Malignant Carcinoid Causing Spinal Cord Compression

Neurosurgery ◽  
1985 ◽  
Vol 17 (5) ◽  
pp. 801-806 ◽  
Author(s):  
Gerald T. Gowitt ◽  
Suzanne S. Mirra
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Compression ◽  
Neurological Complications ◽  
Cord Compression ◽  
Electron Microscopic ◽  
Thoracic Epidural ◽  
Malignant Carcinoid ◽  
Microscopic Demonstration ◽  
Plasma Serotonin ◽  
Electron Microscopic Demonstration

Abstract Neurological complications of malignant carcinoid are infrequent, Only 11 cases of central nervous system metastasis are documented, and neurological symptoms may be the initial or only manifestation of this tumor. We describe the case of a 60-year-old man with no known primary tumor who presented with spinal cord compression by a thoracic epidural tumor. After laminectomy, the diagnosis of carcinoid was made by light and electron microscopic demonstration of neurosecretory granules in tumor cells. Urine 5-hydroxyindole acetic acid and plasma serotonin levels were subsequently found to be elevated. Carcinoid tumors should be considered in the differential diagnosis of lesions metastatic to the spinal cord and brain.

scholarly journals Electron microscopic demonstration of neural connections using horseradish peroxidase: a comparison of the tetramethylbenzidine procedure with seven other histochemical methods.

1982 ◽  
Vol 30 (5) ◽  
pp. 425-435 ◽  
Author(s):  
K A Carson ◽  
M M Mesulam
Keyword(s):  
Electron Microscopy ◽  
Spinal Cord ◽  
Motor Neurons ◽  
Lumbar Spinal Cord ◽  
Reaction Products ◽  
Electron Microscopic ◽  
Anterograde Transport ◽  
Microscopic Demonstration ◽  
Lumbar Spinal ◽  
Electron Microscopic Demonstration

Eight methods for the electron microscopic demonstration of horseradish peroxidase (HRP) labeling have been compared in adjacent series of vibratome sections of mouse lumbar spinal cord. The tracer, a HRP-wheat germ agglutinin (WGA) conjugate, was injected into the gastrocnemius muscle complex. Following retrograde axonal transport to the lumbar motor neurons and transganglionic anterograde transport of the tracer to the dorsal horn, the HRP activity was demonstrated in eight series of adjacent sections of lumbar spinal cord using eight methods. These included procedures using tetramethylbenzidine (TMB), benzidine dihydrochloride (BDHC), o-tolidine, paraphenylenediamine-pyrocatechol (PPD-PC), and 4 methods using 3,3'-diaminobenzidine (DAB). All eight methods were able to demonstrate both retrograde labeling of motor neurons and transganglionic anterograde transport into the dorsal horn. However, there were differences in the appearance of the various reaction products under the electron microscope. In addition, differences in the distribution of the reaction products were observed by both light and electron microscopy. The largest distribution of reaction product was observed with TMB. BDHC and o-tolidine were next, followed by the DAB procedures and PPD-PC. The TMB, BDHC, and o-tolidine reaction products were all found to be suitable for electron microscopy. The TMB reaction product was electron dense and had a very distinctive crystalloid appearance that made identification of HRP-labeled neuronal profiles easy and unequivocal.

Spinal Cord Involvement in Heritable Skeletal Dysplasias

1974 ◽  
Vol 23 (S1) ◽  
pp. 181-186
Author(s):  
A.B. Todorov ◽  
S.E. Kopits ◽  
G.B. Udvarhelyi
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Compression ◽  
Spinal Canal ◽  
Neurological Complications ◽  
Cord Compression ◽  
Neurologic Symptoms ◽  
Skeletal Dysplasias ◽  
Neurological Condition ◽  
Spinal Cord Involvement ◽  
Canal Syndrome

The neurological complications encountered in selected heritable skeletal dysplasias are described. The neurologic deficit may be caused by static (localized spinal cord compression; small spinal canal syndrome) or dynamic (atlantoaxial dislocation) involvement of the spinal cord. The neurologic symptoms have to be recognized early, as neurosurgical management is possible and may definitely improve the neurological condition.

scholarly journals A comparison of spinal laser interstitial thermotherapy with open surgery for metastatic thoracic epidural spinal cord compression

2020 ◽  
Vol 32 (5) ◽  
pp. 667-675
Author(s):  
Dhiego Chaves de Almeida Bastos ◽  
Richard George Everson ◽  
Bruno Fernandes de Oliveira Santos ◽  
Ahmed Habib ◽  
Rafael A. Vega ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Local Control ◽  
Spinal Cord Compression ◽  
Open Surgery ◽  
Systemic Treatment ◽  
Cord Compression ◽  
Controlled Study ◽  
Oncological Treatment ◽  
Thoracic Epidural ◽  
Interstitial Thermotherapy

OBJECTIVEThe proximity of the spinal cord to compressive metastatic lesions limits radiosurgical dosing. Open surgery is used to create safe margins around the spinal cord prior to spinal stereotactic radiosurgery (SSRS) but carries the risk of potential surgical morbidity and interruption of systemic oncological treatment. Spinal laser interstitial thermotherapy (SLITT) in conjunction with SSRS provides local control with less morbidity and a shorter interval to resume systemic treatment. The authors present a comparison between SLITT and open surgery in patients with metastatic thoracic epidural spinal cord compression to determine the advantages and disadvantages of each method.METHODSThis is a matched-group design study comprising patients from a single institution with metastatic thoracic epidural spinal cord compression that was treated either with SLITT or open surgery. The two cohorts defined by the surgical treatment comprised patients with epidural spinal cord compression (ESCC) scores of 1c or higher and were deemed suitable for either treatment. Demographics, pre- and postoperative ESCC scores, histology, morbidity, hospital length of stay (LOS), complications, time to radiotherapy, time to resume systemic therapy, progression-free survival (PFS), and overall survival (OS) were compared between groups.RESULTSEighty patients were included in this analysis, 40 in each group. Patients were treated between January 2010 and December 2016. There was no significant difference in demographics or clinical characteristics between the cohorts. The SLITT cohort had a smaller postoperative decrease in the extent of ESCC but a lower estimated blood loss (117 vs 1331 ml, p < 0.001), shorter LOS (3.4 vs 9 days, p < 0.001), lower overall complication rate (5% vs 35%, p = 0.003), fewer days until radiotherapy or SSRS (7.8 vs 35.9, p < 0.001), and systemic treatment (24.7 vs 59 days, p = 0.015). PFS and OS were similar between groups (p = 0.510 and p = 0.868, respectively).CONCLUSIONSThe authors’ results have shown that SLITT plus XRT is not inferior to open decompression surgery plus XRT in regard to local control, with a lower rate of complications and faster resumption of oncological treatment. A prospective randomized controlled study is needed to compare SLITT with open decompressive surgery for ESCC.

Scheuermann's Dorsal Kyphosis and Spinal Cord Compression: Case Report

Neurosurgery ◽  
1986 ◽  
Vol 18 (5) ◽  
pp. 628-631 ◽  
Author(s):  
David M. Klein ◽  
Richard L. Weiss ◽  
James E. Allen
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Compression ◽  
Neurological Complications ◽  
Cord Compression ◽  
Posterior Fixation ◽  
Childhood And Adolescence ◽  
Disc Protrusion ◽  
Scheuermann’S Disease ◽  
Scheuermann's Disease ◽  
Thoracic Disc

Abstract Although Scheuermann's disease (juvenile dorsal kyphosis) is a common problem of late childhood and adolescence, its potential for neurological complications is not widely appreciated. In rare instances, spinal cord compression appears to be produced by the kyphotic protrusion alone, and we present an example of this unusual problem. Although the results of surgical treatment in this situation cannot be substantiated, anterior spondylotomy and decompression followed by posterior fixation appear to offer the best mechanical relief. Spinal cord compression can also be produced by extradural cysts, with which Scheuermann's disease is frequently associated. Scheuermann's disease also is reported to occur in combination with thoracic disc protrusion, but the coincidence here may be random. Pertinent literature is reviewed.

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