RESUMO
Background: Cystic bone echinococcosis accounts for 0.5-4% of all reported cases, and 45% occur in the spine. Our aim was to review the clinical and radiological features, surgery, and outcomes for 39 patients with recurrent spinal hydatidosis. Methods: Thirty-nine reports of patients with recurrent spinal hydatidosis (2011-2020) were followed for an average of 9.28 ± 5.60 months. Results: Lesions occurred in descending order in the; lumbar (48.7%), thoracic (43.6%), and cervical spine (7.7%). Total cyst resection was achieved in 28 of 39 patients (71.8%). Intraoperative cyst rupture occurred in 13 patients (33.3%). The postoperative American Spinal Injury Association (ASIA) score was "good" in 82% of patients. Those with "poor" postoperative ASIA scores had a 41% incidence of recurrent thoracic hydatid cysts; further, they demonstrated significantly higher recurrence rates if cysts had ruptured intraoperatively (P = 0.001). In addition, laminectomy, subtotal original cyst resection (P < 0.007), and a thoracic location were all significantly associated with higher recurrence rates (P < 0.04). Conclusion: The majority of patients demonstrated improvement following surgery for cervical hydatid cysts. Notably, those with poor outcomes typically experienced intraoperative ruptures of their thoracic hydatid cysts, contributing to high cyst recurrence rates.
RESUMO
Background: Primary Ewing's sarcoma (ES) arising from cranial bones is an extremely rare entity that accounts for only 1-4% of all ES cases. Case Description: A 21-year-old woman presented with ES of the skull affecting the occipital region. The patient underwent surgical excision following radiotherapy and chemotherapy. No recurrence or metastasis occurred over a 10-month follow-up. Conclusion: ES reaches adolescents. The mainstay of treatment includes surgical removal of the tumor, followed by radio- and chemotherapy.
RESUMO
Background: Spinal cord compression (SCC) is a severe consequence of multiple myeloma (MM). Surgical management is appropriate when there are spinal instability and neurological function compromise. The reversibility of peripheral neuropathy during treatment of MM has been reported in some studies after a cycle of Bortezomib (Velcade), Thalidomide, and Dexamethasone (VTD), but very rare in myeloma patients with SCC. Case Description: We report a case of a 58-year-old male tetraplegic secondary to cervical SCC by MM who completely recovered after 5 cycles of VTD chemotherapy without surgery. Conclusion: Surgical spinal cord decompression by laminectomy is known as the gold standard for treating this condition. Nevertheless, some patients can completely recover from nervous insult without surgery.
