Rory Loo ◽  
Max V. Wohlauer ◽  
Parag J. Patel
Keyword(s):  
Vascular Injury ◽  
Gold Standard ◽  
Imaging Techniques ◽  
Computed Tomographic Angiography ◽  
Vascular Trauma ◽  
Endovascular Techniques ◽  
Computed Tomographic ◽  
Arterial Injuries ◽  
Arterial Trauma ◽  
Peripheral Arterial

Abstract. Although management paradigms for certain arterial trauma, such as aortic injuries, have moved towards an endovascular approach, the application of endovascular techniques for the treatment of peripheral arterial injuries continues to be debated. In the realm of peripheral vascular trauma, popliteal arterial injuries remain a devastating condition with significant rates of limb loss. Expedient management is essential and surgical revascularization has been the gold standard. Initial clinical assessment of vascular injury is aided by readily available imaging techniques such as duplex ultrasonography and high resolution computed tomographic angiography. Conventional catheter based angiography, however, remain the gold standard in the determination of vascular injury. There are limited data examining the outcomes of endovascular techniques to address popliteal arterial injuries. In this review, we examine the imaging modalities and current approaches and data regarding endovascular techniques for the management popliteal arterial trauma.

Customized anterior craniocervical reconstruction via a modified high-cervical retropharyngeal approach following resection of a spinal tumor involving C1–2/C1–3

2020 ◽  
Vol 32 (3) ◽  
pp. 432-440
Author(s):  
Shaohui He ◽  
Chen Ye ◽  
Nanzhe Zhong ◽  
Minglei Yang ◽  
Xinghai Yang ◽  
...  
Keyword(s):  
Cervical Spinal Cord ◽  
Perioperative Complications ◽  
Japanese Orthopaedic Association ◽  
Spinal Tumor ◽  
Spinal Tumors ◽  
Limited Information ◽  
Improvement Rate ◽  
The Mean ◽  
High Cervical ◽  
Occipital Condyles

OBJECTIVEThe surgical treatment of an upper cervical spinal tumor (UCST) at C1–2/C1–3 is challenging due to anterior exposure and reconstruction. Limited information has been published concerning the effective approach and reconstruction for an anterior procedure after C1–2/C1–3 UCST resection. The authors attempted to introduce a novel, customized, anterior craniocervical reconstruction between the occipital condyles and inferior vertebrae through a modified high-cervical retropharyngeal approach (mHCRA) in addressing C1–2/C1–3 spinal tumors.METHODSSeven consecutive patients underwent 2-stage UCST resection with circumferential reconstruction. Posterior decompression and occiput-cervical instrumentation was conducted at the stage 1 operation, and anterior craniocervical reconstruction using a 3D-printed implant was performed between the occipital condyles and inferior vertebrae via an mHCRA. The clinical characteristics, perioperative complications, and radiological outcomes were reviewed, and the rationale for anterior craniocervical reconstruction was also clarified.RESULTSThe mean age of the 7 patients in the study was 47.6 ± 19.0 years (range 12–72 years) when referred to the authors’ center. Six patients (85.7%) had recurrent tumor status, and the interval from primary to recurrence status was 53.0 ± 33.7 months (range 24–105 months). Four patients (57.1%) were diagnosed with a spinal tumor involving C1–3, and 3 patients (42.9%) with a C1–2 tumor. For the anterior procedure, the mean surgical duration and average blood loss were 4.1 ± 0.9 hours (range 3.0–6.0 hours) and 558.3 ± 400.5 ml (range 100–1300 ml), respectively. No severe perioperative complications occurred, except 1 patient with transient dysphagia. The mean pre- and postoperative visual analog scale scores were 8.0 ± 0.8 (range 7–9) and 2.4 ± 0.5 (range 2.0–3.0; p < 0.001), respectively, and the mean improvement rate of cervical spinal cord function was 54.7% ± 13.8% (range 42.9%–83.3%) based on the modified Japanese Orthopaedic Association scale score (p < 0.001). Circumferential instrumentation was in good position and no evidence of disease was found at the mean follow-up of 14.8 months (range 7.3–24.2 months).CONCLUSIONSThe mHCRA provides optimal access to the surgical field at the C0–3 level. Customized anterior craniocervical fixation between the occipital condyles and inferior vertebrae can be feasible and effective in managing anterior reconstruction after UCST resection.

scholarly journals Management of a spontaneous supra-aortic arterial dissection: a case report

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Omar M. Sharaf ◽  
Tomas D. Martin ◽  
Eric I. Jeng
Keyword(s):  
Innominate Artery ◽  
Operative Management ◽  
Computed Tomographic Angiography ◽  
Artery Dissection ◽  
Term Therapy ◽  
Type I ◽  
Computed Tomographic ◽  
Tomographic Angiography ◽  
Aortic Dissections ◽  
Isolated Innominate Artery

Abstract Background Acute DeBakey type I and type II aortic dissections are indications for emergent surgical repair; however, there are currently no standard protocols in the management of isolated supra-aortic dissections. Prompt diagnosis and management of an isolated innominate artery dissection are necessary to prevent distal malperfusion and thromboembolic sequelae. Case presentation A 50-year-old Caucasian gentleman presented with chest pain radiating to his jaw and right arm. He had no recent history of trauma. On physical exam, he was neurologically intact and malignantly hypertensive. Computed tomographic angiography of the chest and neck confirmed a spontaneous isolated innominate artery dissection without ascending aorta involvement. Given the lack of evidence for rupture, distal emboli, and/or end-organ malperfusion, the decision was made for initial non-operative management—anti-impulse regimen, antiplatelet therapy, and close follow-up. Conclusions Medical management of a spontaneous isolated innominate artery dissection is appropriate for short-term and potentially long-term therapy. This not only spares the patient from a potentially unnecessary surgical operation but also provides the surgeon and the patient the time to plan for a surgical approach if it becomes necessary.

scholarly journals An orphan disease: IgG4-related spinal pachymeningitis: report of 2 cases

2016 ◽  
Vol 25 (6) ◽  
pp. 790-794 ◽  
Author(s):  
Bishan D. Radotra ◽  
Ashish Aggarwal ◽  
Ankur Kapoor ◽  
Navneet Singla ◽  
Debajyoti Chatterjee
Keyword(s):  
Plasma Cells ◽  
Treatment Guidelines ◽  
Spinal Tumor ◽  
Spinal Tumors ◽  
Igg4 Related Disease ◽  
Inflammatory Conditions ◽  
Lumbar Level ◽  
Multisystem Involvement ◽  
Spinal Compression ◽  
Storiform Fibrosis

IgG4-related disease is relatively new disease entity and a rare one, and our knowledge of this entity continues to evolve. It was first described in the pancreas and since then has been described in virtually every organ. Spinal involvement resulting in pachymeningitis is rare, and there are only 8 reported cases of the same to date, with the cervicothoracic spine being the most commonly affected region. The authors describe 2 cases in which the patients presented with spinal compression resulting in myeloradiculopathy (Case 1) and radiculopathy (Case 2). Imaging of spine in both cases revealed an ill-defined contrast-enhancing lesion at the lumbar level. Preoperatively, a diagnosis of spinal tumor was made, but intraoperatively no spinal tumor was found. The diagnosis was established histopathologically. The disease has no particular defining features clinically or radiologically and can mimic common spinal tumors. It is important to accurately diagnose this rare entity because of its multisystem involvement and progressive course. Strict treatment guidelines have yet to be formulated. Although histologically this disease can mimic other inflammatory conditions, the presence of storiform fibrosis and an increased number of IgG4-positive plasma cells can help in clarifying the diagnosis.

scholarly journals POS0294 PROFILE OF SPINAL TUMORS IN RHEUMATOLOGY DEPARTMENTS

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 372.2-372
Author(s):  
B. A. Hiba ◽  
H. Sahli ◽  
S. Boussaid ◽  
S. Nouicer ◽  
S. Jemmali ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Signal Intensity ◽  
Spinal Tumor ◽  
Sensory Function ◽  
Spinal Tumors ◽  
Vertebral Compression Fractures ◽  
Myxopapillary Ependymoma ◽  
Resonance Imaging ◽  
Weighted Sequences

Background:Spine tumors remain a hot topic because of their associated morbidity by affecting motor and sensory function. Contrary to metastatic spine disease (MSD), extremely prevalent, rise within or surrounding the spinal cord and/or vertebral column, primary spinal tumors are rare, 5% of all primary skeletal tumors and frequently benign (20%). The diagnostic delay of these tumors, even when benign, is associated with a poor prognosis. Establishing the correct diagnosis is heavily reliant on magnetic resonance imaging and histological confirmation.Objectives:to provide an overview of the epidemiology, radiological and histopathological of spinal tumors diagnosed in a rheumatology department.Methods:A retrospective study consisting of clinical characteristics analysis, laboratory and x-ray examinations, was performed on 40 patients who were hospitalised for a spinal tumor, in a rheumatology department, over 5-year period from 2015 to 2020.Results:A total of 40 patients with a mean age of 66 ± 13.5 years [18-93] and a sex-ratio of 1.1, were included. The most common initial complaints were inflammatory back pain (67.5%) and fatigue (52.5%), with a median duration of 5 months. Physical examination abnormalities included lumbar stiffness (32.5%), radicular signs (18.7%), hepatomegaly (12.5%), and lymphadenopathy (17.5%). Neurological deficit was found in only 3 patients (7.5%). Hypercalcemia (corrected serum calcium > 105 mg/l), and anemia (hemoglobin (Hb) < 100 g/l in female, Hb <110g/l in male) were present initially in respectively 47.5% and 46.3% patients, while biological inflammatory syndrome was present in 89.7% patients (median C-reactive protein of 44.7). Tumor markers were performed in 12 patients and they were positive in 9 of them.Plain radiographs findings were vertebral compression fractures (43.6%), osteolytic lesions (30.8%) and osteoblastic lesions (12.5%). Lumbar spine was the most affected (57.5%), followed by the dorsal spine (45%). Magnetic resonance imaging (MRI) was performed in 55%, and the most common lesion was low signal intensity on T1-weighted sequences and high signal intensity on T2-weighted sequences (68.1%).In our study, only one patient was diagnosed for a myxopapillary ependymoma, a benign primary spinal tumor characterised by a metastatic dissemination risk. For the rest (39 patients), the diagnosis of bone metastasis, multiple myeloma (57.7%), and of solid tumor cancers (40%), were established. Primary cancers were mainly prostate cancer (37.5%), lung cancer (18.7%) and kidney cancer (18.7%). By a median follow-up time of 25 months, overall survival rate was 30%.Conclusion:Extradural lesions are the most common, and are typically metastatic. Special attention should be pain to the patient’s medical history and laboratory abnormalities. In fact, an early diagnosis requires a high index of clinical suspicion.Disclosure of Interests:None declared

scholarly journals Does preoperative transarterial embolization decrease blood loss during spine tumor surgery?

2015 ◽  
Vol 21 (1) ◽  
pp. 129-135 ◽  
Author(s):  
Zhihong Qiao ◽  
Ningyang Jia ◽  
Qian He
Keyword(s):  
Blood Loss ◽  
Transarterial Embolization ◽  
Surgical Excision ◽  
Spinal Tumor ◽  
Gelatin Sponge ◽  
Spinal Tumors ◽  
Control Group ◽  
Time Interval ◽  
Estimated Blood Loss ◽  
Spine Tumor Surgery

This paper aimed to evaluate the effect of preoperative transarterial embolization (TAE) on estimated blood loss (EBL) during surgical excision of the vertebral tumors. Three hundred and forty-eight patients with spinal tumors were retrospectively analyzed. The preoperative TAE group consisted of 190 patients and the control group consisted of 158 patients. Gelatin sponge particles mixed withy contrast agent were used in the TAE group to embolize the tumor-feeding artery. The factors evaluated included: the time interval between embolism and surgery; the number of vertebrae involved by the tumor; pathological type of tumor; surgical approach; extent of excision and instrumental fixation. The time interval (P = 0.4669)between embolism and surgery had no significant correlation with EBL during surgery. The pathological diagnosis of vertebral tumor such as plasma cell myeloma, giant cell tumor, chondrosarcoma, hemangioma and metastasis had no significant correlation with EBL between the TAE group and control group during surgery, while the EBL of chordoma in the TAE group was significantly higher than that in the control group (p = 0.0254). The number of vertebrae involved (p = 0.4669, 0.6804, 0.6677), posterior approach (p = 0.3015), anterior approach (p = 0.2446), partial excision (p = 0.1911) and instrumental fixation (p = 0.1789) had no significant correlation with EBL during surgery between the TAE group and the control group. This study showed that preoperative TAE of the spinal tumor had no significant effect on intra-operative blood loss during surgical excision of the spinal tumor. In view of the risk of embolism, this method should be carefully considered.

scholarly journals A case of retroperitoneal tumor – clinical and therapeutic considerations

2016 ◽  
Vol 22 (3) ◽  
pp. 203-207
Author(s):  
R. Osman ◽  
V. Sarbu ◽  
S. Osman
Keyword(s):  
Rare Condition ◽  
Surgical Excision ◽  
Retroperitoneal Tumor ◽  
Lumbar Pain ◽  
Pathological Examination ◽  
Nerve Sheath Tumor ◽  
Abdominal Girth ◽  
Computed Tomographic ◽  
Appropriate Treatment ◽  
History Of

Abstract Introduction: The aim of this paper is to present a case of rare retroperitoneal tumor. Material and Methods. A 72 year old man presented with six month history of abdominal girth, lumbar pain and occasional episodes of constipation was admitted in our clinic. A computed tomographic abdominal scan revealed a retroperitoneal solid mass. Surgical exploration performed later displayed solid and well delimited mass throughout retroperitoneal space followed by excision of lesion and multiple drainages. Microscopic pathological examination was benign nerve sheath tumor. Conclusion. These tumors are characteristically firm, smooth, and asymptomatic. They range in size from 1-2 mm to over 20 cm. Awareness of this indolent and rare condition is an important prerequisite for early diagnosis and appropriate treatment. Surgical excision can usually be accomplished by enucleating of the tumor without damage to the adjacent nerve.

Sign in / Sign up

Export Citation Format

Share Document