Adult ; Diagnosis, Differential ; Endometriosis ; pathology ; surgery ; Female ; Humans ; Laminectomy ; Spinal Canal ; pathology ; surgery ; Spinal Diseases ; pathology ; surgery ; Spinal Neoplasms ; pathology ; surgery

A 24-year-old man with tuberculosis meningitis developed acute paraplegia and sensory disturbances 5 weeks after receiving conventional antituberculous therapy. Magnetic resonance imaging revealed an intradural extramedullary long segmental mass mimicking en plaque meningioma at the T2-T6 vertebrae levels. Prompt surgical decompression was performed. A histology examination of the mass revealed a tuberculoma. After surgery, the patient showed improved motor power and a normal bladder function. Intradural extramedullary tuberculoma of the spinal cord is rare complication of tuberculosis meningitis, which can occur as a response to conventional antituberculous therapy.
Diagnosis, Differential ; Humans ; Male ; Meningeal Neoplasms/*diagnosis ; Meningioma/*diagnosis ; Spinal Cord Diseases/*diagnosis/surgery ; Thoracic Vertebrae ; Tuberculoma/*diagnosis/surgery ; Tuberculosis, Meningeal/*diagnosis/surgery ; Young Adult

Cervical Vertebrae ; Hemangioma, Cavernous ; diagnosis ; pathology ; Humans ; Male ; Middle Aged ; Rupture, Spontaneous ; Spinal Canal ; pathology ; Spinal Neoplasms ; diagnosis ; surgery

Although intracranial dural metastasis of Ewing's sarcoma is a very rare finding, its imaging characteristics are similar to those of its primary form in the central nervous system. Thus, this tumor must be considered in the differential diagnosis of extra-axial dural masses.
Adult ; Dura Mater/*pathology ; Female ; Humans ; Magnetic Resonance Imaging ; Sarcoma, Ewing's/diagnosis/*pathology/surgery ; Skull Neoplasms/diagnosis/*secondary/surgery ; Spinal Neoplasms/diagnosis/pathology/surgery ; Tomography, X-Ray Computed

Although lumbosacral lipoma is reported to occur in 4-8 of 100,000 patients, and 66% of lipomyelomeningoceles in young patients are accompanied by hypertrophic filum terminale, it is very rare to find two isolated spinal lipomas simultaneously. A 3 month-old baby girl was admitted to the hospital for a protruding, non-tender, soft, subcutaneous 2.5 cm mass of the lumbosacral area that had been present since birth. Simple radiography showed a spinal posterior arch defect from L3 to L5, and magnetic resonance imaging (MRI) demonstrated two isolated spinal lipomas, a transitional type from L3 to L5, and a terminal type below S1 without dural defect. The cornus medullaris was severely tethered descending to the S1, but there was no cerebellar or brain stem herniation on the MRI. We suggest that the presence of a combined spinal lipoma should be a point for careful differentiation in an infant with spinal lipoma.
Treatment Outcome ; Spinal Cord Neoplasms/*diagnosis/*surgery ; Neural Tube Defects/*diagnosis/*surgery ; Lumbosacral Region/*surgery ; Lipoma/*diagnosis/*surgery ; Infant ; Humans ; Female

OBJECTIVETo investigate the diagnosis and surgical techniques of intramedullary hemangioblastoma of the cervical spinal cord.

METHODSMR imaging and the methods and results of surgery were analyzed in 21 patients.

RESULTSThe tumors were divided into three types on MR imaging. Syringeal type, where the tumor varied in size and was accompanied by syringobulbia and syringomyelia; Cystic type, where the tumor presented as a cyst with a small mural node; and Solid type, where the tumor was revealed as a huge solid mass. All tumors were totally removed and diagnosis was confirmed by histological study. Post-operative neurological status was improved in 20 patients and aggravated in 1.

CONCLUSIONSThe localization and the nature diagnosis of the tumor can be made by cervical MR imaging. Operative methods vary with tumor types. It is the most important that the tumor is dissected along the right interface and removed after devascularization.

Adolescent ; Adult ; Cervical Vertebrae ; Female ; Hemangioblastoma ; diagnosis ; surgery ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Spinal Cord Neoplasms ; diagnosis ; surgery

Adult ; Cervical Vertebrae ; Female ; Giant Cell Tumor of Bone ; diagnosis ; surgery ; Humans ; Middle Aged ; Spinal Neoplasms ; diagnosis ; surgery

The spine is the most common site of metastatic tumors. The highest incidence of metastatic tumors on the spine is in the lumbar region, followed by the thoracic and cervical levels. Most associated spinal cord lesions, however, are located in the thoracic spine. The goals of surgery is decompression of the neural tissues, prevention of neural injury by stabilization of the unstable spinal column,or pain control. When there is a need to decompress the neurologic tissues,the most direct approach is anterior because the most common site of metastatic tumors is in the vertebral body. Laminectomy alone is not effective in improving neurologic function. Nevertheless,the posterior approach is more accessible, less hazardous, and effective in the correction of deformity if combined with instrumentation. If complete vertebrectomy is feasible in anterior bone strut combined with anterior and posterior stabilization is necessary following the vertebrectomy.
Biopsy ; Humans ; Neoplasm Invasiveness ; Spinal Neoplasms ; diagnosis ; pathology ; secondary ; surgery ; Treatment Outcome

BACKGROUNDChordomas of the upper cervical spine are rare and present unique surgical challenge. This study aimed to describe the clinical characteristics and surgical management of patients with chordomas of the upper cervical spine.

METHODSTwenty-one patients with chordomas of the upper cervical spine who were treated in Peking University Third Hospital from January 1999 to October 2012 were retrospectively analyzed. Survival was calculated by the Kaplan-Meier method and was compared between groups using the log-rank test.

RESULTSThe postoperative diagnosis was classical chordoma in 20 cases and chondroid chordoma in one case. The mean operative time was 9.5 hours (range 6-17 hours), and the mean blood loss was 2 812 ml (range 700-4 800 ml). There were two postoperative deaths. Unilateral vertebral artery ligation was performed in six patients, cervical nerve roots were cut in six patients, and the external branch of the superior laryngeal nerve was repaired after being cut in one case. Two patients developed postoperative velopharyngeal incompetence, and loosening of the occipitocervical screws was observed in one patient. The recurrence rate was 66.7% (10/15) after a mean follow-up period of 46.8 months (range 14-150 months). The 5- and 10- year overall survival rates were (39.8±13.1)% and (31.9±12.7)%, respectively. There was a significant difference in survival rate between patients who underwent surgery and those who did not.

CONCLUSIONIn spite of the high rates of recurrence and complications after surgical treatment of chordomas of the upper cervical spine, intralesional resection combined with adjuvant radiotherapy remains the optimal treatment to prolong survival.

Adult ; Aged ; Cervical Vertebrae ; pathology ; surgery ; Chordoma ; diagnosis ; surgery ; Female ; Humans ; Male ; Middle Aged ; Neoplasm Recurrence, Local ; diagnosis ; surgery ; Retrospective Studies ; Spinal Neoplasms ; pathology ; surgery ; Treatment Outcome

Adult ; Calmodulin-Binding Proteins ; metabolism ; Desmin ; metabolism ; Diagnosis, Differential ; Female ; Humans ; Leiomyoma ; metabolism ; pathology ; surgery ; Leiomyosarcoma ; pathology ; Spinal Canal ; Spinal Neoplasms ; metabolism ; pathology ; surgery ; Young Adult