We report a case of metastatic hemangiopericytoma to the cervical spine. A 55-year-old female having a history of intracranial cavernous hemangiopericytoma, which was found 78 months ago was admitted to our hospital with posterior neck pain and left arm radiating pain. Magnetic resonance image revealed a tumor invading the C6 and C7 vertebral body and compressing the spinal cord. The histopathologic findings were characteristic of hemangiopericytoma. Extracranial metastases of hemangiopericytoma can occur long after the previous treatment in unexpected sites, especially in skeletal system. Bone scintigraphy is an useful tool to detect osseous metastasis, furthermore single negative scan is not sufficient to exclude bone metastasis.
Arm ; Female ; Hemangiopericytoma ; Humans ; Middle Aged ; Neck Pain ; Neoplasm Metastasis* ; Radionuclide Imaging ; Spinal Cord ; Spine*

Background: The present study evaluated the association between participation in a rehabilitation program during a hospital stay and 1-year survival of patients requiring at least 21 days of mechanical ventilation (prolonged mechanical ventilation [PMV]) with various respiratory diseases as their main diagnoses that led to mechanical ventilation. Methods: Retrospective data of 105 patients (71.4% male, mean age 70.1±11.3 years) who received PMV in the past 5 years were analyzed. Rehabilitation included physiotherapy, physical rehabilitation, and dysphagia treatment program that was individually provided by physiatrists. Results: The main diagnosis leading to mechanical ventilation was pneumonia (n=101, 96.2%) and the 1-year survival rate was 33.3% (n=35). One-year survivors had lower Acute Physiology and Chronic Health Evaluation (APACHE) II score (20.2±5.8 vs. 24.2±7.5, p=0.006) and Sequential Organ Failure Assessment score (6.7±5.6 vs. 8.5±2.7, p=0.001) on the day of intubation than non-survivors. More survivors participated in a rehabilitation program during their hospital stays (88.6% vs. 57.1%, p=0.001). The rehabilitation program was an independent factor for 1-year survival based on the Cox proportional hazard model (hazard ratio, 3.513; 95% confidence interval, 1.785 to 6.930; p<0.001) in patients with APACHE II scores ≤23 (a cutoff value based on Youden’s index). Conclusion Our study showed that participation in a rehabilitation program during hospital stay was associated with an improvement of 1-year survival of PMV patients who had less severe illness on the day of intubation.

No abstract available.