OBJECTIVE: The spinal cord tumors(including vertebral tumors) are increasingly diagnosed and operated due to development of refined diagnostic and therapeutic tools. It is necessary to re-evaluate clinical features and surgical results of spinal cord tumors with increasing cases and developing treatment modalities. The authors reviewed the spinal cord tumor cases to evaluate their clinical characteristics. MATERIALS AND METHODS: The retrospective review of 654 cases of spinal cord tumors between 1973 and 1999 was done. The clinical features, pathological analysis and surgical results were analyzed and compared to the literature. The results of the study are analyzed with a more detailed consideration of each of major pathologies: neurogenic tumors, meningeal tumors, neuroepithelial tumors, and metastatic tumors. RESULTS AND CONCLUSION: The spinal cord tumor was most common in the 5th decade of age(145 cases, 22.1%) and 78 cases(11.9%) were found in children under 15 years of age. The ratio of male to female was 1.2:1. The pathologic diagnosis was neurogenic tumor in 266 cases(40.7%), neuroepithelial tumor in 131(20.0%), metastatic tumor in 118(18.0%), and meningeal tumor in 94(14.4%) in the order of frequency. The tumor was located most frequently in the thoracic area(36.5%) and in the intradural extramedullary space(38.1%). The most common initial presentation was pain(40.1%) and the mean duration for presentation to operation was 14.8 months. The total or gross total removal was possible in 404 cases(61.7%) and the surgical result on the postoperative one month was recovery or improvement in 424 cases(64.8%), stationary in 188(28.7%), progression in 42(6.4%). As a surgical complication, there was a spinal deformity(12 cases), wound infection(5 cases), aspiration pneumonia(5 cases) etc. Neurogenic tumors and menigiomas showed good surgical results, whereas neuroepithelial tumors(except ependymoma) and metastatic tumors showed relatively poor prognosis.
Child ; Diagnosis ; Female ; Humans ; Male ; Meningeal Neoplasms ; Neoplasms, Neuroepithelial ; Pathology ; Prognosis ; Retrospective Studies ; Spinal Cord Neoplasms* ; Spinal Cord* ; Wounds and Injuries

Humans ; Ependymoma/secondary* ; Brain Neoplasms/pathology* ; Skin Neoplasms ; Melanoma ; Spinal Cord Neoplasms/pathology*

OBJECTIVE: Laminoplasty is one of the potential surgical options for compressive spinal pathologies. The use of laminoplasty in spinal cord tumor surgery is not popularized by this time. To demonstrate the usefulness of laminoplasty in spinal cord tumor surgery, the authors analyze the results of patients who underwent laminoplasty for removal of cervical spinal cord tumor. METHODS: Between 1992 and 2000, 47 patients had received operation for the removal of the cervical spinal cord tumor. Of them, 29 patients were enrolled for this study. 17 patients received laminoplasty and 12 patients received laminectomy. The medical records and radiologic studies were analyzed retrospectively. The mean follow-up duration was 61.6 months. RESULTS: Modified Kurokawa method for laminoplasty was utilized in all cases. Neurilemmoma was the most common pathology. Average operated segments ware 2.8 segments in laminectomy group and ware 3.8 segments in laminoplasty group. Taking time for the operation with laminoplasty(avg. 291min) was longer than that for laminectomy(avg. 275min). Kyphotic deformity was developed in 1 patient in laminoplasty group and in 2 patients in laminectomy group. All laminoplasty patients revealed stability in radiologic follow-up. One patient who underwent laminoplasty presented recurrent neurilemmoma, which could be removed easily by virtue of less adhesion and undistorted anatomy. CONCLUSION: This study demonstrates that patients who underwent laminoplasty have less kyphotic deformity and keep space with protection from adhesion. We conclude that the laminoplasty is one of the useful procedures, especially in younger patients with large multiple intradural tumors and mass over several segments.
Congenital Abnormalities ; Follow-Up Studies ; Humans ; Laminectomy ; Medical Records ; Neurilemmoma ; Pathology ; Retrospective Studies ; Spinal Cord Neoplasms* ; Spinal Cord* ; Virtues

The author have presented 58 cases with tumors in spinal canal who were admitted to the department of neurosurgery, Presbyterian Medical Center, Keimyung university school of medicine from March 1975 to September 1979. Of these, 35 cases had spinal metastasis causing cord or cauda equina compression and 23 cause had spinal cord tumors. We attempted to analyse these cases clinically and discussed with the review of the literatures. The results were summarized as follows: In the age distribution, The common incidence of age was between first and second decade in spinal cord tumors and fifth decade in metastatic epiural tumors. The ratio of male to female was about 2:1 in both cases. 2) The most common complaint was weakness of extremities(33 cases:94%) in metastatic epidural tumor and pain in back and extremities(23 cases:10%) in spinal cord tumors. The sphincter disturbance was somewhat more common in metastatic epidural tumors(25 cases:71%) than in spinal cord tumors(11 cases:48%). 3) The duration of symptoms from onset to admission in the patients with metastatic epidural tumors were shorter than in those with spinal cord tumors. The majorities of the duration of symptoms were some monthes in both cases. 4) Motor weakness, reflex change and sensory impairment were the most frequent physical findings. 5) The thoracic region was the most common site of spinal cord tumors and metastatic epidural tumors. 6) Plain spine X-ray was abnormal in 13 cases(56%) of spinal cord tumors, 5 cases(71%) in the metastatic epidural tumors. Twenty three cases in the spinal cord tumors and twenty five cases in the metastatic epidural tumors had done myelography, and it showed intradural convexity in 23 cases(100%) of spinal cord tumors, complete obstruction(serrated or transverse) in 23 cases(91%) of metastatic epidural tumors. 7) The most frequent pathology of spinal cord tumors was schwannoma(16 cases) and the most frequent primary site of metastatic epidural tumors was lung(4 cases). 8) The prognosis was relatively excellent in spinal cord tumors and poor in metastatic epidural tumors in spite of treatment with decompression and radiation therapy.
Age Distribution ; Cauda Equina ; Decompression ; Epidural Neoplasms ; Female ; Humans ; Incidence ; Male ; Myelography ; Neoplasm Metastasis* ; Neurosurgery ; Pathology ; Prognosis ; Protestantism ; Reflex ; Spinal Canal ; Spinal Cord Neoplasms* ; Spinal Cord* ; Spine

Child ; Germinoma ; chemistry ; pathology ; surgery ; Humans ; Immunohistochemistry ; Male ; Spinal Cord Neoplasms ; chemistry ; pathology ; surgery

Meningioma is relatively common, benign, and extra-axial tumor accounting for about 20% of primary brain and spinal cord tumors. The World Health Organization (WHO) classified these tumors into Grade I (benign), Grade II (atypical), and Grade III (anaplastic) meningioma. Grade I meningioma which is slowly growing tumor and have some rare subtypes. Among them, metaplastic subtype is defined as a tumor containing focal or widespread mesenchymal components including osseous, cartilaginous, lipomatous, myxoid or xanthomatous tissue, singly or in combinations. We report a rare metaplastic meningioma overspreading nearly whole cerebral convexity from main extra-axial tumor bulk in the parietal lobe.
Brain ; Brain Neoplasms ; Meningioma* ; Parietal Lobe ; Pathology ; Spinal Cord Neoplasms ; World Health Organization

Adult ; Cauda Equina ; Female ; Humans ; Magnetic Resonance Imaging ; Meningeal Neoplasms ; diagnosis ; pathology ; Meningioma ; diagnosis ; pathology ; Spinal Cord Neoplasms ; diagnosis ; pathology

The authors analyzed 175 cases of spinal cord tumor who had been operated upon at the Department of Neurosurgery of the Seoul National University Hospital from 1973 to 1986. The tumor was most common in the 5th decade of age(47 cases, 26.9%) and 24 cases(13.7%) were children. And the ratio of male to female was 1.2:1. The pathologic diagnosis was neurogenic tumor in 73 cases(41.7%), metastatic tumor in 29 cases(16.6%), glial tumor in 24 cases(13.7%), and meningeal tumor in 23 cases(13.1%) in the order of frequency, and the tumors of dysembryogenesis were only 2 cases(1.1%). The tumors were located most frequently in the thoracic area(79 cases, 45.1%) and I the intradural extramedullary space(79 cases, 45.1%). The most common initial presentation was pain(86 cases, 49.1%) and the mean duration of presentation was 20.6 months. On admission 70 cases(40.0%) were in the 'paraparesis stage'. The mean value of the CSF protein was 741mg%. The rate of positivity of the plain spinal radiologic study was 55.7% and the most common positive findings was the increased interpedicular distance(46 cases, 29.1%). the total or gross total removal was possible in 105 cases (60.0%). The surgical result within the postoperative one month was recovery in 52 cases(29.7%), improvement in 76 cases(43.4%), stationary state in 36 cases (20.6%), progression in 11 cases(6.3%). After 20.1 months of the mean follow-up duration in 109 cases(62.3%), the result was recovery in 69 cases(63.3%), improvement in 16 cases(14.7%), stationary state in 8 cases(7.3%), progression in 16 cases(14.7%). As a major complication, there was a spinal deformity in 6 cases(3.4%), pulmonary embolism in 2 cases(1.1%), postoperative hematoma and meningitis in 1 case(0.6%) each. Ten cases(5.7%) were followed up to their deaths. And the authors discussed the clinical features of the spinal cord tumors reported in the literatures and the results of the present study with a more detailed consideration on each of major pathologies, neurogenic tumors, meningeal tumors, glial tumors, and metastatic tumors.
Child ; Congenital Abnormalities ; Diagnosis ; Female ; Follow-Up Studies ; Hematoma ; Humans ; Male ; Meningeal Neoplasms ; Meningitis ; Neurosurgery ; Pathology ; Pulmonary Embolism ; Seoul ; Spinal Cord Neoplasms* ; Spinal Cord*

A case of spinal meningeal melanocytoma is reported along with clinicopathologic, immunohistochemical and ultrastructural studies. This patient presented clinically with paraparesis, tingling sensation and numbness of both lower extremities of 4 months duration. No mucocutaneous pigmented nevi were found. On operation, scattered coal-black pigmented lesions were found in the meninges between T3 and T4-5 interspace level. Nearly total removal was carried out. The tumor was composed of spindle and epithelioid cells with heavy brown-black pigmentation. There was no pleomorphism, mitosis, hemorrhage, necrosis or invasion to the underlying cord tissue. In Korea, this case appears to be the first example of this disease. Neurologic deficit improved after surgical excision.
Adult ; Female ; Humans ; Immunoenzyme Techniques ; Meningeal Neoplasms/chemistry/*pathology/ultrastructure ; Microscopy, Electron ; Spinal Cord

A primary intraspinal primitive neuroectodermal tumor is very rare, with only 24 cases having been reported in the literature. In general this type of tumor is treated with surgery followed by radiotherapy and chemotherapy; however, the prognosis still remains poor. The case of a primary intraspinal primitive neuroectodermal tumor, at the conus medullaris in a 17 year old male patient is presented. He had sufferred from paraparesis, urinary difficulty and lower back pain of 1 month duration. A thoracolumbar MRI demonstrated a 2x2x8cm isointense intraspinal mass, on T1-weighted images, with strong contrast enhancement from the T11 to L2 level. There was no clinical or radiological evidence for the existence of an intracranial tumor. A histological examination revealed a small round cell tumor and immunohistochemical characteristics of PNET. The clinical, radiological and pathological features are discussed with a review of the literatures.
Adolescent ; Human ; Lumbar Vertebrae ; Magnetic Resonance Imaging ; Male ; Neuroectodermal Tumors, Primitive/*pathology/therapy ; Spinal Cord Neoplasms/*pathology/therapy ; Thoracic Vertebrae