Intramedullary spinal cord sarcoidosis

1972 ◽  
Vol 37 (2) ◽  
pp. 233-236 ◽  
Author(s):  
Howard Semins ◽  
G. Robert Nugent ◽  
Samuel M. Chou
Keyword(s):  
Spinal Cord ◽  
Mass Lesion ◽  
Intramedullary Spinal Cord ◽  
Content Type ◽  
Spinal Cord Sarcoidosis ◽  
Rare Lesion ◽  
Dorsal Laminectomy ◽  
Fine Print

✓ A dorsal laminectomy was performed on a 68-year-old woman with an intramedullary mass lesion, ultimately diagnosed as sarcoidosis. This rare lesion of the spinal cord is presented with references to similar cases.

Primary intramedullary spinal cord germinoma

1996 ◽  
Vol 84 (6) ◽  
pp. 1060-1061 ◽  
Author(s):  
Akira Miyauchi ◽  
Katsumi Matsumoto ◽  
Eiji Kohmura ◽  
Teruo Doi ◽  
Kazuhiko Hashimoto ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Central Nervous System ◽  
Nervous System ◽  
Conus Medullaris ◽  
Rare Occurrence ◽  
Partial Removal ◽  
Intramedullary Spinal Cord ◽  
Content Type ◽  
Disease Free ◽  
Fine Print

✓ Primary central nervous system germinoma usually presents as an extraaxial intracerebral mass. The authors report the rare occurrence of an intramedullary spinal cord germinoma at the conus medullaris in a 24-year-old man, which was treated by partial removal and radiation therapy. The tumor was highly radiosensitive and the patient remains disease free 15 months posttreatment.

Intramedullary ependymoma of the spinal cord

1990 ◽  
Vol 72 (4) ◽  
pp. 523-532 ◽  
Author(s):  
Paul C. McCormick ◽  
Roland Torres ◽  
Kalmon D. Post ◽  
Bennett M. Stein
Keyword(s):  
Spinal Cord ◽  
Mr Imaging ◽  
Tumor Recurrence ◽  
Neurological Deficits ◽  
Functional Improvement ◽  
Consecutive Series ◽  
Intramedullary Spinal Cord ◽  
Content Type ◽  
Fine Print

✓ A consecutive series of 23 patients underwent operative removal of an intramedullary spinal cord ependymoma between January, 1976, and September, 1988. Thirteen women and 10 men between the age of 19 and 70 years experienced symptoms for a mean of 34 months preceding initial diagnosis. Eight patients had undergone treatment prior to tumor recurrence and referral. Mild neurological deficits were present in 22 patients on initial examination. The location of the tumors was predominantly cervical or cervicothoracic. Radiological evaluation revealed a wide spinal cord in all cases. Magnetic resonance (MR) imaging was the single most important radiological procedure. At operation, a complete removal was achieved in all patients. No patient received postoperative radiation therapy. Histological examination revealed a benign ependymoma in all cases. The follow-up period ranged from 6 to 159 months (mean 62 months) with seven patients followed for a minimum of 10 years after surgery. Fourteen patients underwent postoperative MR imaging at intervals ranging from 8 months to 10 years postoperatively. No patient has been lost to follow-up review and there were no deaths. No patient showed definite clinical or radiological evidence of tumor recurrence during the follow-up period. Recent neurological evaluation revealed functional improvement from initial preoperative clinical status in eight patients, no significant change in 12 patients, and deterioration in three patients. The data support the belief that long-term disease-free control of intramedullary spinal ependymomas with acceptable morbidity may be achieved utilizing microsurgical removal alone.

Intramedullary spinal cord tumors in patients older than 50 years of age: management and outcome analysis

2005 ◽  
Vol 2 (3) ◽  
pp. 249-255 ◽  
Author(s):  
Raj K. Shrivastava ◽  
Fred J. Epstein ◽  
Noel I. Perin ◽  
Kalmon D. Post ◽  
George I. Jallo
Keyword(s):  
Spinal Cord ◽  
Older Adult ◽  
Adult Population ◽  
Spinal Cord Tumors ◽  
Intramedullary Spinal Cord ◽  
Content Type ◽  
The Mean ◽  
Older Adult Population ◽  
Fine Print

Object. Intramedullary spinal cord tumors (IMSCTs) in the older-age adult population pose complex management issues regarding the extent of resection and functional outcome, especially in terms of quality of life. Historically, IMSCTs in the older adult population were treated with irradiation alone because it was assumed that functional recovery would be poor. The authors examined their IMSCT database and report the first large series of IMSCTs in patients older than 50 years of age. Methods. In this retrospective clinical and chart review there were 30 cases meeting inclusion criteria drawn from databases at three different institutions. A modified McCormick Scale was used to assess functional levels in all 30 patients pre- and postoperatively. The mean age of patients in this cohort was 59.8 years (range 50–78 years), and the mean follow- up period was 10.6 years (range 2–16 years). Ependymoma was the most common tumor (83%), and 55% were located in the thoracic spine. The most common presenting symptom was sensory dysesthesia, with rare motor loss. The prodromal period to treatment was 19.4 months. Based on the McCormick Scale score at last follow-up examination 67% of patients were clinically functionally the same, 9% were worse, and 24% were improved after surgery. There were two deaths due tumor progression (both malignant tumors) and one recurrence (anaplastic astrocytoma). All three patients in whom malignant astrocytomas were diagnosed underwent postoperative radiation therapy. Conclusions. In the population of patients older than age 50 years, thoracic ependymomas are the most common IMSCTs that present characteristically with sensory symptoms. The longer prodromal period in the older adult population may reflect the fact that their diagnosis and workup is inadequate. There was no significant increase in the length of stay in the neurosurgical ward. The authors recommend motor evoked potential-guided aggressive microsurgical resection, because the long-term outcome of benign lesions is excellent (good functional recovery and no tumor recurrence).

Spinal intramedullary metastatic medulloblastoma

1978 ◽  
Vol 48 (4) ◽  
pp. 632-635 ◽  
Author(s):  
B. Joseph Zumpano
Keyword(s):  
Spinal Cord ◽  
Cerebrospinal Fluid ◽  
Metastatic Spread ◽  
Intramedullary Spinal Cord ◽  
Content Type ◽  
Documented Case ◽  
Leptomeningeal Seeding ◽  
Extracranial Metastases ◽  
Fine Print

✓ Metastatic spread of medulloblastoma along the neuraxis by leptomeningeal seeding through the cerebrospinal fluid pathways is well known. The occurrence of extracranial metastases outside the neuraxis has been well established, but the occurrence of intramedullary spinal cord metastases not related to surface seeding is rare. A histologically documented case of the latter type is described.

Intramedullary spinal cord tumors in children under the age of 3 years

1996 ◽  
Vol 85 (6) ◽  
pp. 1036-1043 ◽  
Author(s):  
Shlomo Constantini ◽  
John Houten ◽  
Douglas C. Miller ◽  
Diana Freed ◽  
Memet M. Ozek ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Glioblastoma Multiforme ◽  
Spinal Cord Tumor ◽  
Low Grade ◽  
New York University ◽  
Spinal Cord Tumors ◽  
Intramedullary Spinal Cord ◽  
Content Type ◽  
Fine Print

✓ Over a 13-year period extending from 1980 to 1993, 27 children less than 3 years of age underwent operation for removal of an intramedullary spinal cord tumor (IMSCT). The majority (18 of 27) of children had undergone surgery before being referred to New York University (NYU) Medical Center. The most common reasons for radiological investigation were pain (42%), motor regression (36%), gait abnormalities (27%), torticollis (27%), and progressive kyphoscoliosis (24%). Forty procedures were performed in 27 children. Nine children underwent two operations and two children underwent three procedures. A gross-total resection was achieved in 72% of the procedures. There was no surgical mortality. A comparison of the preoperative and 3-month postoperative functional grades for the first NYU procedure (NYU-1) yielded the following findings: 20 patients' conditions remained the same, five patients improved, and two patients deteriorated. The functional outcomes of a second operation (NYU-2) were similar. The majority of the children (24 of 27, 89%) had histologically determined low-grade lesions. There were 12 patients with low-grade astrocytomas (Grades I-III), eight with gangliogliomas, two with ganglioglioneurocytomas, one with a glioneurofibroma, and one child with a mixed astro/oligodendroglioma. Two children had anaplastic astrocytomas (Grades II–III) and one child had a glioblastoma multiforme. In a median follow-up review of 76 months, two patients died and two patients were lost to follow up. The 3- and 5-year progression-free survival (PFS) rates were 81.7% (standard error of the mean (SEM) 0.083) and 76.2% (SEM 0.094), respectively. Eight of 24 patients suffered a recurrence within a mean time of 45.4 ± 28.9 months. All were treated with surgery (NYU-2). Lesions recurred in three of 12 children with low-grade astrocytomas, two of eight children with gangliogliomas, one child with an anaplastic astrocytoma, one child with a ganglioglioneurocytoma, and one child with a glioblastoma multiforme. At follow-up review, most of these children were doing well. Sixteen are in functional Grades I or II and 18 children attend a normal school system. The authors conclude that surgery for the removal of IMSCTs in children less than 3 years of age can be performed radically and safely. The postoperative functional performance is determined by the degree of the preoperative deficit. It is, therefore, of utmost importance to diagnose and treat these children as early as possible. Spinal cord tumors should be recognized as potentially excisable lesions on their initial presentation and when they recur. The optimum treatment for malignant lesions is still to be determined.

Surgical management of holocord intramedullary spinal cord astrocytomas in children

1981 ◽  
Vol 54 (6) ◽  
pp. 829-832 ◽  
Author(s):  
Fred Epstein ◽  
Nancy Epstein
Keyword(s):  
Spinal Cord ◽  
Surgical Management ◽  
Therapeutic Approach ◽  
Pediatric Patients ◽  
Radical Resection ◽  
Neurological Recovery ◽  
Total Removal ◽  
Intramedullary Spinal Cord ◽  
Content Type ◽  
Fine Print

✓ This report describes the therapeutic approach to extensive multisegmental spinal cord astrocytomas in three pediatric patients. It is concluded that radical resection (gross total removal) is compatible with neurological recovery.

Radical resection of intramedullary spinal cord tumors in adults

1985 ◽  
Vol 63 (4) ◽  
pp. 492-499 ◽  
Author(s):  
Paul R. Cooper ◽  
Fred Epstein
Keyword(s):  
Spinal Cord ◽  
Neurological Deficit ◽  
Radical Resection ◽  
Spinal Cord Tumors ◽  
Intramedullary Tumors ◽  
Duration Of Symptoms ◽  
Intramedullary Spinal Cord ◽  
Content Type ◽  
The Past ◽  
Fine Print

✓ The management of patients with intramedullary spinal cord tumors is controversial. In the past, these tumors have often been treated with biopsy or subtotal removal followed by irradiation — a therapy that is usually associated with early tumor recurrence and progressive neurological impairment. In an attempt to improve on the outcome of patients with intramedullary tumors, the authors performed radical resection in most of the 29 adult patients who had surgery for these tumors within the past 30 months. The mean duration of symptoms was 9½ years, and all patients presented because of progressive neurological deficit. Patients were evaluated with metrizamide myelography-computerized tomography scanning and intraoperative ultrasound imaging to define the site of the tumor and cystic components. There were 14 ependymomas, 11 astrocytomas, two lipomas, and one case each of intramedullary fibrosis and astrogliosis. Solid tumor spanned a mean of five spinal cord segments and 16 tumors were associated with cysts. Twenty tumors were in the cervical and/or cervicothoracic regions. Total removal was achieved in 14 patients and “99% removal” in seven others. In 21 of 29 patients (72%), the neurological condition was stabilized or improved as a result of the operation. Postoperative deterioration occurred for the most part in patients who could not walk or who had minimal motor function at the time of operation, and these patients are no longer considered as operative candidates. Radical resection of intramedullary tumors can be achieved, with stabilization or improvement of neurological deficit in the majority of patients.

Adult intramedullary spinal cord ependymomas: the result of surgery in 38 patients

1993 ◽  
Vol 79 (2) ◽  
pp. 204-209 ◽  
Author(s):  
Fred J. Epstein ◽  
Jean-Pierre Farmer ◽  
Diana Freed
Keyword(s):  
Spinal Cord ◽  
Tumor Recurrence ◽  
Resonance Imaging ◽  
Intramedullary Spinal Cord ◽  
Content Type ◽  
Postoperative Magnetic Resonance Imaging ◽  
Significant Disability ◽  
Surgical Adjunct ◽  
Fine Print

✓ Thirty-eight patients underwent surgery for an intramedullary spinal cord ependymoma. In 37 patients, postoperative magnetic resonance imaging confirmed that the tumor was totally removed. The morbidity of surgery was directly related to the preoperative neurological condition. Patients who were normal or nearly normal preoperatively were rarely worse after surgery, and those who had significant disability preoperatively were at greatest risk of being more impaired after surgery. There has been no tumor recurrence in any patient after a mean follow-up period of 24 months, and radiation therapy has not been employed as a surgical adjunct.

Spinal cord sarcoidosis

1984 ◽  
Vol 61 (5) ◽  
pp. 981-982 ◽  
Author(s):  
Carolyn A. Martin ◽  
Raj Murali ◽  
Sunil S. Trasi
Keyword(s):  
Spinal Cord ◽  
Lymph Node ◽  
Deleterious Effect ◽  
Hilar Lymph Node ◽  
Content Type ◽  
Spinal Cord Sarcoidosis ◽  
Corticosteroid Drugs ◽  
Fine Print

✓ A case of spinal cord sarcoidosis is presented. Diagnosis was established from a biopsy of the hilar lymph node. The patient was successfully treated with corticosteroid drugs. The literature is reviewed and the deleterious effect of surgery is stressed.

Atraumatic bloodless removal of intramedullary hemangioblastomas of the spinal cord

2002 ◽  
Vol 97 (1) ◽  
pp. 1-6 ◽  
Author(s):  
Leonard I. Malis
Keyword(s):  
Spinal Cord ◽  
Private Practice ◽  
Personal Experience ◽  
Tumor Resection ◽  
Tumor Removal ◽  
Bipolar Coagulation ◽  
Intramedullary Spinal Cord ◽  
Content Type ◽  
Microsurgical Technique ◽  
Fine Print

Object. The goal of this study was to summarize the author's personal experience in the surgical treatment of 19 patients with intramedullary spinal cord hemangioblastomas. Methods. All cases were from the author's private practice and were treated between 1967 and 1990. In all cases the intramedullary hemangioblastomas were totally removed by using a unique microsurgical technique of bipolar coagulation, which is fully described in this paper. A bipolar forceps was used to shrink each tumor and detach it from its feeding and draining vessels. Tumor resection was successfully accomplished in all patients. Blood loss was minimal, averaging less than 100 ml, and what little bleeding occurred did so during laminotomy or laminectomy. No bleeding occurred during tumor removal, and no transfusions were given. All patients were symptomatic preoperatively, and all recovered or improved following surgery. Conclusions. The technique described in this paper makes tumor removal safe, effective, and relatively easy.

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