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Metastatic spinal tumor

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OBJECTIVEPercutaneous vertebral augmentation procedures such as vertebroplasty and kyphoplasty are often performed in cancer patients to relieve mechanical axial-load pain due to pathological collapse deformities. The collapsed vertebrae in these patients can be associated with varying degrees of spinal canal compromise that can be worsened by kyphoplasty. In this study the authors evaluated changes to the spinal canal, in particular the cross-sectional area of the thecal sac, following balloon kyphoplasty (BKP) prior to stereotactic radiosurgery (SRS)...
October 1, 2018: Journal of Neurosurgery. Spine
Paul Oni, Rolf Schultheiß, Kai-Michael Scheufler, Jakob Roberg, Ali Harati
BACKGROUND: Multilevel anterior cervical decompression and fixation of four and more levels is a common surgical procedure used for several diseases. METHODS: We reviewed the radiological and clinical outcomes after anterior cervical discectomy or corpectomy and fixation of four and more levels in 85 patients (55 men and 30 women) with an average age of 59.6 years. Surgical indication was multilevel cervical degenerative myelopathy and radiculopathy in 72 (85%) patients, multilevel cervical spondylodiscitis in four (5%), complex traumatic cervical fractures in four (5%), metastatic cervical spine tumor in two (2%), and ossification of the posterior longitudinal ligament in three (3%) patients...
November 23, 2018: Journal of Clinical Medicine
Carole S L Spake, Daniel B C Reid, Alan H Daniels
BACKGROUND: Rapid progression of metastatic non-small cell lung cancer (NSCLC) following discontinuation of tyrosine kinase inhibitors (TKI) or anaplastic lymphoma kinase (ALK) inhibitors has been described and is associated with a poor prognosis. We describe the first reported case of accelerated NSCLC tumor extension throughout the entire spinal epidural space. CASE DESCRIPTION: A 68-year-old woman with stage IV ALK-positive metastatic NSCLC presented with acute neck pain, urinary retention, and lower extremity weakness 15 days following discontinuation of alectinib...
November 23, 2018: World Neurosurgery
Daniel Wei, Dominic A Nistal, Stanislaw Sobotka, Michael Martini, Arthur L Jenkins
OBJECTIVE: Patients with spinal metastases have broad variability in morbidity, mortality, and survival. Existing prognostic scoring systems have limited predictive value. Our aim is, given recent advances in surgical and medical care for patients with cancer and spinal metastases, to develop a new survival index with superior prognostic value. METHODS: We completed a retrospective analysis on 77 patients who received surgery for metastatic tumors to the spine, of patient factors like pathological subtype, age, neurological examination, type of surgical procedure, Hauser Ambulation Index (HAI), and a novel scoring system for degree of tumor burden in several organ systems, among others...
November 20, 2018: World Neurosurgery
Patrizia Straccia, Guido Fadda, Francesco Pierconti
OBJECTIVE: The current tools available for detecting malignant neoplasms in the cerebrospinal fluid (CSF) are neurologic examination, followed by neuroimaging, cytology and molecular techniques. To highlight the role of cytology the diagnosis of metastatic tumors in cerebrospinal fluid (CSF) samples, we present our experience using cytospin and ThinPrep liquid-based cytology (LBC). METHODS: A retrospective analysis was conducted using the pathological records of 8,181 cytological specimens of CSF which were diagnosed over a 17-year period...
November 23, 2018: Cytopathology: Official Journal of the British Society for Clinical Cytology
Noritaka Yonezawa, Hideki Murakami, Apiruk Sangsin, Eishiro Mizukoshi, Hiroyuki Tsuchiya
PURPOSE: To report systemic immunological enhancement following preoperative spinal embolization and total en bloc spondylectomy (TES) using tumor-bearing frozen autograft in a patient with spinal metastatic leiomyosarcoma. METHODS: A 44-year-old woman with metastatic uterine leiomyosarcoma of the lung and L1 vertebra underwent TES following bilateral three-level preoperative segmental artery embolization. Resected tumor-bearing lamina was frozen using liquid nitrogen and used as tumor-bearing bone graft for spinal reconstruction...
November 21, 2018: European Spine Journal
Ahmad Sweid, Mohammad Hassan A Noureldine, Selim Nasser, Mohammad Badra, Ibrahim Saikali
BACKGROUND AND IMPORTANCE: Hemangiopericytomas (HPC) are rare and aggressive vascular mesenchymal tumors. Unlike meningiomas which have a similar radiological appearance, these tumors have a higher risk of local recurrence after resection, and distant metastasis can reach up to 23%. Metastases to the vertebral bones from an intracranial HPC are very rare, with so far only 9 cases reported in the literature. CLINICAL PRESENTATION: We present the case of a 46-year-old male who was surgically treated for a presumed left parieto-occipital falx meningioma in 2008...
November 14, 2018: World Neurosurgery
Elias Shaaya, Jared Fridley, Sean M Barber, Sohail Syed, Jimmy Xia, Michael Galgano, Adetokunbo Oyelese, Albert Telfeian, Ziya Gokaslan
BACKGROUND: Cervical spine metastases with circumferential spinal cord compression are often treated with combined anterior-posterior decompression and stabilization. In patients with large anterior neck masses, prior radiotherapy to the neck, or prior anterior neck surgery, however, anterior approaches may pose additional risk. In such cases, posterior-only approaches that allow for circumferential decompression and anterior column reconstruction may be beneficial. CASE DESCRIPTION: We present the case of a seventy-year-old male with follicular thyroid carcinoma metastatic to the cervical spine causing spinal cord compression...
November 14, 2018: World Neurosurgery
Rituparna Biswas, Subhash Gupta, K P Haresh, Anirban Halder, G K Rath
Giant cell glioblastoma (GCG) is a rare subtype of classic glioblastoma multiforme with favorable prognosis and little is known about its metastatic potential. We hereby present a unique case of GCG in a 7-year-old child who developed spinal and spinal leptomeningeal metastasis during adjuvant therapy. She succumbed to it in spite of salvage therapy.
July 2018: Journal of Craniovertebral Junction and Spine
Carlos Eduardo Salazar-Mejía, Edio Llerena-Hernández, David Hernández-Barajas, Oscar Vidal-Gutiérrez, Adriana González-Gutiérrez, Rolando Jacob Martínez-Granados, Blanca Otilia Wimer-Castillo
Malignant spinal cord compression syndrome (MSCCS) occurs in 2.5 to 5% of all oncological patients. In 20% of the cases, it is the initial manifestation. This syndrome is a rare event among germ cell tumors (GCT), occurring in only 1.7% of the patients. We present the case of a 24-year-old man who arrived at the emergency department with dysesthesia and paraparesis as well as urinary incontinence. Imaging studies showed an infiltrative lesion in the left testicle, pulmonary and hepatic metastatic disease, and a large retroperitoneal ganglionar conglomerate that infiltrated the spinal cord through the intervertebral foramina of the vertebra level T11 with displacement of the L1 vertebral body...
2018: Case Reports in Oncological Medicine
Shijia Chan, Wei Qiang Leow
Hepatocellular carcinoma (HCC) is a common cancer worldwide with a great potential for metastatic spread. Hepatocellular carcinoma often arises in people with underlying viral hepatitides or liver cirrhosis and may present in various ways including abdominal pain, liver mass, and signs of hepatocellular decompensation. Many tumors may have metastasized to other organs such as the lungs, lymph nodes, bone, and adrenal glands at the time of diagnosis. However, it is uncommon for HCC to present purely due to its metastasis, such as spinal cord compression from vertebral metastasis...
October 23, 2018: Journal of Forensic Sciences
Ben Wang, Liang Jiang, Feng Wei, Xiao Guang Liu, Zhong Jun Liu
RATIONALE: Vertebral hemangiomas (VHs), one of the most common benign tumors of the spine, can be aggressive, which is a rare condition and causes neurological deficits. Pregnancy is related to the worsening of aggressive VHs. The diagnosis and treatment of aggressive VHs remain challenging, especially for pregnant cases. PATIENT CONCERNS: We report 3 cases of aggressive VH in women who developed progressive neurological deficits during pregnancy among 95 patients treated for aggressive VH in our hospital in the past 15 years...
October 2018: Medicine (Baltimore)
Imza Feroz, Rumana Hamid Makhdoomi, Nayil Khursheed, Feroze Shaheen, Parveen Shah
Introduction: Computed tomography (CT)-guided biopsy of spine is currently a valuable diagnostic tool and effective technique for diagnosing and planning a proper therapeutic strategy for certain spinal lesions. The reported diagnostic accuracy of core biopsy ranges from 77% to 97%. Materials and Methods: We included all patients with spinal lesions suspicious of metastasis on magnetic resonance imaging, who presented between May 2012 and April 2014 and underwent CT-guided biopsy in our study...
July 2018: Asian Journal of Neurosurgery
Katharina Rosian, Katharina Hawlik, Brigitte Piso
BACKGROUND: Metastatic spinal lesions are difficult-to-treat entities that are most commonly associated with pain and severely reduced health-related quality of life (HRQoL). Within the last 5 to 10 years, radiofrequency ablation (RFA) has emerged as an option in the palliative treatment of vertebral metastases. OBJECTIVES: Our review aims to evaluate the clinical effectiveness and safety of RFA, mostly in combination with vertebroplasty, in patients with painful vertebral metastases...
September 2018: Pain Physician
Maksim Liaukovich, Susan Wu, Sydney Yoon, Jeff Schaffer, Jen C Wang
BACKGROUND: Hepatocellular carcinoma is a common malignancy in Asia. It is associated with chronic hepatitis B virus or hepatitis C virus infection and alcoholic hepatitis. Commonly, the tumor metastasizes to the lungs, regional lymph nodes, and bone. Recently, the incidence of metastatic spinal cord compression caused by primary hepatocellular carcinoma has been reported more frequently due to improved diagnosis and therapeutic modalities. The presentation of primary hepatocellular carcinoma with spinal cord compression is very rare...
September 30, 2018: Journal of Medical Case Reports
Jiang-Tao Feng, Xiong-Gang Yang, Feng Wang, Kun-Chi Hua, Yong-Heng Liu, Yong-Cheng Hu, Hao Zhang, Li Yang, Ming-You Xu, Hao-Ran Zhang
BACKGROUND: Contradictory results have been reported regarding the prognostic effect of ambulatory status in patients with metastatic spinal cord compression (MSCC). The aim of this study was to investigate whether ambulatory status is a significant predictor of overall survival in patients with MSCC and to distinguish the differences of predictors between patients who were ambulatory and those who were not ambulatory before operation. METHODS: Three clinical centers were retrospectively reviewed to identify patients operated on for MSCC between 2005 and 2015...
September 24, 2018: World Neurosurgery
Kevin Phan, Zoe B Cheung, Khushdeep S Vig, Awais K Hussain, Mauricio C Lima, Jun S Kim, John Di Capua, Samuel K Cho
Study Design: Retrospective cohort study. Objectives: To evaluate age as an independent predictive factor for perioperative morbidity and mortality in patients undergoing surgical decompression for metastatic cervical and thoracic spinal tumors using the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database from 2011 to 2014. Methods: We identified 1673 adult patients undergoing excisional laminectomy of cervical and thoracic extradural tumors...
August 2018: Global Spine Journal
Audrey Petit, Amandine Rubio, Chantal Durand, Christian Piolat, Cécile Perret, Anne Pagnier, Dominique Plantaz, Hervé Sartelet
Spinal cord compression in Wilms' tumor (WT) is an extremely rare event that can have a very poor prognosis if not taken care of rapidly. Most cases reported in the literature involve widely metastatic patient with bone or paraspinal metastases or occasionally intradural metastasis. Here, we present the case of a 3-year-old girl of WT confirmed by biopsy, with spinal cord compression due to the direct contiguous spread of a tumor through 2 vertebral foramina. Abdominal ultrasonography and magnetic resonance imaging performed for an abdominal mass revealed a large heterogeneous tumor near the upper pole of the left kidney...
2018: Case Reports in Pediatrics
Hannah E Gilder, Ross C Puffer, Mohamad Bydon, Robert J Spinner
OBJECTIVE: In this study, the authors sought to compare tumors with intradural extension to those remaining in the epidural or paraspinal space with the hypothesis that intradural extension may be a mechanism for seeding of the CSF with malignant cells, thereby resulting in higher rates of CNS metastases and shorter overall survival. METHODS: The authors searched the medical record for cases of malignant peripheral nerve sheath tumors (MPNSTs) identified from 1994 to 2017...
September 21, 2018: Journal of Neurosurgery. Spine
Mark L Higdon, Charles J Atkinson, Kelley V Lawrence
Most oncologic emergencies can be classified as metabolic, hematologic, structural, or treatment related. Tumor lysis syndrome is a metabolic emergency that presents as severe electrolyte abnormalities. Stabilization is focused on vigorous rehydration, maintaining urine output, and lowering uric acid levels. Hypercalcemia of malignancy, which is associated with poor outcomes, is treated with aggressive rehydration, intravenous bisphosphonates, and subspecialty consultation. Syndrome of inappropriate antidiuretic hormone should be suspected if a patient with cancer has hyponatremia...
June 1, 2018: American Family Physician
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