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

Intramedullary metastatic tumor comprise about 0.9 to 5% among the spinal metastatic tumors. Authors presented a rare case of intramedullary metastatic spinal cord tumor treated with operative total removal followed by radiation therapy and chemotherapy.
Drug Therapy ; Lung Neoplasms ; Spinal Cord Neoplasms* ; Spinal Cord*

PURPOSE: A spinal cord partial block technique (PBT) with dynamic multileaf collimator (dMLC) for the reduction of the spinal cord dose while keeping the tumor dose unchanged has been developed and its effectiveness has been examined. MATERIALS AND METHODS: Conventional 3-D conformal therapy treatment plan is deigned prior to the PBT application. Beam parameters such as, number of beams, beam directions were determined during 3-D conformal therapy planning process. The shape and the weight of the partial block for optimizing the dose distribution are designed with the forward intensity modulated radiation therapy (fIMRT). Eight cases of lung cancer, in which it was found to be impossible to deliver enough doses to targets with the conventional technique because the doses of the normal lungs or the spinal cords were over the tolerance limit, are used to verify the usefulness of this technique. Comparison of the dose volume histogram (DVH) is performed to compare the treatment plan. RESULTS: PBT plan cauld reduce the maximum dose to the spinal cord up to 29.7% and the mean dose to the lungs up to 11.1%. CONCLUSION: All of the cases showed that the PBT plans are better than the conventional 3-D plans and the spinal cord doses or the normal lung doses can be reduced to tolerance limit
Lung Neoplasms* ; Lung* ; Spinal Cord

Although cavernous hemangiomas occur frequently in the intracranial structures, they are rare in the spine. Most of spinal hemangiomas are vertebral origin and "pure" epidural hemangiomas not originating from the vertebral bone are very rare. Our spinal hemangioma case is extremely rare because of its "pure" epidural involvement and intralesional hemorrhage. A 64-year-old man presented with progressive paraparesis from two months ago. His motor weakness was rated as grade 4/5 in bilateral lower extremities. He also complained of decreased sensation below the T4 sensory dermatome, which continuously progressed to the higher dermatome level. Magnetic resonance imaging demonstrated thoracic spinal tumor at T3-T4 level. The tumor was located epidural space compressing thoracic spinal cord ventrally. The tumor was not involved with the thoracic vertebral bone. We performed T3-5 laminectomy and removed the tumor completely. The tumor was not infiltrating into intradural space or vertebral bone. The histopathologic study confirmed the epidural tumor as cavernous hemangioma. Postoperatively, his weakness improved gradually. Four months later, his paraparesis recovered completely. Here, we present a case of pure spinal epidural cavernous hemangioma, which has intralesional hemorrhage. We believe cavernous hemangioma should be included in the differential diagnosis of the spinal epidural tumors.
Diagnosis, Differential ; Epidural Neoplasms ; Epidural Space ; Hemangioma ; Hemangioma, Cavernous* ; Hemorrhage* ; Humans ; Laminectomy ; Lower Extremity ; Magnetic Resonance Imaging ; Middle Aged ; Paraparesis ; Sensation ; Spinal Cord ; Spinal Cord Diseases* ; Spine

Cervical Vertebrae ; Dura Mater ; Epidural Space ; Humans ; Spinal Cord Neoplasms ; surgery

A 31-year-old male presented with severe back pain and paraparesis. Imaging studies demonstrated an extraosseous, extradural mass without bone invasion at the T11-T12 vertebral level, located dorsal to the thecal sac. The spinal cord was compressed ventrally. The lesion was completely excised after a T11-T12 laminectomy. Histopathological examination revealed a cavernous hemangioma. The patient's symptoms improved after excision of the lesion.
Adult ; Back Pain ; Epidural Neoplasms ; Hemangioma, Cavernous* ; Humans ; Laminectomy ; Male ; Paraparesis ; Spinal Cord ; Thoracic Vertebrae

A case is reported which raised intracranial pressure with papilledema due to hydrocephalus associated with a intramedullary spinal cord tumor at the T10-T12 levels. The pathlogical diagnosis of the tumor is pleomorphic xanthoastrocytoma which is very rare in the spinal cord. CSF protein was elevated. The mechanisms of the raised intracranial pressure are discussed with a review of the literatures.
Diagnosis ; Hydrocephalus* ; Intracranial Pressure ; Papilledema ; Spinal Cord Neoplasms* ; Spinal Cord*

Primary melanotic schwannoma in spinal cord is a very uncommon disorder, eight cases of melanotic schwannoma in spinal cord have been found in the literature. We present a case report of a patient with an intradural, extramadullary melanotic schwannoma in cervical spine and the literature on melanotic schwannoma is reviewed. The proposed theories on the origin of these tumors and treatment are discussed.
Humans ; Neurilemmoma* ; Spinal Cord ; Spinal Cord Neoplasms ; Spine*

Spinal cord compression is fatal condition to oncologic patients. Metastatic spinal cord compression from ovarian cancer is rarely reported in the literature. We experienced a case of solitary spinal cord compression with paraplegia in recurrent ovarian cancer patients.
Humans ; Ovarian Neoplasms ; Paraparesis ; Paraplegia ; Spinal Cord ; Spinal Cord Compression

There were many surgical approaches for the ventral or ventrolateral thoracic spinal cord tumor. Six ventrally or ventrolaterally located thoracic spinal tumors were successfully resected through the posterolateral approach. This approach allows direct visualization of the ventral and dorsal boundaries of the tumor with minimal manipulation of the spinal cord. Compared to the traditional laminectomy, visualization of the tumor and spinal cord can be shown to markedly improved. Also, when compared to the transthoracic approach, this approach has be associated with fewer potential complications, such as violation of pleural space and mediastinum, and eliminates the necessity of vertebrectomy. Neurological improvement was obtained in all six patients. It is believed that this approach offers significant advantages for the treatment of ventrally or ventrolaterally located thoracic tumors, and should be considered an to alternative the transthoracic approach.
Humans ; Laminectomy ; Mediastinum ; Spinal Cord ; Spinal Cord Neoplasms