Long-term outcome after removal of spinal schwannoma: a clinicopathological study of 187 cases.

Are spinal schwannomas as benign as we think? To what extent do patients recover? Are patients prone to develop late complications such as cystic myelopathy or symptomatic spinal deformity? Is their life expectancy compromised? In an effort to answer these questions, the authors analyzed the long-term outcome for 187 patients from one neurosurgical department with surgically treated spinal schwannoma. Median follow-up period was 12.9 years (2454 patient years). One-fifth of the patients considered themselves free of symptoms at follow-up examination. The most common late complaint was local pain (46%), followed by radiating pain (43%), paraparesis (31%), radicular deficit (28%), sensory deficit due to a spinal cord lesion (27%), and difficulty voiding (19%). Late complications occurred in 21% of the patient population, including cystic myelopathy (2%), spinal arachnoiditis (6%), spinal deformity (6%), and troublesome pain (7%). Life expectancy of the patients corresponded to that of the general population.

Long-term outcome after removal of spinal neurofibroma.

Spinal neurofibromas are uncommon, comprising approximately 3% of all spinal tumors. They occur both sporadically and in association with neurofibromatosis 1 (NF1; von Recklinghausen's disease). This study presents the clinical characteristics of 32 patients who underwent surgery for symptomatic spinal neurofibromas. Twenty-two of these patients showed clinical signs of NF1. The patients were typically younger (median age 31 years) than those with spinal schwannomas. The tumors were located mainly in the cervical region and tended to grow both extra- and intradurally. Patients with NF1 were prone to develop new spinal neurofibromas. A life-table analysis showed a reduced survival rate for these patients compared to that of the general population.

Relationship between occupation and lung cancer as analyzed by age and histologic type.

The information on occupations obtained in Finland's 1970 census was linked with the files of the Finnish Cancer Registry from 1971 through 1980 in order to establish the occupational group-specific relative risks (RR) of lung cancer. The distribution of lung cancers into histologic types varied with the age of the patients at the time of diagnosis. When 38 high-risk occupational groups were combined, the age-specific distribution of lung cancer into histologic types did not differ significantly from the corresponding distribution for other economically active men. Of individual occupational groups, young farmers had a higher RR of small cell carcinoma than older farmers or other economically active young men. Besides their high overall lung cancer risk, miners and quarriers had a very high risk of small cell carcinoma as compared with other economically active men. Servicemen and repairmen in the metal industry had a high risk of epidermoid carcinoma. Welders had a high risk of epidermoid carcinoma, but their risk of small cell carcinoma was lower than expected. There were no other excess risks of any histologic type of lung cancer attributable to occupational factors.