Primary Spinal Tumors and Masses in Children.

Objectives: Spinal cord tumors are rare in children, mostly presented with unspecific symptoms that might pose a problem due to their possible malignancy and further complications. However, there are limited data on spinal cord lesions in Iran. This study aimed to present a series of 37 cases of primary spinal tumors treated at the same institution and briefly review their pathology, symptoms, and site of occurrence. Materials & Methods: In this study, 37 cases of spinal cord tumors and masses were selected within March 2007-2017, excluding spinal dysraphism. The data on age, gender, clinical presentation, location of the mass, and pathology were retrospectively collected. Results: The mean age at diagnosis was 5 years and 8 months (standard deviation: 4.1 years). Moreover, 21 and 16 cases were male and female, respectively (male-to-female ratio: 1.31). Pathological findings included 9 neuroepitheliomas (i.e., 6 neuroblastoma, 2 ganglioneuroma, and 1 ganglioneuroblastoma/ganglioneuroma), 4 ependymomas, 3 primitive neuroectodermal tumors, 3 glial tumors, 4 neurodevelopmental tumors, 3 lymphomas, 1 hemangiopericytoma, and 1 neurofibroma. In addition, 26 (74.2%), 14 (40%), 6 (16.6%), and 4 (11.4%) patients had motor symptoms, pain, sensory symptoms, and urinary symptoms, respectively. The most common location of occurrence was the lumbosacral region. Conclusion: In conclusion, while differing in pathological composition and location of tumors in comparison to other papers, this study presents possible presentations and/or expected pathologies in pediatric spinal cord tumors.

Spinal Subdural Hematomas in a Normal Child without Trauma History: A Case Report.

Acute Spinal Subdural Hematoma (ASSH) is a rarely recognized condition that may result in severe irreversible neurologic complication. A 7-yr old girl presented to Neurology Department, Mofid Hospital, ShahidBeheshti University of Medical Sciences, Tehran, Iran with limping and pain in lower extremities and acute paraplegia without history of direct trauma. The patient had muscle weakness in lower limbs and was unable to bear weight. Deep Tendon Reflexes (DTR) in lower extremities had increased. Her MRI showed spinal subdural hematoma we reextended from T2 to T6. We performed laminectomy from T2 to T5 and about 70 cc of subdural hematoma was evacuated. One month after the surgery, the patient's neurological deficit resolved completely. The results showed the pivotal role of attention to clinical manifestation in acute spinal subdural hematoma and early diagnosis to prevent irreversible neurologic complication.

Enterobacter Meningitis Due To Dermoid Cyst Manipulation.

Gram-negative meningitis can occurssubsequent to dura-arachnoid barrier disruption because of trauma, surgery and rarely an infected dermoid cyst. Association of neurosurgical procedures with Gram-negative meningitis was described for the first time in 1940. Intracranial infections from gram-negative bacilli like Enterobacter are serious and difficult to treat as many antibiotics fail to achieve bactericidal concentrations in the cerebrospinal fluid. Here in, we report a rare case of pediatric Enterobacter meningitis in a patient with a dermoid cyst that had been manipulated. She was managed with antibiotic therapy plus surgical removal of the infected cyst.

Tumors of the Central Nervous System: An 18-Year Retrospective Review in a Tertiary Pediatric Referral Center.

OBJECTIVE: Few studies exist on the demographics and trends of pediatric central nervous system (CNS) tumors in Iran. In this study, we retrospectively reviewed all cases with confirmed CNS tumors admitted to Mofid Pediatric Hospital, Tehran, Iran during the last 18 years. MATERIALS & METHODS: Data on gender, age of diagnosis, pathologic classification and tumor location were extracted from the available medical records. We used the last version of International Classification of Childhood Cancer. RESULT: Overall, 258 (81.9%) brain tumors and 57 (18.1%) spinal tumors were identified. Our subjects comprised of 147 (46.7%) female and 168 (53.3%) male children. More male dominancy was observed in brain tumors with a male to female ratio of 1.2 compared with 1.03 of spinal tumors. Malignant CNS tumors were most common in 1-4 yr age group. The four most common brain tumors in our subjects were astrocytomas, medulloblastoma, ependymoma and craniopharyngioma. Overall, 53.1% of the brain tumors were supratentorial. Gliomas, PNET and neuroblastma were the most frequent primary spinal tumors in our study. We observed an increasing trend for both brain and spinal tumors that was moreremarkable in the last 5 years. CONCLUSION: Our results are comparable with similar single center studies on CNS tumors during childhood. The observed disparities could be attributed to the single center nature of our study and geographical, environmental and racial variations in pediatric CNS tumors. The increasing trend of both brain and spinal tumors could warrant further investigations at provincial and national levels to investigate probable contributing environmental risk factors.

Brown tumor of lumbar spine in chronic renal failure: a case report.

Brown tumors may occur secondary to hyperparathyroidism in patients with chronic renal failure (CKD). They are increasingly rare because hyperparathyroidism in now diagnosed and treated at an early stage. We report 67-year-old man who had been on hemodialysis for CRF for over 3 years, who presented with back pain over the thoracolumbar junction from 2 years ago and because of pain he could not stand or walk in the last 3 months before surgery. Ambulation was regained after surgical decompression and stabilization. In conclusion, when brown tumor arises in the spine, surgery may be needed to preserve neurologic function.