Primary intramedullary spinal cord germinoma

2013 ◽  
Vol 11 (5) ◽  
pp. 605-609 ◽  
Author(s):  
Megha Madhukar ◽  
Vinod G. Maller ◽  
Arabinda K. Choudhary ◽  
Mark R. Iantosca ◽  
Charles S. Specht ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Pediatric Population ◽  
Unique Case ◽  
Spinal Cord Atrophy ◽  
Intramedullary Spinal Cord ◽  
Intramedullary Lesion ◽  
Initial Imaging ◽  
Spinal Cord Dysfunction ◽  
Patient Presentation ◽  
Rare Diagnosis

Primary intramedullary spinal cord germinoma (PISCG) is an exceedingly rare diagnosis, with fewer than 30 cases reported in the literature. It is even less common in the pediatric population. Usually, initial imaging at patient presentation reveals a mass. The authors describe the unique case of a child whose initial imaging showed only focal spinal cord atrophy, which was the earliest sign of a slowly growing intramedullary lesion that was eventually proven via biopsy to represent a PISCG. The authors outline this child's diagnostically challenging presentation, review the events leading up to a diagnosis, briefly discuss PISCG, and summarize their recommendations for other physicians who may encounter a similar case. They assert that PISCG should be considered as a rare entity in the differential diagnosis of progressive spinal cord dysfunction even in the absence of an MRI abnormality of an intrinsic spinal cord mass, especially if there is unexplained focal atrophy of the cord.

Thoracic spinal iophendylate-induced arachnoiditis mimicking an intramedullary spinal cord neoplasm

2008 ◽  
Vol 8 (3) ◽  
pp. 292-294 ◽  
Author(s):  
Steven W. Hwang ◽  
Rafeeque A. Bhadelia ◽  
Julian Wu
Keyword(s):  
Spinal Cord ◽  
Magnetic Resonance ◽  
Unusual Case ◽  
Magnetic Resonance Images ◽  
Intramedullary Spinal Cord ◽  
Intramedullary Lesion ◽  
Thoracic Spinal

✓Iophendylate (Pantopaque or Myodil) was commonly used from the 1940s until the late 1980s for myelography, cisternography, and ventriculography. Although such instances are rare, several different long-term sequelae have been described in the literature and associated with intrathecal iophendylate. The authors describe an unusual case of arachnoiditis caused by residual thoracic iophendylate imitating an expansile intramedullary lesion on magnetic resonance images obtained 30 years after the initial myelographic injection.

scholarly journals Isolated Solitary Intramedullary Spinal Cord Metastasis Presenting as the First Manifestation of Small-Cell Lung Cancer: Report of a Rare Case

2012 ◽  
Vol 2012 ◽  
pp. 1-4
Author(s):  
Yusuf Kurtuluş Duransoy ◽  
Mesut Mete ◽  
Mehmet Selçuki ◽  
Aydın Işisağ
Keyword(s):  
Spinal Cord ◽  
Whole Body ◽  
Resonance Imaging ◽  
Intramedullary Spinal Cord ◽  
Spinal Magnetic Resonance Imaging ◽  
Intramedullary Lesion ◽  
Positron Emission ◽  
Spinal Cord Metastasis ◽  
Primary Focus ◽  
Intramedullary Spinal Cord Metastasis

Background. Intramedullary spinal cord metastases presenting as the first manifestation of malignancies are extremely rare lesions.Case Description. The authors report a 74-year-old woman who presented with an isolated intramedullary spinal cord metastasis which presents as first manifestation of malignancy without central nervous system and/or other organ involvement. She went under surgery, and after histopathological evaluation, primary focus was determined in lung in positron emission tomography. She is still alive after 9 months since the first diagnosis of primary focus.Conclusion. In patients with solitary intramedullary lesion in the spinal magnetic resonance imaging, whole-body investigation might help for diagnosis of primary focus and approach to treatment.

Intramedullary Spinal Cord Tumors

2018 ◽  
Author(s):  
Paul C. McCormick
Keyword(s):  
Spinal Cord ◽  
Transverse Myelitis ◽  
Tumor Control ◽  
Spinal Cord Tumors ◽  
Intramedullary Spinal Cord ◽  
Inflammatory Conditions ◽  
Optimal Patient Outcome ◽  
Spinal Cord Dysfunction ◽  
Slow Growing

Intramedullary spinal cord tumors represent a heterogeneous group of neoplasms that may cause progressive spinal cord dysfunction. With few exceptions, however, most are slow-growing, biologically indolent neoplasms for which surgery is the treatment of choice. Long-term tumor control with preservation of neurological function is achievable in most patients. Challenges to the evaluation and management of these lesions include accurate differentiation of these tumors from inflammatory conditions such as transverse myelitis, sarcoidosis, and demyelinating conditions; the management of patients with asymptomatic tumors; and the timing and techniques of surgery to achieve the optimal patient outcome.

scholarly journals A Rare Case of Infected Cervicodorsal Intramedullary Epidermoid Cyst

2020 ◽  
Author(s):  
Pawan Chawla ◽  
Milind Sankhe
Keyword(s):  
Spinal Cord ◽  
Epidermoid Cyst ◽  
Cervical Spinal Cord ◽  
Neurophysiological Monitoring ◽  
Dermal Sinus ◽  
Moderate Degree ◽  
Intermittent Fever ◽  
Intramedullary Spinal Cord ◽  
Intramedullary Lesion ◽  
Sinus Opening

Abstract Introduction  Intramedullary spinal epidermoid cysts have a reported incidence of less than 1% of intramedullary spinal cord tumors; and out of these, intramedullary epidermoid lesions within the cervical spinal cord are even rarer. Here, we present the case of an adult patient with an infected intramedullary epidermoid cyst, identified on magnetic resonance imaging (MRI) at the C7–D1 level that was successfully excised without any worsening of neurological status. Case Presentation A 23-year-old female patient presented with history of moderate degree intermittent fever followed by gradually progressive right-sided weakness. She had paresthesia below C5 dermatome on the right side. On close inspection of the back, a tiny sinus opening was noted at the D2 level near the midline. MRI of the spine showed an intramedullary lesion at the C6–D1 level with the tract connecting to the subcutaneous lesion. Somatosensory evoked potential (SSEP) monitoring was done during the surgery with near total excision of the lesion. Conclusion Even though the location is rare, a differential diagnosis of the epidermoid should always be considered. A tiny dermal sinus opening helped us in proper diagnosis, along with surgical excision, by providing us a direct path to the intramedullary lesion. An early diagnosis and treatment with neurophysiological monitoring helped us in the maximum safe resection of the lesion without developing any new deficit.

scholarly journals Intramedullary spinal cord paracoccidioidomycosis: report of two cases

1996 ◽  
Vol 54 (3) ◽  
pp. 466-473 ◽  
Author(s):  
Benedicto Oscar Colli ◽  
João Alberto Assirati Jr ◽  
Hélio Rubens Machado ◽  
José Fernando de Castro Figueiredo ◽  
Leila Chimelli ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Paracoccidioides Brasiliensis ◽  
Systemic Disease ◽  
Clinical Signs ◽  
Cord Compression ◽  
Neurological Deficits ◽  
Intramedullary Tumor ◽  
Intramedullary Spinal Cord ◽  
Intramedullary Lesion ◽  
The Central Nervous System

Two cases of intramedullary paracoccidioidomycosis are reported. Paracoccidioidomycosis is a systemic disease that involves the buccopharyngeal mucosa, lungs, lymph nodes and viscera and infrequently the central nervous system. Localization in the spinal cord is rare. Case 1: a 55-year old male admitted with crural pararesis, tactile/painful hypesthesia and sphincter disturbances of 15 days duration. Cutaneous-pulmonary blastomycosis was diagnosed 17 years ago. Myelotomography showed a blockade of T3-T4 (intramedullary lesion). The lesion surgically removed was a Paracoccidioides brasiliensis granuloma. Treatment with sulfadiazine was started after the surgery. Follow-up of 15 month showed an improvement of the clinical signs. Case 2: a 57-year old male was admitted elsewhere 6 months ago and, with a radiologic diagnosis of pulmonary paracoccidioidomycosis, was treated with amphotericin B. He progressively developed paresthesia and tactile/ pain anaesthesia on the left side, sphincter disturbances and tetraparesis with bilateral extensor plantar response and clonus of the feet. Myelotomography showed a blockade of C4-C6 (intramedullary lesion). The lesion was not found during surgical exploration and the patient deteriorated and died. Post-mortem examination revealed an intramedullary tumor above the site of the mielotomy (Paracoccidioides brasiliensis granuloma). The preoperative diagnosis of intramedullary paracoccidioidomycotic granulomas is difficult because the clinical and radiologic manifestations are uncharacteristic. Clinical suspicion was possible in our cases based on the history of previous systemic disease. Contrary to intracranial localizations, paracoccidioidomycotic granulomas causing progressive spinal cord compression may require early surgery because response to clinical treatment is slow and the reversibility of neurological deficits depends on the promptness of the decompression.

scholarly journals Intramedullary spinal cord cavernous malformations in the pediatric population

2020 ◽  
Vol 11 ◽  
pp. 275
Author(s):  
Brian Fiani ◽  
Taylor Reardon ◽  
Ryne Jenkins ◽  
Claudia Covarrubias ◽  
Manraj Sekhon ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Vascular Malformations ◽  
Pediatric Population ◽  
Age Groups ◽  
Single Layer ◽  
Neurological Status ◽  
Outcome Data ◽  
Pediatric Age ◽  
Intramedullary Spinal Cord ◽  
Cavernous Malformations

Background: Intramedullary spinal cavernous malformations (ISCM) account for just 1% of all intramedullary pediatric spinal cord lesions. Pathologically, they are well-circumscribed vascular malformations that typically appear dark blue or reddish-brown, often coming to the spinal cord surface. With regard to the histopathology findings, ISCMs are comprised sinusoidal vascular spaces lined by a single layer of endothelial cells within a loose connective tissue stroma. As these lesions are often misdiagnosed in the pediatric population, appropriate treatment may be unduly delayed. Methods: The authors performed an extensive review of the published literature (PubMed) focusing on ISCM in the pediatric age group. Results: The search yielded 17 articles exclusively pertaining to ISCM affecting the pediatric population. Conclusion: Here, we reviewed the clinical, radiographic, surgical, and outcome data for the treatment of ISCM in the pediatric age groups. Notably, over 50% of pediatric patients with ISCM experienced an improvement in their neurological status after a mean postoperative follow-up duration of 4 years. Future meta-analyses are needed to highlight the potential presence of ISCM and, thereby, decrease the rate of misdiagnosis of these lesions in the pediatric population presenting with recurrent intramedullary spinal cord hemorrhages.

scholarly journals Fibroepithelial Polyp of the External Auditory Canal in a 2-Year-Old Child

2020 ◽  
pp. 014556132094334
Author(s):  
Martin Formánek ◽  
Karol Zeleník ◽  
Vladimír Židlík ◽  
Pavel Komínek
Keyword(s):  
Differential Diagnosis ◽  
External Auditory Canal ◽  
Pediatric Population ◽  
Fibroepithelial Polyp ◽  
Unique Case ◽  
First Report ◽  
Rare Diagnosis

Here, we report a unique case in which a fibroepithelial polyp was found in the cartilaginous part of the external auditory canal of a 2-year-old child. The polyp was successfully treated by excision using an endaural approach and healed without complications. This is the very first report of a fibroepithelial polyp in the external auditory canal in the pediatric population. Although fibroepithelial polyp is an extremely rare diagnosis, it should be considered in the differential diagnosis of a child’s external auditory canal polyp.

scholarly journals P.137 Use of intravenous fluorescein for intra-operative localization of an intramedullary spinal cord tumour; a technical note

2018 ◽  
Vol 45 (s2) ◽  
pp. S52-S52
Author(s):  
JT Adams ◽  
M Hong ◽  
S Christie ◽  
S Barry
Keyword(s):  
Spinal Cord ◽  
High Grade Glioma ◽  
Technical Note ◽  
Intramedullary Tumor ◽  
High Grade ◽  
Intramedullary Spinal Cord ◽  
Intramedullary Lesion ◽  
Multiple Biopsies ◽  
Spinal Cord Tumours ◽  
Spine Tumour

Background: Localization of intramedullary spine tumors can be difficult. Various intraoperative aids have previously been described, but have limited use due to expense, complexity, and time. Intravenous fluorescein is an inexpensive and safe drug that may be useful in the localization of such tumors. We describe a technical description of the intra-operative use of fluorescein as an aid in the localization of a intramedullary spine tumour. Methods: In this technical report, the authors present a case example of a 56 year old man presenting with a intramedullary tumor at the level of C5/6. Intra-operatively intravenous Fluorescein was administered and the Pentero microscope BLUE™ 400 feature was used to accurately identify the lesion. Multiple biopsies of the fluorescent tissue were taken. Results: After 10 cardiac cycles the fluorescent coloring was isolated to what was thought to be the intramedullary lesion. Our myelotomy was made based on the uptake of this fluorescent coloring and multiple biopsies were taken. Final pathology confirmed this tissue was consistent with a high grade glioma. Conclusions: The use of intravenous fluorescein was a valuable aid in localizing the lesion and minimizing the size of our myelotomy. The use of intravenous fluorescein to localize high grade intramedullary spinal cord tumours appears to be safe, accurate, and inexpensive.

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