• Title/Summary/Keyword: Spinal cord metastasis

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Percutaneous Vertebroplasty in Spinal Metastasis and Myeloma : 25 Cases Experience (척추 전이암 및 골수종 환자를 대상으로 시행한 경피적 척추체 성형술)

  • Park, Woo-Min;Jang, Jee-Soo;Rhee, Chang-Hun;Gwak, Ho-Shin;Lee, Seung-Hoon
    • Journal of Korean Neurosurgical Society
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    • v.29 no.11
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    • pp.1484-1490
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    • 2000
  • Objectives : In spinal metastasis and myeloma, percutaneous vertebroplasty could be an effective treatment method to provide spinal stabilization and to relief pain for early rehabilitation. The authors report twenty-five cases the clinical results of percutaneous vertebroplasty for twenty-five cases of spinal metastasis and myeloma. Materials and Methods : From September 1998 to December 1999, seventy percutaneous vertebroplasties(PVP) were performed for spinal metastases and myeloma in 25 patients, sixteen women and nine men ranging in age from 34 to 74. The primary malignancies were 6 multiple myelomas, and in metastatic tumore from various origin. All patients complained of severe pain and had osteolytic vertebral body destructions without spinal cord compression. To evaluate clinical improvement, suObjective verbal analogue pain score(VAS) and Karnofsky performance scale(KPS) were used. Thin sliced(2mm-thickness) sectional computed tomography(CT) was performed before and after PVP. Plain X-ray film was followed up every 1 month to assess the vertebral column stability. Results : In 25 patients, a total of seventy PVPS were performed successfully : 6 cervical, 33 thoracic and 31 lumbar vertebrae. Most patients had clear improvement of pain after PVP ; mean as score was 8.1 and 2.9 before and after PVP, respectively. Improvement was maintained in most patients. No further collapse of treated vertebrae was observed(mean follow-up, 7 months). Leakage of PMMA was notod in the spinal canal(13 levels), neural foramen (2 levels), adjacent disk(15 levels), paravertebral soft tissue(14 levels) and vein(8 levels). Pulmonary embolism was detected in three patients after the procedure, but was not associated with clinical symptoms. Conclusion : These results indicate that percutaneous vertebroplasty can be valuable treatment method in osteolytic spinal metastasis and myeloma, providing immediate pain relief and spinal stabilization and contributing to early rehabilitation.

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A Case Report of "Spinal Cord Apoplexy" Elicited by Metastatic Intramedullary Thyroid Carcinoma

  • Choi, In-Jae;Chang, Jae-Chil;Kim, Dong-Won;Choi, Gun
    • Journal of Korean Neurosurgical Society
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    • v.51 no.4
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    • pp.230-232
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    • 2012
  • A 31-year-old man presented with acute onset of paraplegia. The patient's history was significant for thyroid carcinoma that had been treated 2 years earlier by thyroidectomy. A magnetic resonance imaging scan showed an enhancing intramedullary lesion at T7-8. Patient underwent surgical treatment and a tumor with hematoma was resected via posterior midline myelotomy. Postoperatively, the patient's motor weakness was improved to grade 3. The lesion showed typical histologic features consistent with papillary thyroid carcinoma. Early diagnosis and microsurgical resection can result in improvement in neurological deficits and quality of life of patients with an ISCM.

Priamry Pulmonary Meningioma -A Case Reprot- (폐의 원발성 수막종 -1예보고-)

  • 장운하
    • Journal of Chest Surgery
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    • v.33 no.2
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    • pp.199-202
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    • 2000
  • Primary pulmonary meningioma is an extremely rare disease. It is mostly benign and asymptomatic. This tumor shows the same cytohigstologic appearance as brain or spinal cord meninioma. It can be diagnosed as a primary pulmonary meningioma only if there is no evidence of metastasis from the brain or spinal cord meningioma. We experienced a case of primary pulmonary meningioma in a 60-year-old woman who had asymptomatic 2 cm-sized solitary pulmonary tumor in the right lower lobe. It is rather peripherally located. Fine needle aspiration cytology has suggested the possibility of either well-differentiated epithelial malignancy such as papillary adenocarcinoma or mucoepidermoid carcinoma or metastatic carcinoma such as from ductal carcinoma of the breast. Right lower lobectomy was performed. The tumor was bilobated and soild with yellowish color. pathologically it proved to be a primary pulmonary and solid with yellowish color. Pathologically it proved to be a primary pulmonary meningioma because there was no evidance of brain or spinal cord tumor. To the best of our knowledge this is the first case reported in Korea. We report this case with review of the literature.

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Spinal Metastases from Supratentorial Glioblastoma

  • Han, Seong-Rok;Yee, Gi-Taek;Lee, Dong-Jun;Whang, Choong-Jin
    • Journal of Korean Neurosurgical Society
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    • v.38 no.6
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    • pp.475-477
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    • 2005
  • The tendency of glioblastoma multiforme[GBM] to metastasize to the cerebrospinal fluidis well documented. However, symptomatic intradural extramedullary metastasis of GBM in the spinal cord are rarely reported. A 31-year-old female with a previously treated supratentorial GBM presented with back pain and lower extremities weakness. Magnetic resonance imaging of the thoracic spine demonstrated an intradural extramedullary mass at levels of T2-T4 and arachnoid membrane enhancement. The patient underwent an operation. Pathologic diagnosis was confirmed as spinal metastases of GBM. We present a case of spinal metastases from supratentorial GBM presented with paraparesis.

Computed Tomography and Magnetic Resonance Imaging Features of Spinal Chondrosarcoma in a Cat

  • Minhee Lee;Sang-Kwon Lee;Juyoung Shin;Seulgi Bae;Kija Lee
    • Journal of Veterinary Clinics
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    • v.41 no.2
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    • pp.133-138
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    • 2024
  • An 8-year-old, spayed female Persian cat weighing 3.6 kg presented with a lumbosacral mass and bilateral weight bearing hindlimb lameness. Computed tomography (CT) and magnetic resonance imaging (MRI) revealed a dumbbell-shaped heterogeneous mass extending through the internal surface of the ileum and surrounding the lumbosacral junction. CT also revealed extensive osteoproliferation and bone lysis of the sacrum, but no evidence of any pulmonary metastasis. Furthermore, MRI revealed a focal area in the spinal cord showing connection with the adjacent tumor, suggesting tumor invasion into the spinal cord. Low-grade myxoid chondrosarcoma was histopathologically diagnosed. This is the first report describing CT and MRI findings of spinal cord chondrosarcoma in veterinary medicine. This study suggests that combining CT with MRI is a more sensitive tool for evaluating spinal tumors than using CT or MRI alone.

Intramedullary Spinal Cord Metastasis : A Report of Two Cases and a Review of the Literature (척수내 전이암 - 2례 보고 및 문헌고찰 -)

  • Oh, Yoon-Kyeong;Park, Hee-Chul
    • Radiation Oncology Journal
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    • v.19 no.4
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    • pp.353-358
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    • 2001
  • Intramedullary spinal cord metastases (ISCM) account for only $3.4\%$ of symptomatic metastases to the spinal cord. The survival of patients with ISCM is characteristically short, often no longer than 2 months, due to a rapid neurologic deterioration and the presence of widespread metastases, Including metastases to the brain. We report two cases of ISCM arising from primary sphenoid sinus carcinoma and primary lung cancer along with a review of the literature. The case of ISCM from the primary sphenoid sinus is the third case of secondary syringomyelia due to ISCM In the world literature, and ISCM from the primary lung cancer is the first case reported in Korea. One case showed a slow progression of symptoms and a longer survival (26 months after the radiotherapy to the spine), and the other showed a rapid deterioration of symptoms with a shorter survival. More effective palliation can be achieved if the disease is diagnosed at an early stage when the neurologic deficits are still reversible.

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Paraplegia Caused by Vertebral Metastasis during Pain Control in Cervical Cancer Patient -A case report- (자궁경부암 환자의 통증치료중 척추전이에 의한 하반신 마비 -증례 보고-)

  • Kim, In-Jung;Chun, Bum-Soo;Kyeon, Il-Soo;Lee, Jung-Koo
    • The Korean Journal of Pain
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    • v.10 no.2
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    • pp.304-307
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    • 1997
  • Continuous epidural infusion, a combination of local anesthetic and opioid, have been widely administered for treatment of chronic cancer pain. A serious complications of epidural block is paraplegia which can also be caused by : direct spinal cord injury, epidural hematoma, epidural abscess, ischemic change, neurotoxicity, preexisting disease. Continuous epidural block for pain control of patient with cervical cancer was performed at $T_{12}/L_1$ interspace. A 4 cm catheter was inserted cephalad into the epidural space. After four months, back pain and motor weariless of lower extremities progressively developed. Spine CT showed bony destruction and soft mass-like lesion at $T_9$ & $T_{12}$ spine. We propose paraplegia was caused by spinal cord compression which resulted from vertebral metastasis of cervical cancer.

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Intercostal Neuralgia and Spinal Cord Compression Symptom due to Spinal Tumor -A Case Report- (척추 종양에 의한 늑간 신경통 및 척수 압박 증상 -증례 보고-)

  • Lee, Hyo-Keun;Shin, Dong-Yeop;Lee, Hee-Jeon;Kim, Chan
    • The Korean Journal of Pain
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    • v.7 no.2
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    • pp.287-291
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    • 1994
  • A 49 years old male patient was admitted to our neuro-pain clinic with symptoms of left 11th intercostal neuralgic pain and low back pain that developed 2 months prior to admission. Upon initial physical examination, motor weakness or sensory deficit were absent. Intercostal neuralgic pain improved significantly after we performed thoracic root thermocoagulation. However on the afternoon of the procedure the patient started to experience voiding difficulty, saddle anesthesia and rapidly progressing motor weakness and hypoesthesia that involved the lower back area and the lower extremities for three days. Based on these symptoms spinal cord compression was suspected and subsequently plain T-L spine X-rays and T-L spine MRI were performed. A spinal tumor that appeared metastatic in origin was seen at the T11 and T12 level. Liver ultrasonography demonstrated the presence of a $4{\times}4cm$ sized ill defined mass in the posterior segment of the right lobe. The patient was diagnosed to have hepatocellular carcinoma after needle aspiration biopsy and cytologic studies. Further orthopedic surgery was recommended but as the patient rejected any further treatment and examination, it was not possible to confirm the primary focus of the tumor. However as metastasis of a primary liver tumor to the spine is a rare occurrence, some other primary focus of metastasis or even a malignant primary tumor of the spine is more likely to explain this patient's condition.

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A Case of Intramedullary Spinal Cord Metastasis From Non-small Cell Lung Cancer (비소세포 폐암의 척수수질내 전이 1예)

  • Park, Sang-Woo;Wi, Hyung-Soo;Kim, Hoon-Soo;Cho, Jae-Hwa;Lee, Hong-Lyeol;Loh, John-Kyu;Ryu, Jeong-Seon
    • Tuberculosis and Respiratory Diseases
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    • v.52 no.6
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    • pp.627-632
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    • 2002
  • Intramedullary spinal cord metastasis (ISCM) has rarely been reported in patients with carcinomas. In about half the ISCM reported the primary origins are lung cancer, with small cell lung cancer responsible for almost all reported cases. Thus, ISCM from small cell lung cancer is relatively well documented, but ISCM from non-small cell lung cancer is rarely diagnosed prior to the patients' demise, so very little data about such patients is available. Spine MRI is the most sensitive technique for diagnosing ISCM. ISCM are now being encountered with increasing frequency due to the increasing survival rates of lung cancer patients, and the development of new imaging technique. We reported a case of an ISCM from non-small cell lung cancer with a brief review of the literature.

The Role of Stereotactic Radiosurgery in Metastasis to the Spine

  • Sohn, Se-Il;Chung, Chun-Kee
    • Journal of Korean Neurosurgical Society
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    • v.51 no.1
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    • pp.1-7
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    • 2012
  • Objective : The incidence and prevalence of spinal metastases are increasing, and although the role of radiation therapy in the treatment of metastatic tumors of the spine has been well established, the same cannot be said about the role of stereotactic radiosurgery. Herein, the authors present a systematic review regarding the value of spinal stereotactic radiosurgery in the management of spinal metastasis. Methods : A systematic literature search for stereotactic radiosurgery of spinal metastases was undertaken. Grades of Recommendation, Assessment, Development, and Education (GRADE) working group criteria was used to evaluate the qualities of study datasets. Results : Thirty-one studies met the study inclusion criteria. Twenty-three studies were of low quality, and 8 were of very low quality according to the GRADE criteria. Stereotactic radiosurgery was reported to be highly effective in reducing pain, regardless of prior treatment. The overall local control rate was approximately 90%. Additional asymptomatic lesions may be treated by stereotactic radiosurgery to avoid further irradiation of neural elements and further bone-marrow suppression. Stereotactic radiosurgery may be preferred in previously irradiated patients when considering the radiation tolerance of the spinal cord. Furthermore, residual tumors after surgery can be safely treated by stereotactic radiosurgery, which decreases the likelihood of repeat surgery and accompanying surgical morbidities. Encompassing one vertebral body above and below the involved vertebrae is unnecessary. Complications associated with stereotactic radiosurgery are generally self-limited and mild. Conclusion : In the management of spinal metastasis, stereotactic radiosurgery appears to provide high rates of tumor control, regardless of histologic diagnosis, and can be used in previously irradiated patients. However, the quality of literature available on the subject is not sufficient.