ABSTRACT
Paravertebral muscle metastasis is an extremely rare cause of low back pain. Lipomas, haemangiomas, hibernomas and liposarcomas should be considered first in the aetiology of paravertebral muscle masses. Schwannoma, neurofibroma, ganglioneuroma and paraganglioneuromas that show contiguous spread should also be included in the differential diagnosis. Haematogenous metastases are most frequently caused by lung cancers. Lung cancers typically metastasize to liver, brain, bone, kidney, and adrenal glands. They rarely metastasize to skeletal muscles due to metabolism, high tissue pressure and blood flow of muscles. Our case was a 48-year-old male who had been smoking 40 cigarettes per day and presented to our clinic with low back pain and a mass in the lower back region. The mass in his lower back region was excised and histopathological examination confirmed metastasis of a neuroendocrine tumour. Further examinations revealed the lung as the primary source of the metastasis.
Subject(s)
Low Back Pain/etiology , Lung Neoplasms/diagnosis , Muscle Neoplasms/diagnosis , Muscle Neoplasms/secondary , Neuroendocrine Tumors/diagnosis , Neuroendocrine Tumors/secondary , Back/diagnostic imaging , Humans , Male , Middle Aged , Muscle Neoplasms/complications , Muscle, Skeletal/diagnostic imaging , Muscle, Skeletal/pathology , Neuroendocrine Tumors/complications , RadiographyABSTRACT
We report an unusual case of a 6-year-old boy with a sinus tract terminating with an intramedullary dermoid cyst and holocord central lesion, presenting with tetraparesis secondary to intramedullary abscess. Total excision of dermal sinus tract, dermoid cyst, and the intramedullary abscess by means of a L2-S3 laminectomy, followed by antibiotic therapy resulted in good functional recovery. Strengths of the upper extremities have fully recovered, and a remarkable improvement was detected in the muscles of the lower extremities. Postoperative magnetic resonance imaging (MRI) of the spine showed complete removal of the dermoid cyst, decreased inflamed granulation tissue over the medullary conus, and disappearance of the holocord high intensity lesion. The pathomechanism of holocord central lesion is discussed herein.
Subject(s)
Abscess/diagnosis , Dermoid Cyst/diagnosis , Gram-Negative Bacterial Infections/diagnosis , Spina Bifida Occulta/diagnosis , Spinal Cord Neoplasms/diagnosis , Abscess/etiology , Cefotaxime/administration & dosage , Child , Dermoid Cyst/surgery , Drug Therapy, Combination , Follow-Up Studies , Gram-Negative Bacterial Infections/surgery , Humans , Laminectomy , Lumbar Vertebrae/surgery , Magnetic Resonance Imaging , Male , Metronidazole/administration & dosage , Neurologic Examination , Postoperative Care , Postoperative Complications/diagnosis , Quadriplegia/etiology , Sacrum/surgery , Spina Bifida Occulta/surgery , Spinal Cord/pathology , Spinal Cord Neoplasms/surgery , Vancomycin/administration & dosageABSTRACT
Neonatal teratomas are rarely located in the scalp. We present a 10-day-old female newborn with mature teratoma of the occipital scalp. The tumor mass, which had no intracranial extension, was excised completely when the patient was 14 days old. The scalp defect was reconstructed with local flaps. No recurrence was detected 3 months after the surgery. Because the patient did not return for routine follow-up 6 months after surgery, we called the parents and learned that the patient had suddenly died. A necropsy to explain the cause of death was not available.
Subject(s)
Head and Neck Neoplasms/pathology , Scalp/pathology , Skin Neoplasms/pathology , Teratoma/pathology , Female , Head and Neck Neoplasms/surgery , Humans , Infant, Newborn , Scalp/surgery , Skin Neoplasms/surgery , Teratoma/surgeryABSTRACT
Due to a lack of large clinical series in the literature of chondrosarcomas and hydatid disease presenting as mediastinal dumbbell tumours, clinicians have limited experience on this topic. We present three unusual cases of dumbbell tumour involving the spinal canal; two patients had chondrosarcoma originating from Th8-Th9 and Th10-Th12; one patient had a hydatid cyst at Th5-Th6. We performed a single-stage combined thoracic-neurosurgical approach in two patients, and a double-staged approach in one patient. During the intraspinal dissection, an operating microscope was used under electrophysiological monitoring. Spinal canal reconstruction was not required for any of the cases. Preoperative knowledge of neuroforaminal extension and the relations between the tumour and adjacent neural-vascular structures is essential to prevent spinal cord damage and plan the surgical approach. In chondrosarcomas, prognosis depends on patient age, histological grade, extent of surgery and response to radiotherapy and/or chemotherapy. In this article, the diagnostic and surgical difficulties of these unusual tumours and current treatment modalities are discussed with a review of the relevant literature.
Subject(s)
Chondrosarcoma/diagnosis , Echinococcosis/complications , Echinococcosis/diagnosis , Mediastinal Neoplasms/diagnosis , Spinal Neoplasms/diagnosis , Thoracic Vertebrae/pathology , Adult , Chondrosarcoma/surgery , Diagnosis, Differential , Drug Therapy/standards , Echinococcosis/surgery , Humans , Intraoperative Complications/etiology , Intraoperative Complications/physiopathology , Intraoperative Complications/prevention & control , Laminectomy , Magnetic Resonance Imaging , Male , Mediastinal Neoplasms/surgery , Middle Aged , Monitoring, Intraoperative/standards , Neurosurgical Procedures , Radiotherapy/standards , Spinal Canal/diagnostic imaging , Spinal Canal/parasitology , Spinal Canal/pathology , Spinal Cord Injuries/prevention & control , Spinal Neoplasms/surgery , Thoracic Vertebrae/diagnostic imaging , Thoracic Vertebrae/parasitology , Thoracostomy , Tomography, X-Ray Computed , Treatment OutcomeABSTRACT
Reports have noted aneurysmal dilatation of arteries in association with brucellosis, but involvement of intracranial vessels has not been documented to date. Sixty-one year old female patient who had been diagnosed with brucellosis 14 months earlier presented with symptoms of subarachnoid hemorrhage (SAH). Due to deterioration of the patient's clinical condition in spite of a two-drug antibiotic regimen, she was treated surgically and made a full recovery. It is important to identify this association promptly, as there are clinical implications for optimal management. The article also discusses the timing and duration of antibiotic therapy, indications for and considerations regarding surgery, and the use of other treatment modalities.
Subject(s)
Aneurysm, Ruptured/etiology , Brucellosis/complications , Carotid Artery, Internal/microbiology , Intracranial Aneurysm/etiology , Subarachnoid Hemorrhage/etiology , Blood/microbiology , Brucellosis/microbiology , Cerebrospinal Fluid/microbiology , Female , Humans , Middle Aged , Tomography, X-Ray ComputedABSTRACT
A 41-year-old female patient with fronto-orbital leptomeningeal cyst is presented. After decompression of the cyst, repair of bone and dura defects were achieved with autogenous bone grafts and pericranial flap. Our case was very interesting in several aspects: a head trauma at 3 years of age and manifestation of clinical symptoms (headaches and exophthalmia) after almost 4 decades that had been progressive for 6 months and a rare location (fronto-orbital region) that required a special management. A thorough history is crucial in such cases because clinical symptoms might appear after decades. An old fracture that is surrounded by thin calvarial tissue in conjunction with intracranial cystic formation should make one take a leptomeningeal cyst into consideration in differential diagnosis. Extensive dissection and adequate access osteotomies followed by repair with autologous and vascular tissues are the key factors for a successful outcome in the management of fronto-orbital pathologies.
Subject(s)
Arachnoid Cysts/etiology , Adult , Arachnoid Cysts/diagnosis , Arachnoid Cysts/surgery , Decompression, Surgical , Exophthalmos/etiology , Female , Humans , Skull Fractures/complicationsABSTRACT
Osteogenic sarcomas of the head and neck are rarely seen; approximately 6% to 13% these tumors occur in the head and neck, and less than 2% occur in the cranium. Not only eradication of the tumor but reconstruction to achieve satisfactory esthetic and functional results are the main issues regarding these tumors. In this report, a case of osteogenic sarcoma that invaded the infratemporal area, fronto-orbital region, and sphenoid wing is presented. The surgical results of eradication and reconstruction are also presented.
Subject(s)
Head and Neck Neoplasms/surgery , Osteosarcoma/surgery , Plastic Surgery Procedures/methods , Adult , Female , HumansABSTRACT
The precise nature of the underlying plasma cell dyscrasias is not well understood. Even today, no causative factor has been found for this disease. It has been suggested that, several factors may act together in the development of this disease. This is a report of a 62-year-old man who initially had a T7 compression fracture and developed a multiple myeloma two years later at that site and at the adjacent vertebral level (T7-T8), respectively. Although the notion that trauma would initiate such a malignancy is speculative, the preceding trauma may be a causative factor in plasma cell dyscrasias.
Subject(s)
Multiple Myeloma/etiology , Spinal Fractures/complications , Spinal Neoplasms/etiology , Thoracic Vertebrae/injuries , Humans , Magnetic Resonance Imaging , Male , Middle Aged , Multiple Myeloma/pathology , Plasma Cells/pathology , Spinal Fractures/pathology , Spinal Neoplasms/pathologyABSTRACT
Hypothalamic hamartoma is a rare congenital lesion. We present the case of a 7-year-old girl who suffered from precocious puberty, the cause of which was diagnosed by using MR imaging and CT as pedunculated hypothalamic hamartoma associated with a large craniopharyngeal canal and sellar spine mimicking pituitary duplication.
Subject(s)
Hamartoma/congenital , Hypothalamic Diseases/congenital , Image Enhancement , Image Processing, Computer-Assisted , Magnetic Resonance Imaging , Puberty, Precocious/etiology , Sella Turcica/abnormalities , Skull Base/abnormalities , Tomography, X-Ray Computed , Child , Diagnosis, Differential , Female , Hamartoma/diagnosis , Humans , Hypothalamic Diseases/diagnosis , Hypothalamus/pathology , Pituitary Gland/abnormalities , Pituitary Gland/pathology , Sella Turcica/pathology , Skull Base/pathologyABSTRACT
Giant cell tumours of the vertebral column are rare and cervical vertebrae involvement is even less common. As these lesions may be closely related to the vertebral artery, therapeutic decision-making may be complex. Reviewing the literature, we found that there was no consensus on treatment or outcome assessment for these rare and difficult lesions. We present a case of a giant cell tumour of the sixth cervical vertebrae involving the posterior elements, neural foramina and transverse foramina and closely related to the vertebral artery. Radiological evaluation and therapeutic solutions are also discussed.
Subject(s)
Cervical Vertebrae/pathology , Giant Cell Tumors/pathology , Spinal Neoplasms/pathology , Vertebral Artery/pathology , Adult , Cervical Vertebrae/diagnostic imaging , Female , Giant Cell Tumors/diagnostic imaging , Humans , Neurosurgical Procedures , Spinal Neoplasms/diagnostic imaging , Tomography, X-Ray Computed , Vertebral Artery/diagnostic imagingABSTRACT
Anterior cervical discectomy and fusion, as originally described by Robinson, is highly successful in the treatment of neural compression caused by disc material or osteophytes. Although the necessity for fusion after anterior cervical discectomy is still debated, anterior cervical fusion with interbody bone graft and anterior plate implantation is a commonly accepted procedure. In this study, preliminary results with a recently developed PCB cervical plate system (SCIENT'X, Paris, France), which combines a hollow intradiscal cage with an integrated plate, in the management of cervical disc disease are reported.