scholarly journals Conus Medullary Syndrome secondary to Spinal Schwannoma : A report of 3 cases

2016 ◽  
Vol 15 (1) ◽  
Author(s):  
Ed Simor Khan Mor Japar Khan ◽  
Nur Akmal Ismail Ismail Mansor ◽  
Mohd Ariff Sharifudin ◽  
Mohd Adham Shah Ayeop ◽  
Chan Kin Hup ◽  
...  
Keyword(s):  
Back Pain ◽  
Schwann Cells ◽  
Nerve Root ◽  
Surgical Excision ◽  
Radicular Pain ◽  
Lower Limbs ◽  
Presenting Symptoms ◽  
Complete Surgical Excision ◽  
Intradural Extramedullary ◽  
Spinal Schwannoma

Spinal Schwannoma originates from the Schwann cells, hence it is called Schwannoma. The tumor localization is in various parts of the spinal cord, but prevails in cervical and thoracic. In the literature 70 to 80% of spinal schwannomas are reported to be intradural in location, and 15% with both intradural and extradural components. All 3 cases were female in their 4th-5th decade, presented with either low back pain, radiculopathy, weakness of both lower limbs associated with urinary incontinence. MRI revealed a well defined mass adjacent to conus medullary area located intradural, extramedullary. All three patients underwent microscopic assisted excision of the tumour. All patients had Good Early Outcome. Spinal schwannoma causing Conus Medullary Syndrome is rare. Back pain and radicular pain were most common early presenting symptoms while urinary symptoms occur later. Schwannomas typically arise from a single nerve root originating from the schwann cells. To obtain total resection, the affected nerve root is commonly sacrificed in order to prevent recurrence. Intradural Extramedullary Schwannoma, even presented at a later stage with significant neurological deficit, has a Good Outcome post operatively owing to its Benign nature, Extramedullary location, and a Meticulous Microscopic assisted Complete Surgical Excision.

scholarly journals Orbital Schwannoma

2020 ◽  
Vol 81 (04) ◽  
pp. 376-380
Author(s):  
Mark B. Chaskes ◽  
Mindy R. Rabinowitz
Keyword(s):  
Surgical Excision ◽  
Treatment Goals ◽  
Resonance Imaging ◽  
Recurrence Rates ◽  
Complete Excision ◽  
Representative Case ◽  
Presenting Symptoms ◽  
Complete Surgical Excision ◽  
Imaging Characteristics ◽  
Magnetic Resonance Imaging Mri

AbstractOrbital schwannomas are rare neoplasms of the orbit. The presenting symptoms are often nonspecific. Classic imaging characteristics seen on magnetic resonance imaging (MRI) and orbital ultrasound can be useful to help aid in the diagnosis of orbital schwannoma. When diagnosed, the goal of treatment is complete surgical excision. The location of the tumor within the orbit dictates which surgical approach would provide the best exposure. When complete excision is achieved, recurrence rates are very low.This article addresses the etiology, patient population, presentation, natural history, and differential diagnosis of orbital schwannomas. Imaging characteristics and histopathologic subtypes are reviewed. Treatment goals, approaches, and specialties involved in the management of these patients is discussed. Finally, a representative case is presented.

scholarly journals Spinal osteoid osteoma: Surgical resection and review of literature

2020 ◽  
Vol 11 ◽  
pp. 308
Author(s):  
Abhinandan Reddy Mallepally ◽  
Rajat Mahajan ◽  
Sandesh Pacha ◽  
Tarush Rustagi ◽  
Nandan Marathe ◽  
...  
Keyword(s):  
Surgical Resection ◽  
Osteoid Osteoma ◽  
Surgical Excision ◽  
Presenting Symptoms ◽  
Complete Surgical Excision ◽  
Rare Benign Tumor ◽  
The Common ◽  
Optimal Approach ◽  
Posterior Elements

Background: Osteoid osteoma (OO) is a rare benign tumor of the spine that involves the posterior elements with 75% tumors involving the neural arch. The common presenting symptoms include back pain, deformity like scoliosis, and rarely radiculopathy. Methods: From 2011 to 2017, we evaluated cases of OO managed by posterior surgical resection while also reviewing the appropriate literature. Results: We assessed five patients (three males and two females) averaging 36.60 years of age diagnosed with spinal OOs. Two involved the lumbar posterior elements, two were thoracic, and one was in the C3 lateral mass. All patients underwent histopathological confirmation of OO. They were managed by posterior surgical resection with/without stabilization. No lesions recurred over the minimum follow-up period of 24 months. Conclusion: Surgical excision is the optimal treatment modality for treating spinal OOs. The five patients in this study demonstrated good functional outcomes without recurrences. Further, the literature confirms that the optimal approach to these tumors is complete surgical excision with/without radiofrequency ablation.

scholarly journals Clear cell sarcoma of the nuchal region with metastasis in stomach

2011 ◽  
Vol 19 (3-4) ◽  
pp. 76-78
Author(s):  
Dragana Tegeltija ◽  
Aleksandra Lovrenski ◽  
Milana Panjkovic ◽  
Slavica Knezevic-Usaj ◽  
Zivka Eri ◽  
...  
Keyword(s):  
Malignant Melanoma ◽  
Soft Tissues ◽  
Clear Cell ◽  
Neck Region ◽  
Surgical Excision ◽  
Clear Cell Sarcoma ◽  
Lower Limbs ◽  
Medical Attention ◽  
Cell Sarcoma ◽  
Complete Surgical Excision

Clear cell sarcoma/malignant melanoma of soft parts is a rare malignant tumor that originates from the neural crest. It is most common in young men in the lower limbs, grows slowly in the form of deep localized nodes around the tendons, fascia, and aponeurosis. Prognosis is poor, local recurrences and metastases are common. We present a case of a 53-year-old patient who sought medical attention due to the presence of a tumefaction in the nuchal neck region, followed by pain, heightened sensitivity, and numbness in his right hand. After excision, histological examination, and application of immunohistochemical and histochemical methods, malignant melanoma of soft tissues was diagnosed. Fourteen months after the excision of the neck tumor, a metastatic stomach disease was diagnosed. Larger tumors with necrosis, expressed pleomorphisam, and increased mitotic activity give metastases before local recurrence. Diagnosis is set using immunohistochemical methods after surgical excision of the tumor and the prognosis of the disease depends on the size of tumor and complete surgical excision.

scholarly journals Upper Cervical Bronchogenic Cyst: A Rare Condition at a Rare Location

2018 ◽  
Vol 09 (01) ◽  
pp. 149-151
Author(s):  
Ranjeet Kumar Jha ◽  
Chandan B. Mohanty ◽  
Chandrashekhar E. Deopujari ◽  
Salman Tehran Shaikh
Keyword(s):  
Bronchogenic Cyst ◽  
Rare Condition ◽  
Surgical Excision ◽  
Cord Compression ◽  
Complete Relief ◽  
Resonance Imaging ◽  
Complete Surgical Excision ◽  
Upper Cervical ◽  
Rare Location ◽  
Intradural Extramedullary

ABSTRACTIntraspinal bronchogenic cyst (SBC) is a rare but important cause of spinal cord compression, commonly seen in the cervicothoracic spine. We report a case of a 43-year-old male, presenting with complaints of neck pain, radiating to right shoulder, with numbness of right hand and fingers. Magnetic resonance imaging of the cervical spine revealed an intradural extramedullary, ventral cystic lesion extending from C2 to C4 vertebral levels. Complete surgical excision was performed, and the patient had a complete relief of symptoms postoperatively. Only 11 cases of SBCs have been reported in literature. We discuss the peculiar location of this lesion, possible embryological reasons and the overall surgical outcome of SBC.

scholarly journals Anterior Corpectomy Approach for Removal of a Cervical Intradural Schwannoma

2008 ◽  
Vol 35 (1) ◽  
pp. 106-110 ◽  
Author(s):  
Steven Casha ◽  
Jing Cheng Xie ◽  
R. John Hurlbert
Keyword(s):  
Spinal Cord ◽  
Schwann Cells ◽  
Spinal Canal ◽  
Anterior Approach ◽  
Cervical Spondylosis ◽  
Spinal Reconstruction ◽  
Anterior Corpectomy ◽  
Intradural Extramedullary ◽  
Spinal Schwannoma ◽  
Dentate Ligament

Spinal schwannomas are typically intradural-extramedullary neoplasms thought to arise from Schwann cells or their progenitors which occur proportionally throughout the spinal canal. They most typically arise from dorsal sensory rootlets and occupy a posterior-lateral location in the spinal canal. Thus, posterior surgical procedures have become the conventional method to remove these tumors providing adequate exposure in most cases. More anteriorly located tumors may be approached through a posterolateral direction with section of the dentate ligament and gentle rotation of the spinal cord. However, posterior and posterolateral approaches may be problematic for removing tumors located in the midline and ventral to the spinal cord.Although the anterior approach has been applied widely to treat cervical spondylosis, it has rarely been used to remove intradural tumors. Here, we present a case of a ventral cervical spinal schwannoma removed through an anterior approach followed by spinal reconstruction.

scholarly journals Neural Decompression by Laminectomy with Spinoplasty for Lumbar Spinal Stenosis

2013 ◽  
Vol 1 (1) ◽  
Author(s):  
RK Pokharel ◽  
K Kafle ◽  
RL Pradhan ◽  
LL Shah
Keyword(s):  
Back Pain ◽  
Conservative Treatment ◽  
Spinal Stenosis ◽  
Lumbar Spinal Stenosis ◽  
Spinous Process ◽  
Radicular Pain ◽  
Lower Limbs ◽  
Neurogenic Claudication ◽  
Neural Tissues ◽  
Lumbar Spinal

BACKGROUND Lumbar spinal stenosis is one of the common morbid conditions of adult population. Surgical intervention is recommended if conservative treatment is not effective. Aim of the surgery is to decompress neural tissues and it may vary from simple unilateral foraminotomy or laminotomy to multilevel bilateral laminectomy. Conventional laminectomy violates posterior stability and foraminotomy limits access to the neural tissues. Different techniques have been developed for adequate decompression with preservation of posterior stabilizing structures. METHODS Degenerative lumbar spinal stenosis in 22 cases was treated by laminectomy with spinous process osteotomy and re-positioning during October 2007 to August 2009. All cases had back pain with radicular pain and intermittent neurogenic claudication. Average age of the cases was 49.5 years and the average duration of symptom was 7 months. Conservative treatment was tried for 4 months. Average follow up period was 2.5 months. RESULTS Post operatively 82% of the cases were satisfied. There was no radicular pain and intermittent claudication in all cases. Persistence of back pain and numbness in lower limbs was common complaints of majority of the cases. CONCLUSION “Laminectomy with spinous process osteotomy and re-positioning” technique easily decompresses lumbar spinal stenosis with preservation of posterior osteo-ligamentous structure. DOI: http://dx.doi.org/10.3126/noaj.v1i1.8127 Nepal Orthopaedic Association Journal Vol.1(1) 2010

scholarly journals Assessment of the utility of the National Health Service England Low Back and Radicular Pain Pathway: analysis of patient reported outcomes

2019 ◽  
Vol 14 (1) ◽  
pp. 42-46
Author(s):  
Philip McKeag ◽  
Niall Eames ◽  
Lynn Murphy ◽  
Raymond McKenna ◽  
Eilish Simpson ◽  
...  
Keyword(s):  
Back Pain ◽  
National Health Service ◽  
Health Service ◽  
Intervertebral Disc ◽  
Nerve Root ◽  
Waiting Times ◽  
Radicular Pain ◽  
Low Back ◽  
Disc Prolapse ◽  
Pain Pathway

Introduction: Lumbar disc herniation causing radiculopathy is a common reason for referral to spinal out-patient clinics. At our centre following routine referral, patients wait a mean of 109 weeks for a consultation with a spinal surgeon. A pathway in keeping with the National Health Service England Low Back and Radicular Pain Pathway was introduced with two objectives. Patients would be seen sooner by suitably trained health care professionals to avoid long waiting times for assessment with a spinal surgeon, and if a set of criteria were met, they would receive a selective nerve root injection to manage their pain. Methods: Patients were seen by specially trained orthopaedic physiotherapists following routine general practitioner (GP) referral. A radiologically guided nerve root injection was carried out if patients had radicular pain between 6 and 52 weeks duration and a magnetic resonance imaging (MRI) scan demonstrating an intervertebral disc prolapse correlating with their radicular symptoms. Patient-recorded outcome measures were taken before and after nerve root injection. Results: Seventy five patients entered the pathway. Mean patient age was 49.9 years and 27 patients (36.0%) were male. Mean time from referral to assessment was 15.5 weeks. Mean visual analogue score (VAS) for leg pain was 7.4 out of 10 before nerve root injection and 4.8 out of 10 following nerve root injection (p < 0.001). Mean Oswestry Low Back Pain Disability Questionnaire score before nerve root injection was 58.4% and 49.7% following nerve root injection (p = 0.024). Mean Euroqol EQ-5D-5L Health Index was 0.2 before nerve root injection and 0.4 afterwards (p < 0.001). Conclusion: This study suggests that this pathway may help to reduce waiting times for patients with lumbar radiculopathy secondary to intervertebral disc prolapse. The resulting enhanced care may be associated with a reduction in leg and back pain and an improvement in quality of life.

scholarly journals Unusual Isolated Parapharyngeal Second Branchial Cleft Cyst: A Case Report and Literature Review

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Emad A. Magdy ◽  
Geylan A. Fadali ◽  
Mahmoud Seif-Elnasr ◽  
Mohamed F. Fathalla
Keyword(s):  
World Literature ◽  
Parapharyngeal Space ◽  
Case Reports ◽  
Correct Diagnosis ◽  
Management Strategies ◽  
Surgical Excision ◽  
Transcervical Approach ◽  
Presenting Symptoms ◽  
Complete Surgical Excision ◽  
Branchial Cleft

Second branchial cleft cysts (BCCs) are common congenital causes of neck swellings; however, isolated parapharyngeal space presentation is extremely rare, with only sporadic cases reported. Our objectives in this report are to describe a case and review different diagnostic and management strategies adopted in the current world literature. The case presented is a 26-year-old female with a large isolated parapharyngeal BCC extending to skull base in which first presenting symptoms were referred otalgia and painful side-to-side head rotation for months followed by odynophagia. A previously ordered computed tomography (CT) scan suspected a parapharyngeal abscess. Correct diagnosis was preoperatively achieved using magnetic resonance imaging (MRI) showing a 3.1 × 3.4 × 5.4 cm parapharyngeal BCC. Cyst was completely surgically excised transoral without complications. No evidence of recurrence has been noted after 24-month follow-up. A comprehensive world literature search for all reported cases in the last 30-years revealed thirty cases in 23 separate case reports with different diagnostic and surgical modalities adopted. Presentation and management strategies in such rare cases are discussed in detail. Our study shows that although rare, BCC diagnosis should be kept in mind while dealing with isolated parapharyngeal space swellings with MRI being key for successful preoperative diagnosis. If encountered, the transoral route can be a safe, aesthetically pleasing and effective way for complete surgical excision in contrast to most other parapharyngeal swellings, which are usually better excised via a transcervical approach.

scholarly journals Cystic schwannoma of the pelvis

2013 ◽  
Vol 95 (1) ◽  
pp. e1-e2 ◽  
Author(s):  
T Jindal ◽  
S Mukherjee ◽  
MR Kamal ◽  
RK Sharma ◽  
N Ghosh ◽  
...  
Keyword(s):  
Schwann Cells ◽  
Bladder Outlet Obstruction ◽  
Outlet Obstruction ◽  
Surgical Excision ◽  
Nerve Fibres ◽  
Complete Surgical Excision ◽  
Benign Tumours ◽  
Slow Growing ◽  
Open Excision ◽  
Cystic Schwannoma

Schwannomas are benign tumours that arise from the Schwann cells of nerve fibres. They commonly occur in the head and neck, mediastinum and extremities. They are extremely rare in the pelvis. These are usually slow growing tumours and are often detected incidentally. Pre-operative diagnosis is extremely difficult as there are no definitive signs on imaging. Aspiration biopsy is often inconclusive or misleading. Surgical excision is both diagnostic and therapeutic. As these tumours are often large in size, open excision is most commonly performed. We describe a case of a large, cystic schwannoma of the pelvis causing bladder outlet obstruction and bilateral hydroureteronephrosis. Complete surgical excision was performed laparoscopically.

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