Extradural spinal involvement by gout

1979 ◽  
Vol 50 (2) ◽  
pp. 236-239 ◽  
Author(s):  
Steven L. Wald ◽  
James E. McLennan ◽  
Richard M. Carroll ◽  
Harold Segal

✓ A case of extradural gouty tophus in the lumbar region in a teen-age girl is presented as an addition to the differential diagnosis of erosive lesions of the spinal canal.

1978 ◽  
Vol 49 (6) ◽  
pp. 914-920 ◽  
Author(s):  
Darrell J. Harris ◽  
Victor L. Fornasier ◽  
Kenneth E. Livingston

✓ Hemangiopericytoma is a vascular neoplasm consisting of capillaries outlined by an intact basement membrane that separates the endothelial cells of the capillaries from the spindle-shaped tumor cells in the extravascular area. These neoplasms are found in soft tissues but have rarely been shown to involve the spinal canal. This is a report of three such cases. Surgical removal of the tumor from the spinal canal was technically difficult. A high risk of recurrence has been reported but in these three cases adjunctive radiotherapy appeared to be of benefit in controlling the progression of the disease. These cases, added to the six cases in the literature, confirm the existence of hemangiopericytoma involving the vertebral column with extension into the spinal canal. This entity should be included in the differential diagnosis of lesions of the spinal canal. The risk of intraoperative hemorrhage should be anticipated.


1998 ◽  
Vol 88 (6) ◽  
pp. 954-961 ◽  
Author(s):  
Gabrielle F. Morris ◽  
Katrina Murphy ◽  
Lucy B. Rorke ◽  
Hector E. James

Object. Congenital spinal hamartomas are defined as tumors of well-differentiated mature elements situated in an abnormal location. In this report, the authors document the clinical and pathological features of spinal hamartomas in 10 patients. Methods. Ten patients presented with midline dorsal malformations at birth, initially diagnosed as teratomas or myelomeningoceles. The locations of the masses were variable: two were located in the thoracic region, four at the thoracolumbar junction, two in the lumbar region, one at the lumbosacral junction, and one in the sacral region. The results of the neurological examination were normal in nine patients. All but one mass had intact skin and seven had palpable bone components. Neuroimaging studies revealed widening of the spinal canal, heterotopic bone located dorsally in some patients, and varying degrees of involvement of the intraspinal contents. During surgery, six patients were found to have involvement of the spinal cord or cauda equina. The pathological characteristics of the masses included three or more of the following: bone, cartilage, synovial membrane, urinary tract tissue, cyst wall, yellow or brown fat, and nerves. The well-differentiated cellular elements, which formed mature structures, along with the absence of primitive cellular components and neoplastic characteristics are more consistent with a diagnosis of hamartoma than teratoma. Conclusions. In this series, the authors describe a lesion that is overt on physical examination, yet can have occult spinal canal involvement. Complete neurosurgical evaluation is essential to provide appropriate treatment and prognosis.


2005 ◽  
Vol 2 (5) ◽  
pp. 596-600 ◽  
Author(s):  
Raphaël Vialle ◽  
Antoine Feydy ◽  
Ludovic Rillardon ◽  
Carla Tohme-Noun ◽  
Philippe Anract ◽  
...  

✓ Chondroblastoma is a benign cartilaginous neoplasm that generally affects the appendicular skeleton. Twenty-six cases of spinal chondroblastoma have been reported in the past 50 years, only six of which were located in the lumbar region. The authors report two cases involving this exceptional location. In both patients, low-back pain, in the absence of radicular pain, was the presenting symptom. In both cases, plain radiography and computerized tomography scanning revealed an osteolytic lesion surrounded by marginal sclerosis. Magnetic resonance imaging allowed the authors to study the tumor's local extension. Examination of a percutaneous fluoroscopy-guided biopsy sample revealed the following typical histological features of chondroblastoma: chondroid tissue, focally alternating with cellular areas, and no nuclear atypia or pleomorphism. To reduce the risk of local recurrence, vertebrectomy and anterior—posterior fusion were performed in both cases. In one case, a structural lumbar scoliosis was corrected during the posterior procedure. There was no postoperative complication. No recurrence was observed during the 3- to 6-year follow-up period. The surgery-related results were deemed successful. Although exceptional, the diagnosis of chondroblastoma is possible in lesions involving the lumbar spine. Other spinal locations are described in the literature, and frequency of recurrence is stressed. A vertebrectomy is advised to reduce the risk of local recurrence.


1980 ◽  
Vol 52 (6) ◽  
pp. 846-848 ◽  
Author(s):  
George M. Kleinman ◽  
T. Forcht Dagi ◽  
Charles E. Poletti

✓ Villonodular synovitis is believed to be an inflammatory, proliferative reaction of synovial tissues. The case of a 65-year-old woman with a cervical epidural mass is presented in which histological examination showed that the lesion was villonodular synovitis, an extremely rare occurrence. Because of its cellularity and occasional multinucleated giant cells, villonodular synovitis may be confused with metastatic malignancies or giant-cell tumor of bone.


1994 ◽  
Vol 81 (5) ◽  
pp. 784-787 ◽  
Author(s):  
Markus Hardenack ◽  
Anje Völker ◽  
J. Michael Schröder ◽  
Joachim M. Gilsbach ◽  
Albrecht G. Harders

The authors report the occurrence of primary eosinophilic granuloma of the oculomotor nerve without osseous involvement in a 68-year-old man. Histopathological and neuroradiological findings are discussed. This case demonstrates that eosinophilic granuloma should be included in the differential diagnosis of tumor in which cranial nerves are involved.


1988 ◽  
Vol 69 (1) ◽  
pp. 137-139 ◽  
Author(s):  
Jordan C. Grabel ◽  
Raphael Davis ◽  
Rosario Zappulla

✓ The case presented is of a patient with an intervertebral disc space cyst producing recurrent radicular pain following microdiscectomy in the lumbar region. Difficulties with the preoperative diagnosis of this and other recurrent radicular syndromes are discussed, and a review of the relevant literature is presented.


2005 ◽  
Vol 2 (3) ◽  
pp. 354-365 ◽  
Author(s):  
Miguel Gelabert-González

✓ The author reports two cases of cauda equina paraganglioma (CEP) and provides a review of all previously published cases. The current radiological, neurosurgical, and pathological literature on this rare tumor is also reviewed.


1988 ◽  
Vol 69 (4) ◽  
pp. 624-627 ◽  
Author(s):  
Shih Sing Liu ◽  
William L. White ◽  
Peter C. Johnson ◽  
Charles Gauntt

✓ Hemophilic pseudotumor is an uncommon complication among hemophiliacs. Most of these lesions are located in the long bones and the pelvis. The authors describe a case of hemophilic pseudotumor in a patient who presented with symptoms of L-5 radiculopathy and evidence of a destructive lesion on computerized tomography scans. Histologically, the lesion consisted of an organizing hematoma with reactive fibrosis. The diagnosis requires a high index of suspicion. Surgery is recommended for symptomatic patients.


1971 ◽  
Vol 34 (4) ◽  
pp. 506-514 ◽  
Author(s):  
John L. Fox ◽  
Joel L. Falik ◽  
Robert J. Shalhoub

✓ Of 80 consecutive neurosurgical patients, 23 exhibited inappropriate secretion of the antidiuretic hormone (ISADH); 11 of these patients required marked fluid restriction. Sodium concentration in the urine characteristically increased as serum values decreased. Only by following the urine sodium concentrations could the differential diagnosis of nutritional hyponatremia and ISADH be made. The role of ISADH in cerebral edema is stressed. The treatment recommended for ISADH is marked fluid restriction, whereas in nutritional hyponatremia, saline replacement is indicated.


1981 ◽  
Vol 54 (4) ◽  
pp. 480-483 ◽  
Author(s):  
Robert G. Fisher ◽  
Richard L. Saunders

✓ Forty-three cases of surgically treated lumbar disc protrusion in patients 21 years or younger are analyzed. The results were generally good. Ten percent of the patients required reoperation within 3 years. No major complications were experienced. Follow-up observation ranged from 4 to 30 years. Disc protrusion should be considered in the differential diagnosis of children with back and sciatic pain, and early myelography should be carried out in the refractory case. The symptoms, signs, myelograms, and surgical findings are usually similar to those of the adult patient with a disc protrusion.


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