RESUMEN
Hemangiopericytoma (HPC) has been described to be aggressive and potentially a malignant tumour. We report a rare case of a 63-year-old Chinese male who presented with primary intradural extramedullary HPC of the thoracic spine. The main presenting complaint was gradual progression of back pain, associated with paraparesis and sensory deficit of lower limbs. He had MRI thoracolumbar with contrast which showed T9 lesion compressing on spinal cord and oedema, he was then operated upon and histopathology report confirmed a thoracic spine HPC. A T8/9 laminectomy and excision of intradural extramedullary lesion was performed, tumour section was sent for frozen section study, and more tissue was sent for paraffin studies and additional immunohistochemical staining. Surgical resection is most commonly performed, radiotherapy remains debatable. In this report, we discussed another rare case of primary spinal HPC to be added into the literature.
RESUMEN
INTRODUCTION: We reviewed the clinical features, brain and spinal cord magnetic resonance (MR) imaging findings and associated abnormalities in six patients with spinal cavernous malformations (CMs). METHODS: Lesions were defined on gradient-recalled echo (GRE) images but measured on T2-weighted images performed on 1.5- and 3-tesla clinical scanners. RESULTS: Four patients had associated multiple cranial CMs and one patient had multiple spinal CMs. All spinal CMs were predominantly hypointense on GRE images, and most were predominantly hyperintense and surrounded by hypointense edge on T2-weighted images. Other associations included asymptomatic vertebral body and splenic haemangiomas. CONCLUSION: We conclude that intramedullary spinal CMs typically have 'mulberry' or 'popcorn' appearances similar to those of cranial CM. The presence of associated haemangioma or familial cranial CM syndrome on MR imaging may suggest the correct diagnosis without requiring invasive investigations.
Asunto(s)
Malformaciones Vasculares del Sistema Nervioso Central/patología , Imagen por Resonancia Magnética , Enfermedades de la Médula Espinal/patología , Adulto , Anciano , Neoplasias Encefálicas/patología , Preescolar , Diagnóstico Diferencial , Femenino , Hemangioma Cavernoso del Sistema Nervioso Central/patología , Humanos , Masculino , Persona de Mediana Edad , Síndromes Neoplásicos Hereditarios/patología , Estudios Retrospectivos , Neoplasias de la Médula Espinal/patologíaRESUMEN
Oligodendroglioma is a relatively uncommon primary brain tumour. The occurrence of metastatic dissemination of oligodendroglioma is rare and usually occurs in patients with anaplastic oligodendroglioma. The dissemination of WHO Grade II oligodendroglioma can occur and we report a patient with an initial diagnosis of a left temporal oligodendroglioma who presented with disseminated disease in the left temporal lobe, sellar region, medulla oblongata, both frontal lobes and ventricles more than 8 years later. Histology at dissemination showed anaplastic oligodendroglioma. Similar reports of metastatic dissemination of oligodendrogliomas reveal that the tumours may remain as WHO Grade II or may progress to anaplastic oligodendroglioma at metastasis. However, regardless of the histological grade at metastasis, the prognosis of metastatic oligodendroglioma is poor.
Asunto(s)
Neoplasias Primarias Secundarias/diagnóstico por imagen , Oligodendroglioma/diagnóstico por imagen , Humanos , Masculino , Persona de Mediana Edad , Neoplasias Primarias Secundarias/etiología , Neoplasias Primarias Secundarias/cirugía , Oligodendroglioma/complicaciones , Oligodendroglioma/cirugía , RadiografíaRESUMEN
We report a case of spinal intradural schwannoma presenting with intracranial subarachnoid hemorrhage. Cerebral angiography studies were negative, but MR imaging of the spine revealed a large hemorrhagic tumor in the thoraco-lumbar junction. The tumor was misdiagnosed as ependymoma of the conus medullaris. This case illustrates the importance of a high index of suspicion for spinal disease in angiographically-negative subarachnoid hemorrhage and pitfalls in MR diagnosis of thoraco-lumbar tumors.
Asunto(s)
Neurilemoma/complicaciones , Neoplasias de la Médula Espinal/complicaciones , Hemorragia Subaracnoidea/etiología , Enfermedad Aguda , Humanos , Imagen por Resonancia Magnética , Masculino , Persona de Mediana Edad , Neurilemoma/diagnóstico , Neoplasias de la Médula Espinal/diagnósticoRESUMEN
Tuberculosis of the atlantoaxial spine is a rare condition that is often overlooked and remains a diagnostic dilemma. We report the rare case of a 56-year-old woman with cervical myelopathy secondary to a lytic lesion of C1-C2 complex with a histological diagnosis of tuberculosis.
Asunto(s)
Tuberculosis de la Columna Vertebral/patología , Tuberculosis de la Columna Vertebral/cirugía , Descompresión Quirúrgica , Femenino , Humanos , Imagen por Resonancia Magnética , Persona de Mediana Edad , Debilidad Muscular/etiología , Examen Neurológico , Procedimientos Neuroquirúrgicos , Cuadriplejía/etiología , Compresión de la Médula Espinal/diagnóstico por imagen , Compresión de la Médula Espinal/etiología , Glándula Tiroides/patología , Tomografía Computarizada por Rayos XRESUMEN
Pigmented villonodular synovitis (PVNS) is a benign proliferative disorder primarily occurring in the large joints of the appendicular skeleton such as the knee and hip joints. We present an unusual case of PVNS involving the cervical spine in an adult. MR imaging showed an enhancing mass lesion arising from the posterior elements of the cervical spine and hyperintensity on the T2-weighted images, without evidence of T2 susceptibility effects. Gross total excision of the tumor was performed, and the diagnosis was established by histopathology.
Asunto(s)
Vértebras Cervicales/diagnóstico por imagen , Vértebras Cervicales/patología , Imagen por Resonancia Magnética , Sinovitis Pigmentada Vellonodular/diagnóstico por imagen , Adulto , Dolor de Espalda/diagnóstico por imagen , Dolor de Espalda/etiología , Dolor de Espalda/terapia , Quistes Óseos Aneurismáticos/diagnóstico por imagen , Quistes Óseos Aneurismáticos/terapia , Neoplasias Óseas/diagnóstico por imagen , Neoplasias Óseas/terapia , Vértebras Cervicales/cirugía , Diagnóstico Diferencial , Progresión de la Enfermedad , Embolización Terapéutica , Tumor Óseo de Células Gigantes/diagnóstico por imagen , Tumor Óseo de Células Gigantes/terapia , Humanos , Masculino , Debilidad Muscular/diagnóstico por imagen , Debilidad Muscular/etiología , Debilidad Muscular/terapia , Dolor de Cuello/diagnóstico por imagen , Dolor de Cuello/etiología , Dolor de Cuello/terapia , Osteoblastoma/diagnóstico por imagen , Osteoblastoma/terapia , Alcohol Polivinílico/uso terapéutico , Radiografía , Sinovitis Pigmentada Vellonodular/terapiaRESUMEN
Spinal epidural haematoma is a rare cause of spinal cord compression. It is most commonly attributed to trauma and coagulation disorders. We report a case of a 64 year-old man with thrombocytopaenia who presented with a traumatic epidural haematoma who p resented with right hemiparesis which progressed to complete tetraplegia. MR of the cervical spine showed an epidural collection on the posterior aspect of the cord throughout the cervical spine. The patient underwent C1-C7 laminectomy and decompression. Postoperatively, the patient has improved gradually and has power of grade 3 (Medical Research Council classification of power) in all 4 limbs at 2-month follow-up. MRI is an important modality in the early diagnosis of spinal epidural haematomas and can facilitate emergent decompressive surgery which offers the best chance of neurological improvement.