scholarly journals A case of recurring spinal ependymoma in 37-years old man after surgery and adjuvant therapy

2021 ◽  
Vol 27 (1) ◽  
pp. 5-8
Author(s):  
Nikola Andjelic ◽  
Bojana Scepanovic ◽  
Svetlana Salma ◽  
Dusko Kozic ◽  
Natasa Prvulovic-Bunovic
Keyword(s):  
Spinal Cord ◽  
Cauda Equina ◽  
Disease Recurrence ◽  
Subtotal Resection ◽  
Older Children ◽  
En Bloc ◽  
Delay In Diagnosis ◽  
Spinal Ependymoma ◽  
First Line Therapy ◽  
Mri Examination

We present the case of a 39-years old man who underwent three surgeries because of spinal ependymoma located in cauda equina region. He presented at the Oncology Institute of Vojvodina for combined adjuvant chemo- and radiotherapy after the second surgery. An MRI examination performed after six cycles of therapy showed no signs of disease. 26 months later, a follow-up MRI showed recurrence of disease in the form of small drop metastasis. Six months later, the patient underwent the third surgery. The patient is currently receiving another cycle of radiotherapy, and is scheduled for additional cycles of chemotherapy. Ependymomas are the most common spinal cord malignancy in adults. The symptoms are nonspecific which often causes a delay in diagnosis. An MRI examination of the spine with contrast admission is the study of choice for detecting spinal cord masses. Surgery is the first-line therapy for ependymomas. Recurrence rate is associated with the extent of surgical resection, with en bloc and gross-total resection being associated with lower rates of disease recurrence. In children under 3 years, adjuvant chemotherapy is advocated, while older children and adults undergo adjuvant radiotherapy or combined chemo- and radiotherapy in cases of subtotal resection or tumor recurrence.

scholarly journals Treatment of pediatric Grade II spinal ependymomas: a population-based study

2015 ◽  
Vol 15 (3) ◽  
pp. 243-249 ◽  
Author(s):  
Yimo Lin ◽  
Andrew Jea ◽  
Stephanie C. Melkonian ◽  
Sandi Lam
Keyword(s):  
Spinal Cord ◽  
Overall Survival ◽  
Radiation Therapy ◽  
Pediatric Patients ◽  
Treatment Patterns ◽  
Gross Total Resection ◽  
Subtotal Resection ◽  
Total Resection ◽  
Spinal Ependymoma ◽  
Grade Ii

OBJECT Grade II spinal cord ependymomas occurring in pediatric patients are exceptionally rare neoplasms. In this paper the authors use a national cancer database to determine patient demographics, treatment patterns, and associated outcomes of this cohort. METHODS The Surveillance Epidemiology and End Results (SEER) database was used to analyze subjects younger than 18 years with histologically confirmed diagnoses of Grade II spinal cord ependymoma from the years 1973 to 2008. Descriptive data on the demographic characteristics of this cohort and the associated treatment patterns are shown. The Kaplan-Meier method was used to estimate overall survival at 1, 2, 5, and 10 years. RESULTS This cohort comprised 64 pediatric subjects with Grade II spinal ependymoma. The median age was 13 years, nearly half of the patients were male, and most were white (84%). The median follow-up was 9.2 years. Overall survival at 5 and 10 years was 86% and 83%, respectively. Gross-total resection was achieved in 57% of subjects, and radiation therapy was administered to 36%. Radiation therapy was administered to 78% of subjects after subtotal resection but only to 19% of patients after gross-total resection; this difference was significant (p < 0.001). In a multivariate regression model analyzing sex, age at diagnosis, year of diagnosis, radiotherapy, and extent of resection, female sex was found to be an independent predictor of decreased mortality (HR 0.15 [95% CI 0.02–0.94], p = 0.04). CONCLUSIONS These data show long-term outcomes for pediatric patients with Grade II spinal ependymoma. Radiotherapy was more likely to be administered in cases of subtotal resection than in cases of gross-total resection. Female sex is associated with decreased mortality, while other demographic or treatment modalities are not.

scholarly journals Spinal Cord Ependymoma – Surgical Management and Outcome

2019 ◽  
Vol 10 (02) ◽  
pp. 316-320 ◽  
Author(s):  
Wail Mohammed ◽  
Michael Farrell ◽  
Ciaran Bolger
Keyword(s):  
Spinal Cord ◽  
Extent Of Resection ◽  
Subtotal Resection ◽  
Spinal Level ◽  
Total Resection ◽  
Spinal Ependymoma ◽  
Slow Progression ◽  
Primary Neoplasm ◽  
Surgical Difficulty

ABSTRACT Background: Ependymoma is a common primary neoplasm of the spinal cord and filum terminale. Patients with spinal ependymoma usually experience gradual symptoms due to slow progression of the tumor; thus, early diagnosis can be challenging to make. Objective: The objective of this study was to report 5 years’ experience in treating spinal intramedullary ependymomas and to illustrate the advantage of aggressive complete resection whenever possible. Patients and Methods: Retrospective medical notes of all patients with spinal ependymoma treated surgically over a 5-year period between January 2003 and January 2008 were recorded. Clinical presentation, spinal level, extent of resection, and complications were recorded. A prolonged follow-up was documented. Results: There were 20 patients – 11 males, and nine females –included in this study. Their median age was 48 years (range 3–75 years). In 18 patients, total gross resection was achieved. Subtotal resection was only possible in one patient due to surgical difficulty. One patient underwent biopsy and referred for further surgery and subsequently had total resection. Conclusions: Radical total resection is achievable in spinal ependymomas, with minimal resultant morbidity.

Spinal Cord Ependymoma: Radical Surgical Resection and Outcome

Neurosurgery ◽  
2002 ◽  
Vol 51 (5) ◽  
pp. 1162-1174 ◽  
Author(s):  
Fadi Hanbali ◽  
Daryl R. Fourney ◽  
Eric Marmor ◽  
Dima Suki ◽  
Laurence D. Rhines ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Surgical Resection ◽  
Tumor Resection ◽  
Neurological Deficits ◽  
Cervical Cord ◽  
Subtotal Resection ◽  
Low Grade ◽  
En Bloc ◽  
Spinal Cord Ependymoma ◽  
Radical Surgical Resection

Abstract OBJECTIVE Several authors have noted increased neurological deficits and worsening dysesthesia in the postoperative period in patients with spinal cord ependymoma. We describe the neurological progression and pain evolution of these patients over the 1-year period after surgery. In addition, our favored method of en bloc tumor resection is illustrated, and the rate of complications, recurrence, and survival in this group of patients is addressed. METHODS We operated on 26 patients (12 male and 14 female) with low-grade spinal cord ependymomas between 1975 and 2001. The median age at diagnosis was 42 years. Tumors extended into the cervical cord in 13 patients, the thoracic cord in 7 patients, and the conus medullaris in 6 patients. Eleven patients had previous surgery and/or radiation therapy. RESULTS We achieved a gross total resection in 88% of patients, whereas 8% had a subtotal resection and 4% had a biopsy. Only 1 patient developed a recurrence over a mean follow-up period of 31 months. CONCLUSION We conclude that radical surgical resection of spinal cord ependymomas can be safely achieved in the majority of patients. A trend toward neurological improvement from a postoperative deficit can be expected between 1 and 3 months after surgery and continues up to 1 year. Postoperative dysesthesias begin to improve within 1 month of surgery and are significantly better by 1 year after surgery. The best predictor of outcome is the preoperative neurological status.

Prognosis by tumor location in adults with spinal ependymomas

2013 ◽  
Vol 18 (3) ◽  
pp. 226-235 ◽  
Author(s):  
Michael C. Oh ◽  
Joseph M. Kim ◽  
Gurvinder Kaur ◽  
Michael Safaee ◽  
Matthew Z. Sun ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Cox Regression ◽  
Statistical Significance ◽  
Cauda Equina ◽  
Tumor Location ◽  
Spinal Cord Tumors ◽  
Prognostic Information ◽  
Who Grade ◽  
Spinal Ependymoma ◽  
Spinal Axis

Object Ependymomas are primary central nervous system tumors that occur more frequently in the spines of adults than they do there in children. Previous studies consist mainly of retrospective single-institutional experiences or case studies. In this study, a comprehensive literature review was performed on reported cases of spinal ependymoma treated with resection to determine whether tumor location along the spinal axis conveys important prognostic information. Methods A PubMed search was performed to identify all papers that included data on patients with spinal ependymoma. Only cases involving adult patients who underwent ependymoma resection with a clearly reported tumor location were included for analysis. Tumor locations were separated into 6 groups: cervicomedullary, cervical, cervicothoracic, thoracic, thoracolumbar, and conus + cauda equina. Kaplan-Meier survival and Cox regression analyses were performed to determine the effect of tumor location on progression-free survival (PFS) and overall survival (OS). Results A total of 447 patients who underwent resection of spinal ependymomas with clearly indicated location of tumor were identified. The most common locations of spinal ependymomas were the cervical (32.0%) and conus + cauda equina (26.8%) regions. The thoracolumbar and cervicomedullary regions had the fewest tumors (accounting for, respectively, 5.1% and 3.4% of the total number of cases). The conus + cauda equina and thoracolumbar regions had the highest percentage of WHO Grade I tumors, while tumors located above these regions consisted of mostly WHO Grade II tumors. Despite the tendency for benign grades in the lower spinal regions, PFS for patients with spinal ependymomas in the lower 3 regions (thoracic, thoracolumbar, conus + cauda equina) was significantly shorter (p < 0.001) than for those with tumors in the upper regions (cervicomedullary, cervical, cervicothoracic), but the difference in OS did not achieve statistical significance (p = 0.131). Conclusions Spinal ependymomas along different regions of spinal axis have different characteristics and clinical behaviors. Tumor grade, extent of resection, and PFS varied by tumor location (upper vs lower spinal regions), while OS did not. Recurrence rates were higher for the lower spinal cord tumors, despite a greater prevalence of lower WHO grade lesions, compared with upper spinal cord tumors, suggesting that tumor location along the spinal axis is an important prognostic factor.

scholarly journals CTNI-03. IMAGING FEATURES OF LEPTOMENINGEAL METASTASES OF NON-SMALL CELL LUNG CANCER: A SINGLE-CENTER REAL-WORLD STUDY

2020 ◽  
Vol 22 (Supplement_2) ◽  
pp. ii41-ii41
Author(s):  
Junjie Zhen ◽  
Lei Wen ◽  
Shaoqun Li ◽  
Mingyao Lai ◽  
Changguo Shan ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Type A ◽  
Brain Parenchyma ◽  
Imaging Features ◽  
Type B ◽  
Type D ◽  
Mri Examination ◽  
Mri Features ◽  
Brain And Spinal Cord ◽  
The Brain

Abstract BACKGROUND According to EANO-ESMO clinical practice guidelines, the MRI findings of LM are divided into 4 types, namely linear enhancement (type A), nodular enhancement (type B), linear combined with nodular enhancement (type C), and sign of hydrocephalus (type D). METHODS The MRI features of brain and spinal cord in patients diagnosed with NSCLC-LM in Guangdong Sanjiu Brain Hospital from 2010 until 2019 were investigated, and then were classified into 4 types. The imaging features were analyzed. RESULTS A total of 80 patients were enrolled in the study. The median age of the patients was 53.5 years old, and the median time from the initial diagnosis to the confirmed diagnosis of LM was 11.6 months. The results of enhanced MRI examination of the brain in 79 cases showed that the number of cases with enhancements of type A, B, C and D were 50 (63.3%), 0, 26 (32.9%) and 3 (3.8%), respectively, and that LM with metastases to the brain parenchyma was found in 42 cases (53.2%). The results of enhanced MRI examination of spinal cord in 59 cases showed that there were only enhancements of type A and C in 40 cases (67.8%) and 3 cases (5.0%), and no enhancement sign in the other 16 cases (27.2%). CONCLUSION MRI examination of brain and spinal cord will improve the detection rate of LM. The MRI features of NSCLC-LM in real world are mainly characterized by the linear enhancements of brain and spinal cord, followed by linear combined with nodular enhancement. The enhancements of type B and type D are rare in clinic. Almost half of the patients have LM and metastases to the brain parenchyma. Therefore, the differentiation of tumor metastases is needed to be paid attention to for the early diagnosis and the formulation of reasonable treatment plans.

Delayed ischemic spinal cord injury after total en bloc spondylectomy in the thoracic spine

2021 ◽  
Author(s):  
Yeong Huei Ng ◽  
Satoshi Kato ◽  
Satoru Demura ◽  
Kazuya Shinmura ◽  
Noriaki Yokogawa ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Thoracic Spine ◽  
En Bloc ◽  
Total En Bloc Spondylectomy ◽  
En Bloc Spondylectomy ◽  
Bloc Spondylectomy ◽  
Cord Injury ◽  
Ischemic Spinal Cord Injury

Penile Erection in Men with Spinal Cord or Cauda Equina Lesions

1992 ◽  
Vol 12 (02) ◽  
pp. 98-105 ◽  
Author(s):  
Fin Biering-Sørensen ◽  
Jens Sønksen
Keyword(s):  
Spinal Cord ◽  
Penile Erection ◽  
Cauda Equina

scholarly journals ATRT-05. RESULTS OF MULTICENTER TRIAL CONCERNING THE TREATMENT OF CHILDREN WITH ATYPICAL TERATOID/RHABDOID TUMORS (ATRT) OF THE CENTRAL NERVOUS SYSTEM

2020 ◽  
Vol 22 (Supplement_3) ◽  
pp. iii276-iii276
Author(s):  
Olga Zheludkova ◽  
Lyudmila Olkhova ◽  
Yuri Kushel’ ◽  
Armen Melikyan ◽  
Marina Ryzhova ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Progression Free Survival ◽  
Multicenter Trial ◽  
Intrathecal Methotrexate ◽  
Subtotal Resection ◽  
Tumor Biopsy ◽  
Atypical Teratoid ◽  
The Central Nervous System ◽  
Atypical Teratoid Rhabdoid Tumors ◽  
Rhabdoid Tumors

Abstract We analyzed 105 patients under 18 years. The median age was 21 months. There were 54 boys and 51 girls. The supratentorial tumors were in 53 patients, infratentorial in 48, and in spinal cord in 4. 60 had stage M0,29-М+and 16-Mx. All the patients got surgical treatment:total tumor removal in 34,subtotal in 37,partial in 30,and biopsy in 4;75 patients got chemoradiotherapy to ATRT-2006;6-CWS;13-EU-RHAB;5-HIT-SKK;individual schemes in 6. RESULTS: 47 are alive,1 was LFU, and 57 died. PFS was 32%±0.05; the five-year OS 40%±0.05. The median survival-30 months, the median progression-free survival-12 months, and the median of follow-up-23 months. PFS was significantly better in patients more than 12 months compared to patients younger than 12 months:40 and 12%;p=0.00161.After total resection PFS was higher compared to subtotal resection, partial resection, and tumor biopsy:48,38,0,and 0%(p=0.025). After chemoradiotherapy, PFS was higher compared to patients without radiotherapy: 49and 0%(р=0.0000000).PFS for stage M0 was higher compared to stage M+and stage Mx:41,15,and 27%,respectively(р=0.00032).PFS was better for the tumors in the spinal cord and infratentorial location compared to the supratentorial location:67,37,and 25%(p=0.0876).The survival rate was higher among the patients who got treatment according to the ATRT-2006 protocol compared to EU-RHAB, individual regimens, CWS, and HIT-SKK:39,19,17,17,and 0% respectively;p=0.00159.The survival was higher among the patients who got intraventricular/intrathecal Methotrexate,Cytarabine, Prednisolone than among the patients who got only Methotrexate or none at all:40,0,and 5%, respectively; p=0.00015. CONCLUSIONS: Survival was significantly better in patients more than 12month, without metastases, with total removal tumor, chemotheradiotherapy by ATRT-2006 protocol with i/t, i/v Methotrexate/Cytarabine/Prednisolone.

Fertility Studies in the Human Male with Traumatic Injuries of the Spinal Cord and Cauda Equina

1948 ◽  
Vol 239 (25) ◽  
pp. 959-961 ◽  
Author(s):  
Herbert W. Horne ◽  
David P. Paull ◽  
Donald Munro
Keyword(s):  
Spinal Cord ◽  
Cauda Equina ◽  
Traumatic Injuries ◽  
Human Male
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