Melanoma arising in a spinal nerve root

1987 ◽  
Vol 67 (6) ◽  
pp. 923-927 ◽  
Author(s):  
Steven J. Schneider ◽  
J. Bob Blacklock ◽  
Janet M. Bruner
Keyword(s):  
Nerve Root ◽  
Primary Melanoma ◽  
Clear Cell Sarcoma ◽  
Spinal Nerve ◽  
Nerve Sheath Tumor ◽  
Spinal Nerve Root ◽  
Content Type ◽  
Pigmented Lesions ◽  
Lumbar Nerve Root ◽  
Malignant Lesions

✓ Melanotic neoplasms of the spinal nerve root are rare but well-documented occurrences. The authors report the case of a 68-year-old woman with a malignant melanotic neoplasm containing premelanosomes and melanosomes and lacking a basal lamina. This tumor was found in a lumbar nerve root and is believed to represent an instance of a primary melanoma arising in a spinal nerve root. The differential diagnosis of pigmented lesions of spinal nerve root includes melanoma, pigmented nerve sheath tumor, blue nevus, melanotic clear-cell sarcoma, and meningeal melanocytoma. Surgeons should be aware of the potential for encountering unexpected malignant lesions involving spinal nerve roots.

Mechanisms of cervical nerve root avulsion in injuries of the neck and shoulder

1974 ◽  
Vol 41 (6) ◽  
pp. 705-714 ◽  
Author(s):  
Sydney Sunderland
Keyword(s):  
Nerve Root ◽  
Spinal Nerve ◽  
Spinal Nerve Root ◽  
Root Avulsion ◽  
Cervical Nerve Root ◽  
Cervical Nerve ◽  
Content Type ◽  
Nerve Root Avulsion ◽  
New Interpretation ◽  
Fine Print

✓ The author reviews the mechanisms of traumatic spinal nerve root avulsion and proposes a new interpretation.

Clinical Characteristics of Spinal Nerve Sheath Tumors: Analysis of 149 Cases

Neurosurgery ◽  
2005 ◽  
Vol 56 (3) ◽  
pp. 510-515 ◽  
Author(s):  
Takahiro Jinnai ◽  
Minoru Hoshimaru ◽  
Tsunemaro Koyama
Keyword(s):  
Nerve Root ◽  
Spinal Nerve ◽  
Nerve Sheath Tumor ◽  
Spinal Nerve Root ◽  
Intervertebral Foramen ◽  
Nerve Roots ◽  
Nerve Sheath Tumors ◽  
Nerve Sheath ◽  
Caudal Portion ◽  
Rostral Portion

Abstract OBJECTIVE: Spinal nerve sheath tumors arise from the spinal nerve root and grow along it. There are two sites at which the growth of a tumor is restricted: the dural aperture for the spinal nerve root and the intervertebral foramen. This article describes the growth pattern of a spinal nerve sheath tumor along the spinal nerve root at various spinal levels. METHODS: We retrospectively reviewed the records for 149 patients with spinal nerve sheath tumors who were treated between 1980 and 2001. Of these, 176 resected tumors were classified into five groups according to the relationship to the dura mater and/or the intervertebral foramen. RESULTS: Strictly intradural tumors compose 8% of nerve sheath tumors of the first two cervical nerve roots. The percentage of these tumors increased gradually from the high cervical region to the thoracolumbar region, where it was more than 80%. In contrast, the percentage of strictly extradural tumors gradually decreased from the rostral portion to the caudal portion. Similarly, a percentage of tumors extending outside the spinal canal decreased from the rostral portion to the caudal portion. These changes of the growth pattern may be explained by the anatomic features of the spinal nerve roots, which have a longer intradural component at the more caudal portion of the spinal axis. CONCLUSION: The anatomic relationship of a nerve sheath tumor with the dura mater and the intervertebral foramen varies depending on the level of the tumor. This knowledge may help us to create a strategy for total resection of a nerve sheath tumor.

Updated assessment and current classification of spinal meningeal cysts

1988 ◽  
Vol 68 (3) ◽  
pp. 366-377 ◽  
Author(s):  
Michael W. Nabors ◽  
T. Glenn Pait ◽  
Edward B. Byrd ◽  
Najmaldin O. Karim ◽  
David O. Davis ◽  
...  
Keyword(s):  
Nerve Root ◽  
Spinal Nerve ◽  
Water Soluble ◽  
Type I ◽  
Spinal Nerve Root ◽  
Content Type ◽  
Spinal Meningeal Cysts ◽  
Spinal Nerve Root Fibers ◽  
Meningeal Cysts

✓ The classification of spinal meningeal cysts (MC's) in the literature is indistinct, confusing, and in certain categories histologically misleading. Based on a series of 22 cases, the authors propose a classification comprising three categories: spinal extradural MC's without spinal nerve root fibers (Type I); spinal extradural MC's with spinal nerve root fibers (Type II); and spinal intradural MC's (Type III). Although water-soluble myelography may disclose a filling defect for all three categories, computerized tomographic myelography (CTM) is essential to reveal communication between the cyst and the subarachnoid space. Communication demonstrated by CTM allows accurate diagnosis of a spinal MC and rules out other mass lesions. Magnetic resonance imaging appears useful as an initial study to identify an intraspinal cystic mass. Final characterization is based on operative inspection and histological examination for all three categories.

scholarly journals Nerve transfer in brachial plexus traction injuries

1992 ◽  
Vol 76 (2) ◽  
pp. 191-197 ◽  
Author(s):  
Miroslav Samardzic ◽  
Danica Grujicic ◽  
Vaso Antunovic
Keyword(s):  
Brachial Plexus ◽  
Nerve Root ◽  
Nerve Transfer ◽  
Spinal Nerve ◽  
Spinal Nerve Root ◽  
Root Avulsion ◽  
Brachial Plexus Palsy ◽  
Content Type ◽  
Spinal Accessory ◽  
Nerve Root Avulsion

✓ Brachial plexus palsy due to traction injury, especially spinal nerve-root avulsion, represents a severe handicap for the patient. Despite recent progress in diagnosis and microsurgical repair, the prognosis in such cases remains unfavorable. Nerve transfer is the only possibility for repair in cases of spinal nerve-root avulsion. This technique was analyzed in 37 patients with 64 reinnervation procedures of the musculocutaneous and/or axillary nerve using upper intercostal, spinal accessory, and regional nerves as donors. The most favorable results, with an 83.8% overall rate of useful functional recovery, were obtained in patients with upper brachial plexus palsy in which regional donor nerves, such as the medial pectoral, thoracodorsal, long thoracic, and subscapular nerves, had been used. The overall rates of recovery for the spinal accessory and upper intercostal nerves were 64.3% and 55.5%, respectively, which are significantly lower. The authors evaluate the results of nerve transfer and analyze different donor nerves as factors influencing the prognosis of surgical repair.

Extrathecal intraradicular nerve sheath tumor

2005 ◽  
Vol 3 (1) ◽  
pp. 1-11 ◽  
Author(s):  
Paolo Celli ◽  
Giuseppe Trillò ◽  
Luigi Ferrante
Keyword(s):  
Nerve Root ◽  
Spinal Nerve ◽  
Nerve Sheath Tumor ◽  
En Bloc ◽  
Content Type ◽  
Nerve Sheath Tumors ◽  
Nerve Sheath ◽  
Radical Removal ◽  
Fine Print

Object. The purpose of this study was to analyze the clinical profile of patients harboring extrathecal and intraradicular nerve sheath tumors (NSTs), located inside the sleeve of an extrathecal nerve root and very often within the proximal portion of the spinal nerve, and to evaluate the incidence of long-term dysfunction of the tumor-affected roots if resected. These tumors have not received particular attention in the literature. Methods. A single-institution series of 16 patients who had undergone surgery for intraradicular NSTs during a 50-year period was selected retrospectively. Data pertaining to clinical features, tumor characteristics, and results of surgery were analyzed. Conclusions. Extrathecal and intraradicular neurofibromas or schwannomas more frequently affect the lumbar and S-1 nerve roots, often producing root pain only. Selective en bloc enucleation sparing at least part of the motor rootlets is possible for small schwannomas of the extrathecal—preganglion segment of the radix, whereas total resection of the affected root is generally required for radical removal of neurofibromas and large schwannomas. In the authors' experience, neither deafferentation pain nor severe radicular weakness occurs after division of the nerve root harboring the tumor.

Neuroblastoma-like schwannoma of lumbar spinal nerve root

2010 ◽  
Vol 13 (1) ◽  
pp. 82-86 ◽  
Author(s):  
Giriraj K. Sharma ◽  
Jennifer M. Eschbacher ◽  
Timothy D. Uschold ◽  
Nicholas Theodore
Keyword(s):  
Nerve Root ◽  
Histopathological Examination ◽  
Case Reports ◽  
Spinal Nerve ◽  
Nerve Sheath Tumor ◽  
Spinal Nerve Root ◽  
Postoperative Course ◽  
Rare Lesion ◽  
The Right ◽  
Lumbar Spinal

Neuroblastoma-like schwannoma is a rare nerve sheath tumor with histological features resembling a neuroblastoma. A comprehensive literature review identified only 10 previous case reports of this condition. The authors present the first reported case of a neuroblastoma-like schwannoma at a spinal nerve root. The patient, a 61-year-old woman, presented with severe pain in the right lower extremity that failed to resolve after conservative management. Magnetic resonance imaging revealed an intradural enhancing lesion extending out of the right neural foramen at L1–2. A right L1–2 hemilaminectomy and facetectomy with gross-total resection of the tumor was performed without complications. Neuroblastoma-like schwannoma was diagnosed based on histopathological examination of the biopsied tumor specimen. A postoperative course of serial examination and imaging was chosen based on a suspected benign postoperative course as in the case of a completely resected schwannoma. The authors present the novel case of neuroblastoma-like schwannoma at a lumbar spinal nerve root and describe the distinguishing pathological features of this rare lesion.

Pilocytic astrocytoma of a spinal nerve root

2002 ◽  
Vol 97 (1) ◽  
pp. 110-112 ◽  
Author(s):  
Mark Robert Philipson ◽  
Jake Timothy ◽  
Aruna Chakrobarthy ◽  
Gerry Towns
Keyword(s):  
Mr Imaging ◽  
Pilocytic Astrocytoma ◽  
Nerve Root ◽  
Residual Tumor ◽  
Conus Medullaris ◽  
Spinal Nerve ◽  
Spinal Nerve Root ◽  
Content Type ◽  
First Case ◽  
Fine Print

✓ A case of pilocytic astrocytoma involving a spinal nerve root is reported. A 39-year-old woman presented with a 1-year history of progressive pain and numbness, predominantly in the S-1 dermatome. Magnetic resonance (MR) imaging revealed an intradural lesion at the tip of the conus medullaris. The intradural tumor was excised as was the sacrificed nerve root. Histological examination showed a pilocytic astrocytoma in which there were unusual features of calcification and ossification. At 3-year follow-up review MR imaging demonstrated no residual tumor. To the best of the authors' knowledge, this is the first case of a primary pilocytic astrocytoma, a tumor typically of central nervous system origin, arising from a spinal nerve root.

Hemangioma of spinal nerve root

1999 ◽  
Vol 91 (2) ◽  
pp. 175-180 ◽  
Author(s):  
Federico Roncaroli ◽  
Bernd W. Scheithauer ◽  
William E. Krauss
Keyword(s):  
Nerve Root ◽  
Cauda Equina ◽  
Spinal Nerve ◽  
Nerve Fibers ◽  
Capillary Hemangioma ◽  
Spinal Nerve Root ◽  
Spinal Nerve Roots ◽  
Nerve Roots ◽  
Content Type ◽  
Fine Print

Object. Hemangiomas of the spinal nerve roots are rare. Only 12 cases have been reported in the literature, all since 1965. These lesions occurred in adults, primarily in males, and were located in the cauda equina. Of the 12 lesions, eight were cavernous hemangiomas. The authors report here the clinicopathological features of 10 cases of hemangioma of the spinal nerve root, nine of which were of the capillary type. Methods. The group included six men and four women who ranged in age from 40 to 62 years. The majority of patients presented with pain and weakness. One patient also experienced worsening of pain during menses. In all cases, gadolinium-enhanced magnetic resonance imaging or computerized tomography myelography demonstrated a discrete intraspinal extramedullary mass. Administration of contrast agent resulted in uniform, intense enhancement. A gross-total resection was achieved in all but one case; in most cases, it was necessary to sacrifice the parent nerve root. Preoperative symptoms and signs improved in nine cases. On histological examination, all but one tumor, a spindle-cell hemangioendothelioma, were shown to be ordinary capillary hemangiomas. Two lesions exhibited a cavernous component, and five showed a partly solid growth pattern resembling juvenile capillary hemangioma. In all cases, the relationship with the nerve root was histologically confirmed. The tumor—nerve relation varied. The intact nerve was displaced by the epineurial mass in three cases. The fascicles appeared separated in six cases, and individual nerve fibers were seen throughout one lesion with endoneurial involvement. Conclusions. Hemangiomas of spinal nerve roots pose a challenging diagnostic problem. Knowledge of their existence is relevant in that they may mimic tumors and are amenable to surgical treatment.

Lumbosacral intersegmental epispinal axons and ectopic ventral nerve rootlets

1987 ◽  
Vol 67 (2) ◽  
pp. 269-277 ◽  
Author(s):  
Wesley W. Parke ◽  
Ryo Watanabe
Keyword(s):  
Nerve Root ◽  
Sensory Nerve ◽  
Conus Medullaris ◽  
Spinal Nerve ◽  
Nerve Fibers ◽  
Ventral Horn ◽  
Spinal Nerve Roots ◽  
Nerve Roots ◽  
Content Type ◽  
Almost All

✓ An epispinal system of motor axons virtually covers the ventral and lateral funiculi of the human conus medullaris between the L-2 and S-2 levels. These nerve fibers apparently arise from motor cells of the ventral horn nuclei and join spinal nerve roots caudal to their level of origin. In all observed spinal cords, many of these axons converged at the cord surface and formed an irregular group of ectopic rootlets that could be visually traced to join conventional spinal nerve roots at one to several segments inferior to their original segmental level; occasional rootlets joined a dorsal nerve root. As almost all previous reports of nerve root interconnections involved only the dorsal roots and have been cited to explain a lack of an absolute segmental sensory nerve distribution, it is believed that these intersegmental motor fibers may similarly explain a more diffuse efferent distribution than has previously been suspected.

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