JUVENILE INTRADURAL CHORDOMA

Neurosurgery ◽  
2008 ◽  
Vol 62 (2) ◽  
pp. E525-E527 ◽  
Author(s):  
Steven W. Chang ◽  
Pankaj A. Gore ◽  
Peter Nakaji ◽  
Harold L. Rekate

Abstract OBJECTIVE We report the youngest known case of a prepontine intradural chordoma. These tumors are exceedingly rare. Unlike their more common extradural counterparts, no recurrence of an intradural chordoma has been reported. CLINICAL PRESENTATION A 9-year-old boy underwent diagnostic imaging for evaluation of headaches. Although neurologically intact, a magnetic resonance imaging scan revealed a large prepontine mass with focal enhancement. INTERVENTION Endoscopic-assisted gross total resection was attained with staged bilateral retrosigmoid approaches. There were no additional adjuvant therapies. At the time of the 1-year follow-up evaluation, the patient had no recurrence. CONCLUSION By using an endoscopic-assisted procedure, we achieved complete resection of an intradural chordoma offering a potential for surgical cure. Resection is particularly advantageous because it spares the young child the need for radiation treatment. Close follow-up is warranted because we postulate that this tumor exists in a biological continuum between benign notochordal hamartomatous remnants and typical invasive chordomas.

Neurosurgery ◽  
2004 ◽  
Vol 55 (6) ◽  
pp. E1430-E1434 ◽  
Author(s):  
Carlo Santaguida ◽  
Abdulrahman J. Sabbagh ◽  
Marie-Christine Guiot ◽  
Rolando F. Del Maestro

Abstract OBJECTIVE AND IMPORTANCE: Intramedullary melanotic schwannomas are very rare lesions; only four cases have been reported previously. We describe a patient with an intramedullary melanotic schwannoma that had a more aggressive course than those reported in the literature, and we review the theories regarding the cause of these lesions. CLINICAL PRESENTATION: A 35-year-old man presented with neck stiffness and paraesthesia extending down his right arm upon neck extension. A magnetic resonance imaging scan revealed an intramedullary lesion extending from C4 to C5. INTERVENTION: Gross total resection of the mass was performed, and pathological characteristics were consistent with a melanotic schwannoma. Two years after resection the tumor recurred, and the patient was treated with radiation therapy. The tumor progressed 2 years after radiotherapy, and at repeat resection, multiple pigmented foci were present on the surface of the spinal cord and dura consistent with metastatic seeding. CONCLUSION: In a patient with intramedullary melanotic schwannoma with an unusually aggressive course, careful follow-up may be essential.


2020 ◽  
Vol 48 (9) ◽  
pp. 030006052095469
Author(s):  
RuiDeng Wang ◽  
Hai Tang

Spinal angiolipomas (SALs) are extremely rare benign tumors composed of both mature fatty tissue and anomalous vascular channels. We present two cases of SALs and review the clinical presentation, radiological appearance, pathological aspects, and treatment of this distinct clinicopathological mass. The patients’ neurologic symptoms improved postoperatively and follow-up revealed no signs of tumor recurrence or neurological deficit. SAL should be considered as a differential diagnosis in patients with spinal cord compression. Magnetic resonance imaging is important for detecting and characterizing SALs. The gold standard treatment modality should be total resection.


Neurosurgery ◽  
2006 ◽  
Vol 59 (6) ◽  
pp. E1339-E1339 ◽  
Author(s):  
Stephanie Greene ◽  
Douglas S. Hawkins ◽  
Joe C. Rutledge ◽  
Karen D. Tsuchiya ◽  
James Douglas ◽  
...  

Abstract OBJECTIVE The diagnosis of intradural synovial sarcoma has not been previously published. This report provides a summary of the literature on this tumor and on tumors arising in this location, as well as a description of this patient's clinical course. CLINICAL PRESENTATION An 11-year-old girl presented with back pain and radiculopathy. A magnetic resonance imaging scan of the spine revealed a spinal intradural, extramedullary mass at L2–L4 and four additional nodules of enhancement. INTERVENTION The mass was nearly totally resected. Radiation and chemotherapy were administered. Intracranial metastases became evident during treatment. The patient died of the disease 14 months after diagnosis. CONCLUSION The rapid progression of leptomeningeal metastasis despite maximal treatment demonstrates the aggressive nature of the tumor and the need for further study.


Neurosurgery ◽  
2006 ◽  
Vol 59 (3) ◽  
pp. E706-E707 ◽  
Author(s):  
Devendra K. Vatsal ◽  
Shalini Kapoor ◽  
Vimala Venkatesh ◽  
Priti Vatsal ◽  
Nuzhat Husain

Abstract OBJECTIVE: Parasitic myelopathy is rare. We report ectopic infestation of the spine by Fasciola hepatica. CLINICAL PRESENTATION: A young woman presented with gradual onset paraplegia with bladder and bowel involvement. A magnetic resonance imaging scan showed an epidural mass lesion that was isotense on T1-weighted images and hyperintense on T2-weighted images, extending from T4–T7 vertebra with extradural cord compression. She was diagnosed with cord compression, possibly owing to tubercular epidural granulation tissue. INTERVENTION: During surgery, a mobile, flat, leaf-like, pink parasite was found in the epidural space. Morphological and histological indices confirmed the parasite as Fasciola hepatica. CONCLUSION: Ectopic spinal localization of Fasciola may occur during the transmigration path of the parasite through peritoneum or from the liver through portal venous system.


2007 ◽  
Vol 65 (4a) ◽  
pp. 1000-1006 ◽  
Author(s):  
Hamilton Matushita ◽  
Fernando Campos Pinto ◽  
José Píndaro Pereira Plese

Meningiomas are uncommon tumors in children and either more rarely encountered in the pineal region. We report two cases of meningioma of the pineal region in children. One of these cases was a five years-old girl and the other a one year-old boy. No specific clinical presentation or tomographic examinations findings was identified before treatment, suggestive of a diagnosis of menigioma. The clinical and laboratory features were very similar to the most common tumors of the pineal region. Prior to the surgery, the histology of these tumors was not suspected. Both patients underwent direct surgery and complete removal was achieved by a suboccipital transtentorial approach. The tumors originated from velum interpositum in both cases. At the follow up, one case presented with recurrence six years later, and she underwent a reoperation with total resection without morbidity. Long-term follow up presented no other recurrences.


Neurosurgery ◽  
1990 ◽  
Vol 27 (4) ◽  
pp. 640-643 ◽  
Author(s):  
Osamu Tachibana ◽  
Narihito Yamaguchi ◽  
Tetsumori Yamashima ◽  
Junkoh Yamashita

Abstract A 26-year-old woman was treated for a prolactin secreting pituitary adenoma by surgery and radiotherapy (5860 rads). Fourteen months later, she developed right hemiparesis and dysarthria. A T1-weighted magnetic resonance imaging scan using gadolinium contrast showed a small, enhanced lesion in the upper pons. Seven months later, she had a sudden onset of loss of vision, and radiation optic neuropathy was diagnosed. A T1-weighted magnetic resonance imaging scan showed widespread gadolinium-enhanced lesions in the optic chiasm, optic tract, and hypothalamus. Magnetic resonance imaging is indispensable for the early diagnosis of radiation necrosis, which is not visualized by radiography or computed tomography.


2019 ◽  
Vol 55 (5) ◽  
pp. 338-341 ◽  
Author(s):  
Brian Wesley Gilbert ◽  
Ali Gabriel ◽  
Laura Velazquez

Purpose: To report a case of posterior reversible encephalopathy syndrome (PRES) in a 75 year-old patient who was taking concomitant ciprofloxacin and metronidazole. Method: Case report Results: A patient had been prescribed ciprofloxacin and metronidazole during a recent hospitalization and continued this regimen outpatient. Two weeks after discharge and 3 weeks after initiation of her regimen, she was brought to the emergency department after developing acute weakness and lightheadedness. After admission, the patient declined more rapidly and began seizing with subsequent intubation. Initial computed tomographic (CT) imaging showed no acute neurological abnormalities, and a sepsis workup was initiated. After negative CT, a magnetic resonance imaging scan was performed that showed a T2 flair and hyperdensity consistent with PRES. The final diagnosis was considered to be PRES secondary to ciprofloxacin/metronidazole utilization. Conclusion: Antibiotic induced PRES is a condition that needs to be explored more thoroughly.


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