scholarly journals Intradural extramedullary spinal cord tumours: A retrospective study of sur­ gical outcomes

2016 ◽  
Vol 9 (1) ◽  
pp. 11
Author(s):  
Md. Kamrul Ahsan ◽  
Md. Abdul Awwal ◽  
Shahidul Islam Khan ◽  
Md. Hamidul Haque ◽  
Naznin Zaman
Keyword(s):  
Spinal Cord ◽  
Surgical Excision ◽  
Clinical Results ◽  
Neurological Deterioration ◽  
Cerebrospinal Fluid Leakage ◽  
Myxopapillary Ependymoma ◽  
Histopathological Diagnosis ◽  
Preoperative Symptom ◽  
Intradural Extramedullary ◽  
Spinal Cord Tumours

<p><strong>Background:</strong> Intradural extramedullary spinal cord tumours (IESCT) accounts for approximately two thirds of all intraspinal neoplasm and are of important clinical consideration and surgery is the essence in cases with neurological deterioration.</p><p><strong>Objective:</strong> To share our experience on the outcome of surgical excision of intradural extramedullary spinal cord tumours. Methods: Results of 60 patients surgically treated intradural extramedullary spinal tumours between Octo­ber 2003 and October 2015 at Bangabandhu Sheikh Mujib Medical University and in our private settings, Dhaka, were analyzed retrospectively. There were 32 males, 28 females with an average age of 52.4 years (13-70 years) and followed up for at least a year. The preoperative symptom with duration, tumours location and intradural space occupancy and the histopathological diagnosis were analyzed. Pain was evaluated by the visual analogue scale (VAS) and the neurologic function was assessed by Nurick's grade.</p><p><strong>Results:</strong> The tumours were located as, thoracic 32 (53.33%), lumbar 16 (26.67%), cervical 04 (6.67%), and junctional 08 (13.33%), CervicoThoracic-01, Thoracolumbar-07). The histopathological diagnosis included schwannoma 35 (58.33%), meningiomas 14 (23.33%), neurofbroma 4 (6.67%), arachnoid cyst and myxopapillary ependymoma 03 (05.00%) each and paraganglioma 01 (01.67%). The VAS score was reduced in all cases from 8.0 ± 1.2 to 1.2 ± 0.8 (p &lt; 0.003) and the Nurick's grade was improved in all cases from 3.0 ± 1.3 to 1.0 ± 0.0 (p &lt; 0.005). The preoperative neurological deficit improved within 8 postoperative weeks in most cases and within 1 postoperative year in all cases. Complications included cerebrospinal fluid leakage, parasthesia, dependant bedsore 02 (3.33%) each and recurrence 03 (05.00%). and further neurological deterioration 1 (01.67%) case.</p><p><strong>Conclusion:</strong> lntradural extramedullary tumors detected by MRI are mostly benign and good clinical results can be obtained when treated surgi­cally. Aggressive surgical excision potentially minimizes neurologic morbidity and improved outcome. ­</p>

scholarly journals Surgical outcome of intradural extramedullary spinal cord tumors - Our experience at a tertiary health care center

2020 ◽  
Vol 1 (2) ◽  
pp. 103-109
Author(s):  
Gyanendra Joshi ◽  
Binod Bijukachhe ◽  
Javed Ahmad Khan
Keyword(s):  
Spinal Cord ◽  
Cauda Equina ◽  
Clinical Results ◽  
Spinal Tumors ◽  
Myxopapillary Ependymoma ◽  
Spinal Cord Tumors ◽  
Vas Score ◽  
Post Surgery ◽  
Intradural Extramedullary

Introduction: To report the treatment results of 19 patients who underwent excision of intradural extramedullary (IDEM) spinal tumors. Materials & Methods:  This is a retrospective study. Patients’ records were retrieved from the electronic database of Grande International Hospital. There were 19 IDEM spinal tumors excised over a period of 6 years between January 2013 and August 2019 by a single surgeon. There were 11 (57.9%) males and 8 (42.1%) females with an average age of 48.37±21.87 years (range, 5-79 years). The mean postoperative follow-up period was 12.87±14.88 months (range, 15 days - 60 months). The histopathological findings, locations of the tumors, and clinical results were analyzed. Neurological findings were evaluated using ASIA grading system and pain was evaluated using VAS score. Results:  Histopathologically the tumors were: 8 meningioma (42.1%), 4 schwannoma (21.1%), 4 neurofibroma (21.1%), 1 dermoid cyst (5.3%), 1 lipoma (5.3%), and 1 myxopapillary ependymoma (5.3%). Tumor locations were: dorsal in 10 (52.6%), lumbar in 5 (26.3%), lumbosacral in 2 (10.5%), dorsolumbar in 1 (5.3%), and cervical in 1 (5.3%) patient. Neurologic status of 7 patients was normal and 12 had neurologic involvement with 3 patients having Cauda Equina Syndrome (CES) preoperatively. At the final follow-up, 3-grade, 2-grade and 1-grade improvement in ASIA score was observed in 1, 6 and 1 cases, respectively. There was no change in the ASIA grade in 1 case. All 3 cases of CES achieved full neural recovery. Preoperative VAS score was 9.21±1.08 and improved significantly to 0.74±1.62 after surgery. Neurological improvement was seen in 91.67% with complete recovery in 75% of the cases and not a single case deteriorated neurologically post-surgery. Conclusion:  Most intradural-extramedullary spinal cord tumors are mostly benign and good clinical results can be obtained when adequately treated with surgery.

scholarly journals Intradural ventral and ventrolateral tumors of the spinal cord: surgical treatment and results

2004 ◽  
Vol 17 (1) ◽  
pp. 1-8 ◽  
Author(s):  
Eugene I. Slin'ko ◽  
Iyad Ischak Al-Qashqish
Keyword(s):  
Spinal Cord ◽  
Surgical Treatment ◽  
Malignant Tumors ◽  
Clinical Results ◽  
Neurological Symptoms ◽  
Surgical Approaches ◽  
Intradural Extramedullary

Object To improve results of surgical treatment of ventral and ventrolateral tumors of the spinal cord, the authors analyzed surgical approaches, defined the indications for various approaches, and assessed the clinical results. Methods Between 1993 and 2004 the authors treated 360 patients: 43 of them had dorsal, 177 dorsolateral, 33 ventral, and 107 had ventrolateral intradural extramedullary tumors. Among 140 patients with intradural extramedullary ventral and ventrolateral tumors, neuromas were seen in 56 and meningiomas in 84. Of the 140 patients studied, tumors were removed totally in 102 (74%), subtotally in 30 (21%), and partially in eight (5%). After ventrolateral and dorsolateral approaches were introduced in 1996, tumors in ventral or ventrolateral locations have been removed totally or subtotally. In the group of patients with meningiomas, 41 of the lesions were the meningothelial type, 22 were transitional, 12 fibroblastic, four psammomatous, three were angiomatous, one was atypical, and one was malignant. Tumors in the neuroma group were schwannomas in 45 patients and neurofibromas in 11. Postoperatively, recovery was observed in 70 patients (50%), improvement in 53 (38%), no change in 10 (7%), and deterioration in seven (5%). At follow-up evaluation recovery was noted in 76 patients, improvement in 58, no change in four, and in two patients the neurological symptoms were worse than before the operation. Conclusions Surgical routes to extramedullary tumors should be chosen based on the location of the tumor, its spread, and the region in which it is localized.

Minimally invasive transmuscular approach for the treatment of benign intradural extramedullary spinal cord tumours: Technical note and results

2015 ◽  
Vol 61 (5) ◽  
pp. 333-338 ◽  
Author(s):  
M. Afathi ◽  
E. Peltier ◽  
T. Adetchessi ◽  
T. Graillon ◽  
H. Dufour ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Minimally Invasive ◽  
Technical Note ◽  
Intradural Extramedullary ◽  
Spinal Cord Tumours

scholarly journals Intradural extramedullary spinal cord tumors: a retrospective study at tertiary referral hospital

2016 ◽  
Vol 30 (1) ◽  
pp. 106-112
Author(s):  
Mangal Govind ◽  
Mittal Radheyshyam ◽  
Sharma Achal ◽  
Gandhi Ashok
Keyword(s):  
Spinal Cord ◽  
Dramatic Improvement ◽  
Tertiary Referral Hospital ◽  
Chi Square ◽  
Duration Of Symptoms ◽  
Intradural Extramedullary ◽  
Spinal Cord Tumours ◽  
Student’S T

Abstract Introduction: Intradural extramedullary (IDEM) spinal cord tumours account two thirds of all intraspinal tumours. The objective of this study was to determine short- and long-term outcomes of surgical patients with IDEM spinal cord tumours, and to see clinical features that could be helpful in management of patients with these lesions (operated by single senior surgeononly). Methods: A retrospective review of 201 operative IDEM spinal cord tumours cases between 1993 and 2014 was performed. Outcomes were scored at one month and at mean follow-up of 8.5 months postoperatively. In addition, patient demographics, tumour types and locations were also collected. Statistical analysis was conducted utilizing Chi-square and Student's t-tests. Results: There were 93 men and 108 women (mean age 48 yrs, range 5-87 yrs). Men presented at a younger age than women (42 vs 51 yrs, P<0.02). 165 (82.08 %) patients presented with severe radiculopathy and myelopathy. The 36 (17.91 %) had symptoms of radiculopathy. Mean duration of symptoms prior to diagnosis was 11 months. Schwannomas (113 patients) had the longest mean duration of symptoms (14.9 months), followed by meningiomas (68 patients, 8.4 months), and ependymomas (20 patients, 2 months). Hundred and eighty nine (94%) of patients demonstrated significant improvement at one-month and 186 (92%) at 6-month mean follow-up. Only 39/201 (19.4%) patients had residual focal deficits on long term follow-up. Conclusions: Surgery for IDEM should be expected to produce significant and dramatic improvement in most of patients. Demographic, tumor-specific and anatomic considerations will be clinically useful while managing IDEM.

scholarly journals P13.04 Transcriptional profiling differentiates spinal cord ependymal tumours from other glial tumours in children

2019 ◽  
Vol 21 (Supplement_3) ◽  
pp. iii62-iii63
Author(s):  
A A Sobocińska ◽  
M Niemira ◽  
A Szałkowska ◽  
B Wojtaś ◽  
J Trubicka ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Pilocytic Astrocytoma ◽  
System Analysis ◽  
Transcriptional Profiling ◽  
Molecular Classification ◽  
Marker Genes ◽  
Myxopapillary Ependymoma ◽  
Histopathological Diagnosis ◽  
Low Grade ◽  
Rna Expression Profiling

Abstract BACKGROUND Spinal cord tumours in children include ependymal and other tumours of glial origin, all of them displaying GFAP marker. Some tumours may present difficulties in histopathological diagnosis e.g. due to intratumour heterogeneity. Therefore, molecular approach should be examined for its diagnostic usefulness. We investigated a series of originally diagnosed spinal cord ependymal tumours, using transcriptional profiling, to confirm if molecular classification is compatible with histopathological diagnosis. MATERIAL AND METHODS Overall, 9 patients diagnosed between 2001 and 2014 in The Children’s Memorial Health Institute (CMHI) in Warsaw, Poland, were included in the analysis. 4 patients were diagnosed with GI myxopapillary ependymomas, 3 patients with GII and 2 patients with GIII grade ependymal tumours. Total RNA was extracted from FFPE tumour samples using RNeasy kits (Qiagen). Transcriptional profiling was performed using NanoString nCounter system analysis. Tumours were analysed according to the manufacturer’s procedures for hybridization, detection and scanning. Raw counts for each gene underwent technical and biological normalization using nSolver software. A custom NanoString CodeSet consisted of 8 marker genes: GFAP as a glial marker, CAPS and FAM81B as the markers for ependymal tumours and OLIG1, OLIG2, PMP2, KLRC3 and C1orf61 as the markers for other gliomas. Marker genes were identified by re-analysis of publically available microarrays data from childhood brain tumour samples. Histopathological reassessment of tumour preparations was performed by two experienced neuropathologists. RESULTS Hierarchical clustering of 9 samples revealed that two tumours clustered separately and displayed low expression of ependymal markers but high expression of all other glioma markers. Subsequent histopathological re-analysis of preparation of the later 2 tumours showed that one of them displayed features of pilocytic astrocytoma with loose, microcytic and fibrillary areas accompanied by advanced myxoid degenerative changes mimicking the picture of myxopapillary ependymoma. The second tumour revealed heterogeneous morphology with areas of diffuse low grade astrocytoma, pilocytic astrocytoma and fragments displaying ependymal features, including angiocentric pattern with ependymoma-like perivascular arrangement of neoplastic cells. CONCLUSION The results of analysis indicate that RNA expression profiling from FFPE tumour samples using NanoString nCounter system may be a useful approach in differentiation of ependymal tumours from other glial tumours with misleading morphology located in the spinal cord in children. Funded by the National Science Centre, Poland (2016/21/B/NZ2/01785 and 2016/23/B/NZ2/03064).

scholarly journals Clinical outcome of intradural extramedullary spinal cord tumors: A single-center retrospective analytical study

2021 ◽  
Vol 12 ◽  
pp. 145
Author(s):  
Pratik Patel ◽  
Dhanish Mehendiratta ◽  
Vivek Bhambhu ◽  
Samir Dalvie
Keyword(s):  
Spinal Cord ◽  
Clinical Outcome ◽  
Surgical Intervention ◽  
Spinal Tumors ◽  
Cerebrospinal Fluid Leakage ◽  
Karnofsky Performance Score ◽  
Spinal Cord Tumors ◽  
Mri Scans ◽  
Intradural Extramedullary ◽  
Acute Neurological Deterioration

Background: Intradural extramedullary spinal cord tumors (IESCT) account for approximately two-thirds of largely benign intraspinal neoplasms. They occasionally present with acute neurological deterioration warranting emergent surgical intervention. Methods: Here, we reviewed a series of 31 patients with intradural extramedullary spinal tumors who underwent surgery from 2012 to 2019. Patients averaged 50.8 years of age, and there were 16 males and 15 females. Patients were followed for a minimum of 1 year. Multiple clinical outcome variables were studied (e.g., Karnofsky Performance Score [KPS], visual analog scale (VAS), and Frankel grade). Results: The majority of IESCT tumors were found in the thoracic spine 18 (58.06%) followed by the lumbar 8 (25.80%), cervical 1 (3.22%), and combined junctional tumors 4 (12.90%) (cervicothoracic-02 and thoracolumbar-02). Histopathological diagnoses included schwannomas-16 (51.61%), meningiomas-11 (35.48%), lipomas-2 (6.45%), hemangiomas-1 (3.22), and ependymomas-01 (03.22%). The VAS score was reduced in all cases, while KPS and Frankel grades were significantly improved. Complications included cerebrospinal fluid leakage, new/residual paresthesias, and tumor recurrence (12.50%). Conclusion: Most intradural extramedullary tumors are benign and are readily diagnosed utilizing MRI scans. Notably, good functional outcomes follow surgical intervention.

scholarly journals Spinal nephroblastoma in an Irish wolfhound : case report

1999 ◽  
Vol 70 (1) ◽  
Author(s):  
T. Vaughan ◽  
J. Goldin ◽  
J.W. Nesbit
Keyword(s):  
Spinal Cord ◽  
Cerebrospinal Fluid ◽  
Surgical Excision ◽  
Complete Recovery ◽  
Old Irish ◽  
History Of ◽  
Spinal Segments ◽  
Pelvic Limb ◽  
Intradural Extramedullary ◽  
Lumbar Cerebrospinal Fluid

A 1-year-old Irish wolfhound was presented with a history of slowly progressive left pelvic limb paresis. A neurological examination demonstrated bilateral deficits referable to the thoracolumbar spinal cord. Lumbar cerebrospinal fluid contained neoplastic cells. An intradural, extramedullary mass was demonstrated by myelography at the caudal aspect of T13. Surgical excision was abandoned owing to severe macroscopic damage to, and apparent infiltration of, the cord, and the dog was euthanased. The tumour was diagnosed histologically as an extrarenal nephroblastoma. Nephroblastoma should be suspected in young, large-breed dogs with intradural extramedullary masses over spinal segments T10-L2. The prognosis for complete recovery after surgical excision is guarded to poor.

scholarly journals Clinical profile, management and surgical outcome of spinal cord tumors

2021 ◽  
Vol 8 (10) ◽  
pp. 3013
Author(s):  
Shobhit Chhabra ◽  
Bhagirath More ◽  
Deepak Ranade ◽  
Sarang Gotecha ◽  
Prashant Punia ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Surgical Excision ◽  
Spinal Tumor ◽  
Spinal Tumors ◽  
Cervical Cord ◽  
Subtotal Resection ◽  
Histopathological Diagnosis ◽  
Tumor Type ◽  
Spinal Cord Tumors ◽  
Significant Drop

Background: Spinal cord tumors can result in dramatic neurological and functional disabilities in the patients. We aimed to know the incidence of different types of spinal tumors and correlation between clinical presentation and pathological findings and compare outcomes of these tumors postoperatively.Methods: A total of 50 patients were included in the study group. After a thorough clinical evaluation, patients were subjected to a magnetic resonance imaging (MRI) and then surgery. They were described on the basis of age, sex, location of the tumor, type of the tumor, symptoms, histopathological type, surgical resection and complications.Results: Study included 29 males and 21 females and their age ranged from 5 years to 70 years. Out of the 50 patients, 39 had intradural and 11 had extradural spinal tumors. Amongst the 39 intradural tumors, 27 were extramedullary and 12 were intramedullary in location. A predilection towards the thoracic region (44%) was seen followed by the cervical cord. The tumors were excised completely in 68% of the patients while subtotal resection was done in 18% and near total resection in 14% patients. There was significant drop in VAS score and improvement in McCormicks score at 3 months of follow up.Conclusions: Based on this study it could be suggested that surgical excision and decompression should be attempted in all patients of intradural spinal tumor fit to undergo the procedure, as it not only helps in reaching a definitive histopathological diagnosis but also achieves neurological improvement in most patients without causing significant morbidity and mortality.

Lipomeningocele associated with diplomyelia in a dog

2018 ◽  
Vol 46 (05) ◽  
pp. 323-329 ◽  
Author(s):  
Nele Ondreka ◽  
Sara Malberg ◽  
Emma Laws ◽  
Martin Schmidt ◽  
Sabine Schulze
Keyword(s):  
Spinal Cord ◽  
Neurological Status ◽  
Split Cord Malformation ◽  
Lumbar Spinal Cord ◽  
Histopathological Diagnosis ◽  
Type I ◽  
Thoracic Spinal Cord ◽  
Thoracic Spinal ◽  
Subcutaneous Mass ◽  
Lumbar Spinal

SummaryA 2-year-old male neutered mixed breed dog with a body weight of 30 kg was presented for evaluation of a soft subcutaneous mass on the dorsal midline at the level of the caudal thoracic spine. A further clinical sign was intermittent pain on palpation of the area of the subcutaneous mass. The owner also described a prolonged phase of urination with repeated interruption and re-initiation of voiding. The findings of the neurological examination were consistent with a lesion localization between the 3rd thoracic and 3rd lumbar spinal cord segments. Magnetic resonance imaging revealed a spina bifida with a lipomeningocele and diplomyelia (split cord malformation type I) at the level of thoracic vertebra 11 and 12 and secondary syringomyelia above the aforementioned defects in the caudal thoracic spinal cord. Surgical resection of the lipomeningocele via a hemilaminectomy was performed. After initial deterioration of the neurological status postsurgery with paraplegia and absent deep pain sensation the dog improved within 2 weeks to non-ambulatory paraparesis with voluntary urination. Six weeks postoperatively the dog was ambulatory, according to the owner. Two years after surgery the owner recorded that the dog showed a normal gait, a normal urination and no pain. Histopathological diagnosis of the biopsied material revealed a lipomeningocele which confirmed the radiological diagnosis.

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