RESUMEN
A 17-year-old male presented with acute onset paraparesis in the lower limbs. Urinary retention was present and the patient required catheterisation. Clinical examination confirmed severe bilateral lower limb weakness and a sensory level at T8. Magnetic resonance imaging (MRI) revealed a haemorrhagic intramedullary tumour extending from T8 to the conus. Microsurgical excision of the tumour was performed and the patient made a good functional recovery. The histology of the tumour demonstrated a ganglioglioma of the spinal cord. Acute paraparesis has not previously been reported with a spinal cord ganglioglioma. We discuss the clinical, diagnostic and pathological features of spinal cord gangliogliomas.
Asunto(s)
Ganglioglioma/complicaciones , Ganglioglioma/patología , Paraparesia/diagnóstico , Paraparesia/etiología , Neoplasias de la Médula Espinal/complicaciones , Neoplasias de la Médula Espinal/patología , Enfermedad Aguda , Adolescente , Antiinflamatorios/uso terapéutico , Dexametasona/uso terapéutico , Diagnóstico Diferencial , Ganglioglioma/cirugía , Humanos , Inyecciones Intravenosas , Imagen por Resonancia Magnética , Masculino , Estadificación de Neoplasias , Procedimientos Neuroquirúrgicos , Paraparesia/tratamiento farmacológico , Índice de Severidad de la Enfermedad , Neoplasias de la Médula Espinal/cirugíaRESUMEN
We report a 66-year-old woman who developed sudden-onset bilateral sensorineural deafness due to leptomeningeal carcinomatosis involving the vestibulocochlear nerves. The clinical and diagnostic features of leptomeningeal carcinomatosis are discussed.
Asunto(s)
Carcinoma/complicaciones , Pérdida Auditiva Bilateral/etiología , Pérdida Auditiva Súbita/etiología , Neoplasias Meníngeas/complicaciones , Anciano , Carcinoma/patología , Femenino , Pérdida Auditiva Bilateral/patología , Pérdida Auditiva Súbita/patología , Humanos , Imagen por Resonancia Magnética/métodos , Neoplasias Meníngeas/patologíaRESUMEN
OBJECTIVE AND IMPORTANCE: Paragangliomas of the thoracic spine are rare. Previously described cases involved nonfunctioning tumors. This report documents the diagnosis and surgical treatment for a patient who presented with a functioning thoracic paraganglioma. CLINICAL PRESENTATION: A 53-year-old woman presented with a 10-month history of headaches, facial flushing, and palpitations associated with hypertension. Urinary catecholamine levels were markedly elevated. Magnetic resonance imaging and m-[(123)I]iodobenzylguanidine scans demonstrated an extradural tumor located within the T12 vertebra, with a significant paraspinal component. The neurological examination revealed mild hypesthesia in the right T12 dermatome. INTERVENTION: The patient underwent resection of the tumor after alpha-adrenergic receptor blockade. Grossly complete excision was achieved without neurological complications. Postoperatively, the patient was normotensive and exhibited catecholamine levels within the normal range. CONCLUSION: Functioning paragangliomas of the thoracic spine are rare lesions that are difficult to treat. Successful treatment requires careful surgical planning and expert pharmacological manipulation.
Asunto(s)
Paraganglioma/fisiopatología , Paraganglioma/cirugía , Neoplasias de la Médula Espinal/fisiopatología , Neoplasias de la Médula Espinal/cirugía , Vértebras Torácicas , Antagonistas Adrenérgicos alfa/uso terapéutico , Catecolaminas/orina , Femenino , Humanos , Imagen por Resonancia Magnética , Persona de Mediana Edad , Paraganglioma/diagnóstico , Paraganglioma/patología , Cuidados Preoperatorios , Neoplasias de la Médula Espinal/diagnóstico , Neoplasias de la Médula Espinal/patologíaRESUMEN
While mild swallowing difficulties are commonly reported transiently following anterior cervical surgery, marked dysphagia is unusual. The authors report a patient who experienced severe and prolonged dysphagia following elective cervical corpectomies with iliac grafting and anterior plate fusion for multilevel cervical canal stenosis. The literature is reviewed and discussed.