• Journal of Korean Neurosurgical Society
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• 제52권4호
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• pp.417-419
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• 2012

Tumors of the central nervous system are common in the pediatric population and constitute the second most prevalent tumor type in children. Within this group, spinal cord tumors are relatively rare and account for 1 to 10% of all pediatric central nervous system tumors. We describe a very rare case of an intradural extramedullary spinal cord tumor with a subcutaneous mass and discuss its clinical presentation, pathogenesis, and treatment. A male infant was delivered normally, with uneventful development. At 16 days post-delivery, his family took him to a pediatrician because of a mass on his upper back. Magnetic resonance imaging of the thoracic spine revealed a well-demarcated soft-tissue mass with central cystic change or necrosis at the subcutaneous layer of the posterior back (T2-7 level). Another mass was found with a fat component at the spinal canal of the T1-3 level, which was intradural extramedullary space. After six weeks, the spinal cord tumor and subcutaneous mass were grossly total resected; pathologic findings indicated an atypical myxoid spindle cell neoplasm, possibly nerve sheath in type. The final diagnosis of the mass was an atypical myxoid spindle cell neoplasm. The postoperative course was uneventful, and the patient was discharged after nine days without any neurological deficit. We report a rare case of an intradural extramedullary spinal tumor with subcutaneous mass in a neonate. It is necessary to monitor the patient's status by examining consecutive radiologic images, and the symptoms and neurological changes should be observed strictly during long-term follow-up.

• Journal of Korean Neurosurgical Society
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• 제30권sup2호
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• pp.361-363
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• 2001

Intradural extramedullary hemangioblastoma of the spinal cord is uncommon tumor. Symptom onset is typically in the forth decade. Complete excision offers the best chance for cure. We report a case of extramedullary hemangioblastoma of the spinal cord in old age. A 76 -year old man presented with 1 month history of paraparesis. Multiple enhancing lower thoracic and lumbar spinal masses were seen on magnetic resonance imaging(MRI). Surgical exploration for symptomatic lesion revealed intradural-extramedullary mass, which had hypervascularity. The excised spinal masses were diagnosed as hemangioblastoma. Postoperative course was uneventful and symptoms improved gradually.

• Journal of Korean Neurosurgical Society
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• 제44권5호
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• pp.334-337
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• 2008

Spinal intradural extramedullary teratoma is a rare condition that develops more commonly in children than in adults and may be associated with spinal dysraphism. We report a rare case of adult-onset intradural extramedullary teratoma in the thoracolumbar spinal cord with no evidence of spinal dysraphism and without the history of prior spinal surgery. The patient was a 38-year-old male whose chief complaint was urinary incontinence. X-ray images of the thoracolumbar spine showed the widening of the interpedicular distance and posterior marginal erosion of the vertebral bodies and pedicles at the T11, T12, and L1 level. Magnetic resonance imagings of the lumbar spine showed a lobulated inhomogeneous high signal intradural mass ($87{\times}29{\times}20mm$) between T11 and L1 and a high signal fluid collection at the T11 level. Laminectomy of the T11- L1 region was performed, and the mass was subtotally excised. The resected tumor was histopathologically diagnosed as a mature cystic teratoma. The patient's symptom of urinary incontinence was improved following the surgery.

• Journal of Korean Neurosurgical Society
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• 제48권2호
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• pp.157-161
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• 2010

Primary central nervous system (CNS) melanoma is a rare condition that accounts for only 1% of all melanomas. A 34-year-old Korean female presented with a two-month history of progressive weakness in both legs. Spinal magnetic resonance image (MRI) revealed a spinal cord tumor at the level of T4, which was hyperintense on T1-weighted imaging and hypointense on T2-weighted imaging. The intradural and extramedullary tumor was completely resected and diagnosed as melanoma. There were no metastatic lesions. At three years after surgery, the patient is still alive, with no evidence of tumor recurrence. We present the details of this case along with a comprehensive review of spinal cord melanoma.

• Journal of Korean Neurosurgical Society
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• 제56권3호
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• pp.265-268
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• 2014

Solitary fibrous tumor is rare benign mesenchymal neoplasm. The spinal solitary fibrous tumor is extremely rare. The authors experienced a case of intramedullary solitary fibrous tumor of cervicothoracic spinal cord in a 48-year-old man with right lower extremity sensory disturbance. Spinal MRI showed intradural mass lesion in the level of C7-T1, the margin between the spinal cord and tumor was not clear on MRI. A Left unilateral laminectomy and mass removal was performed. Intra operative finding, the tumor boundary was unclear from spinal cord and it had intramedullary and extramedullary portion. After surgery, patient had good recovery and had uneventful prognosis. Follow up spinal MRI showed no recurrence of tumor.

• Journal of Korean Neurosurgical Society
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• 제29권9호
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• pp.1238-1242
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• 2000

Spinal schwannomas are usually extramedullary intradural tumors and their intramedullary localizations are thought to be extremely rare. A 60-year-old woman complaining spastic quadriparesis, voiding difficulty and dyspnea was admitted. Her cervical MRI revealed an intramedullary mass in the cervicomedullary junction with multiple cyst which extended from lower cervical to C3 spinal cord. The mass showed a low signal on T1WI, high signal on T2WI with an wall enhancement. The patient underwent a suboccipital craniectomy and C1-2 laminectomy and the cystic tumor was totally removed through a midline myelotomy. The tumor was proved as an intramedullary schwannoma by pathologic examination. The Intramedullary presence of a tumor arising from the cells of the nerve sheath is unusual, because the central nervous system fibers do not contain the Schwann cell. There have been several hypotheses, but none has been accepted universally. This rare tumor is considered as a curable benign neoplasm, and an accurate intraoperative diagnosis and surgically total removal are essential.

• Journal of Korean Neurosurgical Society
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• 제42권6호
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• pp.436-440
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• 2007

Objective : Spinal cord hemangioblastoma is an uncommon vascular neoplasm with a benign nature and is associated with von Hippel-Lindau (VHL) disease in 20-30% of patients. Total removal of these tumors without significant neurological deficit remains a great challenge. The purpose of this study was to investigate the efficacy of VHL mutation analysis and to evaluate surgical outcome of patients with spinal cord hemangioblastomas. Methods : This study included nine patients treated for spinal cord hemangioblastomas at our institute between December 1994 and March 2006. There were four male and five female patients. Mean age was 37.8 years. The mean follow-up period was 22.4 months. Magnetic resonance imaging (MRI) of the complete neuraxis was done in all cases and VHL mutation analysis was performed in three cases for a definite diagnosis. Results : Six patients had intramedullary tumor, and the remaining patients had intradural extramedullary lesions. Five patients were associated with VHL disease. The von Hippel-Lindau mutation analysis was done in three patients and two of them showed VHL gene abnormality. Tumors were located in the cervical cord in five cases and in the thoracic cord in four cases. All patients underwent surgical intervention, and total removal was achieved in six cases. All patients showed improvement or, at least, clinically stationary state. Surgical complications did not develop in any cases. Conclusion : Spinal hemangioblastoma in this series has been safely and effectively removed via a posterior approach. Postoperatively, clinical outcome was excellent in the majority of cases. The VHL mutation analysis was useful in patients with family history and in those with multiple hemangioblastomas.