Bone metastasis from a spinal cord astrocytoma has been reported only twice in the English medical literature. It is generally known that bone metastasis is found after the initial diagnosis with/without intervening surgery rather than being found at the time of the diagnosis of astrocytoma. The purpose of this article is to report for the first time a case of concurrent bone metastasis from a spinal cord astrocytoma at the time of diagnosing the spinal cord astrocytoma.
Astrocytoma/diagnosis/*secondary ; Humans ; *Lumbar Vertebrae ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Spinal Cord Neoplasms/diagnosis/*pathology ; Spinal Neoplasms/diagnosis/*secondary ; *Thoracic Vertebrae

OBJECTIVE: To evaluate the clinical feasibility and obtain useful parameters of 31P magnetic resonance spectroscopy (MRS) study for making the differential diagnosis of brain tumors. MATERIALS AND METHODS: Twenty-eight patients with brain tumorous lesions (22 cases of brain tumor and 6 cases of abscess) and 11 normal volunteers were included. The patients were classified into the astrocytoma group, lymphoma group, metastasis group and the abscess group. We obtained the intracellular pH and the metabolite ratios of phosphomonoesters/phosophodiesters (PME/PDE), PME/inorganic phosphate (Pi), PDE/Pi, PME/adenosine triphosphate (ATP), PDE/ATP, PME/phosphocreatine (PCr), PDE/PCr, PCr/ATP, PCr/Pi, and ATP/Pi, and evaluated the statistical significances. RESULTS: The brain tumors had a tendency of alkalization (pH = 7.28 +/- 0.27, p = 0.090), especially the pH of the lymphoma was significantly increased (pH = 7.45 +/- 0.32, p = 0.013). The brain tumor group showed increased PME/PDE ratio compared with that in the normal control group (p = 0.012). The ratios of PME/PDE, PDE/Pi, PME/PCr and PDE/PCr showed statistically significant differences between each brain lesion groups (p < 0.05). The astrocytoma showed an increased PME/PDE and PME/PCr ratio. The ratios of PDE/Pi, PME/PCr, and PDE/PCr in lymphoma group were lower than those in the control group and astrocytoma group. The metastasis group showed an increased PME/PDE ratio, compared with that in the normal control group. CONCLUSION: We have obtained the clinically applicable 31P MRS, and the pH, PME/PDE, PDE/Pi, PME/PCr, and PDE/PCr ratios are helpful for differentiating among the different types of brain tumors.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Astrocytoma/diagnosis/*metabolism ; Brain Abscess/diagnosis/*metabolism ; *Brain Chemistry ; Brain Neoplasms/diagnosis/*metabolism/secondary ; Case-Control Studies ; Diagnosis, Differential ; Feasibility Studies ; Female ; Humans ; Hydrogen-Ion Concentration ; Lymphoma/diagnosis/*metabolism ; Magnetic Resonance Imaging ; Magnetic Resonance Spectroscopy/*methods ; Male ; Middle Aged ; Phosphorus/diagnostic use ; Prospective Studies ; Young Adult