ABSTRACT
BACKGROUND: Various hematological malignancies, including multiple myeloma, plasmacytoma, aggressive lymphoma, and indolent lymphoma, rarely result in spinal cord compression. METHODS: Here, we retrospectively analyzed 32 patients with multiple myeloma (50%), plasmacytoma (13%), aggressive lymphoma (28%), and indolent lymphoma (9%), resulting in spinal cord compression (2004 and 2016). Patients averaged 57 years of age and presented with the indolent onset of spinal cord compression (91% of cases) resulting mostly in motor deficits (69%). RESULTS: Local treatment modalities included radiotherapy (RT) (28%) alone, decompressive surgery (28%) alone, or decompressive surgery with consolidation RT (40%). The 1-year overall survival was 70%, and the progression-free survival frequency was 62%. CONCLUSION: This study highlighted the importance of standardizing the indications for RT alone versus RT with surgery depending on the patient's underlying pathological diagnosis, neurological deficits, and radiological findings.
ABSTRACT
Candida spp. brain abscess is scare. Clinical presentation is unspecific. Diagnosis requires mycological culture of a puncture or biopsy specimen. Therapeutic management is based on prolonged course of azole or liposomal amphotericin B. We reported the case of Candida glabrata brain abscess in a 27 year-old female patient, with no past history and not secondary to candidemia. The fungus was isolated from a puncture of abscess with complete resection. The outcome was favorable under antifungal treatment by voriconazole.
ABSTRACT
INTRODUCTION: Cervical synovial cysts are uncommon. They are most often responsible for a chronic clinical picture. Rarely, intracystic hemorrhage occurs, and may acutely present as radicular - or even spinal cord compression syndrome leading to irreversible neurological impairment. CASE: We reported a case of bleeding synovial cyst located in the cervico-thoracic spine causing spastic paraparesis in a 68-year-old male patient. MRI revealed narrowing of perimedullary subarachnoid space by a well circumscribed, extra-axial, homogeneous mass located posterolaterally to the right of the spinal cord at the level C7-T1. The cyst was removed thoroughly by laminectomy. Pathological findings were consistent with the diagnosis of hemorrhagic synovial cyst. The patient had an excellent recovery. DISCUSSION: Synovial cysts of the spine are rare and usually asymptomatic. It is extremely rare for intracystic bleeding to occur and be responsible for an abrupt presentation. Diagnosis of spinal synovial cyst relies on MRI but may not be evident as it depends on consistency and density of the cystic fluid. Surgery remains the best therapeutic alternative, especially in the case of neurological impairment. CONCLUSION: Surgery should be considered for any cervical synovial cyst. This is motivated by the risk, although rare, of bleeding and the resulting irreversible neurological damage that may occur.
