Impact of Myelography on the Radiotherapeutic Management of Malignant Spinal Cord Compression

Abstract From December 1981 through August 1984, 24 patients with spinal cord compression syndrome due to epidural neoplasms were evaluated for radiotherapy with clinical examination, radiographs of the spine, and myelography. All plain films were reviewed, and mock radiotherapy fields designed using specific criteria for margins. The same patients were reviewed a second time considering the additional information provided by myelography. The initial treatment fields were found to be inadequate in 69% of the patients. Even in patients with discrete bony lesions, the results of myelography affected the treatment 45% of the time. A history of previous spinal irradiation significantly influenced port design in only 1 of the 7 patients who had received previous radiotherapy. Although invasive, myelography is essential in planning the treatment of spinal cord compression.

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Malignant Spinal Cord Compression Syndrome as an Initial Presentation of Testicular Cancer

Case Reports in Oncological Medicine ◽

10.1155/2018/5757434 ◽

2018 ◽

Vol 2018 ◽

pp. 1-5

Author(s):

Carlos Eduardo Salazar-Mejía ◽

Edio Llerena-Hernández ◽

David Hernández-Barajas ◽

Oscar Vidal-Gutiérrez ◽

Adriana González-Gutiérrez ◽

...

Keyword(s):

Spinal Cord ◽

Spinal Cord Compression ◽

Germ Cell Tumors ◽

Rare Event ◽

Cord Compression ◽

Initial Manifestation ◽

Compression Syndrome ◽

Left Testicle ◽

Spinal Cord Compression Syndrome ◽

Hepatic Metastatic Disease

Malignant spinal cord compression syndrome (MSCCS) occurs in 2.5 to 5% of all oncological patients. In 20% of the cases, it is the initial manifestation. This syndrome is a rare event among germ cell tumors (GCT), occurring in only 1.7% of the patients. We present the case of a 24-year-old man who arrived at the emergency department with dysesthesia and paraparesis as well as urinary incontinence. Imaging studies showed an infiltrative lesion in the left testicle, pulmonary and hepatic metastatic disease, and a large retroperitoneal ganglionar conglomerate that infiltrated the spinal cord through the intervertebral foramina of the vertebra level T11 with displacement of the L1 vertebral body. A postoperative biopsy showed a pure embryonal carcinoma. In the initial approach of a young man who presents spinal cord compression, the presence of MSCCS associated with GCT should be considered as a possible cause. A high level of suspicion is required to achieve a timely diagnosis, to grant the patient the best possible outcome.

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Epidural neural fibrolipoma of the thoracic vertebral canal

Journal of Neurosurgery Spine ◽

10.3171/2012.8.spine11971 ◽

2012 ◽

Vol 17 (5) ◽

pp. 449-452 ◽

Cited By ~ 3

Author(s):

Paolo Missori ◽

Sergio Pandolfi ◽

Manila Antonelli ◽

Maurizio Domenicucci

Keyword(s):

Spinal Cord ◽

Spinal Cord Compression ◽

Benign Tumor ◽

Cord Compression ◽

Thoracic Cavity ◽

Medium Term ◽

Total Removal ◽

Compression Syndrome ◽

Spinal Cord Compression Syndrome

Neural fibrolipoma is a benign tumor that most frequently infiltrates the median nerve. The authors describe a patient with spinal cord compression syndrome caused by a neural fibrolipoma. The tumor originated in the thoracic nerve at the T6–7 extradural level in the left conjugate foramen and extended into the thoracic cavity. Total removal was achieved by a combined posterior and costotransversectomy approach. Postoperatively, the patient's spinal cord compression syndrome resolved. No tumor recurrence has been observed in medium-term follow-up. This is the second case of an extradural spinal neural fibrolipoma to be reported in the literature.

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