[Cervical paraspinal chordoma, a condition we should know. A case report]. / Cordoma cervical paravertebral, entidad que debemos conocer. A propósito de un caso.

Chordoma is a rare, slow-growing tumour arising from remnants of the notochord. It is most often located in the base of the skull and the sacrococcygeal region, being located in the cervical region in only 6% of cases. A rare case is presented of a left para-spinal chordoma, of which less than 10 cases have been reported in literature. It was located at C2-C4 level in a young male with no personal history of interest. Radiographic findings suggested that this was a slow-growing tumour, of cystic dominance, which eroded the bone structures and encompassed the left vertebral artery. Surgical excision was performed, and in the analysis of the surgical piece, cell proliferation was observed, with a stromal myxoid-chondroid appearance, epithelioid and physaliphorous (PAS+) cells, all of them compatible with chordoma.

Cordoma cervical paravertebral, entidad que debemos conocer. A propósito de un caso / Cervical paraspinal chordoma, a condition we should know. A case report

El cordoma es un tumor raro de lento crecimiento, derivado de remanentes de la notocorda. La mayoría se localizan en la base del cráneo y en la región sacrococcígea, mostrando una localización cervical en solo el 6% de los casos. Presentamos el caso, poco frecuente (se han reportado menos de 10 en la literatura), de un cordoma paravertebral izquierdo, localizado a nivel de C2-C4, en un varón joven sin antecedentes personales de interés. Los hallazgos radiológicos sugerían que se trataba de una neoplasia de crecimiento lento, de predominio quístico, que erosionaba estructuras óseas y englobaba a la arteria vertebral izquierda. Se planificó exéresis quirúrgica y en el análisis de la pieza se observó proliferación celular con estroma de aspecto mixo-condroide, células epitelioides y fisalíferas (PAS+), todo ello compatible con cordoma

Chordoma is a rare, slow-growing tumour arising from remnants of the notochord. It is most often located in the base of the skull and the sacrococcygeal region, being located in the cervical region in only 6% of cases. A rare case is presented of a left para-spinal chordoma, of which less than 10 cases have been reported in literature. It was located at C2-C4 level in a young male with no personal history of interest. Radiographic findings suggested that this was a slow-growing tumour, of cystic dominance, which eroded the bone structures and encompassed the left vertebral artery. Surgical excision was performed, and in the analysis of the surgical piece, cell proliferation was observed, with a stromal myxoid-chondroid appearance, epithelioid and physaliphorous (PAS+) cells, all of them compatible with chordoma

Tratamiento endovascular prequirúrgico de la estenosis carotídea sintomática provocada por un meningioma del plano esfenoidal / Presurgical endovascular treatment of symptomatic carotid stenosis caused by a meningioma of the planum sphenoidale

Introducción. El infarto cerebral es una forma muy poco frecuente de presentación de un meningioma. Esta forma de inicio clínico plantea el reto de tratar los eventos isquémicos antes del abordaje quirúrgico de la tumoración. Caso clínico. Mujer de 48 años, natural de Georgia, que consultó por pérdida de fuerza en el hemicuerpo derecho, cefalea intensa y episodios autolimitados de olvido de su idioma. Se realizó tomografía computarizada craneal que mostraba un proceso expansivo frontal izquierdo y lesiones hipodensas en el núcleo caudado izquierdo. La evolución de la paciente fue desfavorable, presentando episodios de deterioro neurológico con hemiparesia derecha y afasia, alternados con períodos de mejoría. La resonancia magnética y el estudio angiográfico demostraron la oclusión tumoral de la arteria cerebral media izquierda secundaria a meningioma clinoideo. El tratamiento fue la recanalización de la arteria cerebral media por vía endovascular y posterior extirpación quirúrgica del meningioma. Conclusión. El tratamiento endovascular mediante angioplastia, previa a la exéresis quirúrgica del tumor, es una técnica adecuada para disminuir la incidencia de los eventos isquémicos(AU)

Introduction. Cerebral infarction is a very rare presenting symptom of a meningioma. This form of clinical onset poses the challenge of treating ischaemic events before dealing with the tumour surgically. Case report. A 48-year-old woman from Georgia who visited due to loss of strength in the right-hand side of the body, intense headache and self-limiting episodes of forgetting her own language. Computerised axial tomography scans of her head revealed a left frontal expansive process and hypodense lesions in the left caudate nucleus. The patient underwent an unfavourable progression, with episodes of neurological deterioration and hemiparesis of the right-hand side and aphasia, which alternated with periods of improvement. Magnetic resonance imaging and an angiographic study revealed tumour occlusion of the left middle cerebral artery, secondary to a clinoidal meningioma. Treatment involved endovascular recanalisation of the middle cerebral artery and later surgical removal of the meningioma. Conclusions. Endovascular treatment by means of angioplasty, prior to the surgical excision of the tumour, is a technique that enables the incidence of ischaemic events to be diminished(AU)

Mielopatía compresiva como forma de presentación de una fractura transdiscal de bloque vertebral en una paciente con espondilitis anquilosante / Compressive myelopathy as the presentation form of a transdiscal fracture of the vertebrae in a patient with ankylosing spondylitis

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