• 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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• 제62권4호
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• pp.467-475
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• 2019

Objective : There is a lack of knowledge regarding whether decompression is necessary in treating patients with epidural spinal cord compression (ESCC) grade 2. The purpose of this study was to compare the outcomes of minimally invasive surgery (MIS) without decompression and conventional open surgery (palliative laminectomy) for patients with hepatocellular carcinoma (HCC) spinal metastasis of ESCC grade 2. Methods : Patients with HCC spinal metastasis requiring surgery were retrospectively reviewed. Patients with ESCC grade 2, medically intractable mechanical back pain, a Nurick grade better than 3, 3-6 months of life expectancy, Tomita score ${\geq}5$, and Spinal Instability Neoplastic Score ${\geq}7$ were included. Patients with neurological deficits, other systemic illnesses and less than 1 month of life expectancy were excluded. Thirty patients were included in the study, including 17 in the open surgery group (until 2008) and 13 in the MIS group (since 2009). Results : The MIS group had a significantly shorter operative time ($94.2{\pm}48.2minutes$ vs. $162.9{\pm}52.3minutes$, p=0.001), less blood loss ($140.0{\pm}182.9mL$ vs. $1534.4{\pm}1484.2mL$, p=0.002), and less post-operative intensive care unit transfer (one patient vs. eight patients, p=0.042) than the open surgery group. The visual analogue scale for back pain at 3 months post-operation was significantly improved in the MIS group than in the open surgery group ($3.0{\pm}1.2$ vs. $4.3{\pm}1.2$, p=0.042). The MIS group had longer ambulation time ($183{\pm}33days$ vs. $166{\pm}36days$) and survival time ($216{\pm}38days$ vs. $204{\pm}43days$) than the open surgery group without significant difference (p=0.814 and 0.959, respectively). Conclusion : MIS without decompression would be a good choice for patients with HCC spinal metastasis of ESCC grade 2, especially those with limited prognosis, mechanical instability and no neurologic deficit.

• Journal of Chest Surgery
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• 제27권6호
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• pp.502-505
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• 1994

Neurogenic tumors of the mediastinum may have an intraspinal component connected by a narrowed segment of tumor in the intervertebral foramen,hence the descriptive term dumbbell.Recently we had an occasion to remove a dumbbell neurilemmoma in a 62 years old woman using an approach designed to allow wide posterolateral thoracotomy and concomitant laminectomy for a single stage removal of the entire tumor. The mass in the posterior mediastinum was discovered on routine chest roentgenography. CT scan demonstrated a dumbbell shaped soft tissue mass density compressing spinal canal but preserving spinal cord. There were no neurologic signs. A standard posterolateral thoracotomy incision was made to remove tumor mass and then T5 unilateral laminectomy has done by Neurosurgeon. 7 x 7 cm sized extrapleural neurilemmoma was round, cystic, soft mass which covered parietal pleural with invaded regional vertebrae. There was no postoperative neurological complication.

• 대한근전도전기진단의학회지
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• 제20권2호
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• pp.98-105
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• 2018

Objective: To evaluate whether the increase of the amplitude of motor evoked potentials (MEPs) during surgery can imply favorable prognosis postoperatively in spinal cord tumor surgery. Method: MEPs were monitored in patients who underwent spinal cord tumor surgery between March 2016 and March 2018. Amplitude changes at the end of monitoring compared to the baselines in limb muscle were analyzed. Minimum and maximum changes were set to $MEP_{min}$ (%) and $MEP_{max}$ (%). Strengths of bilateral 10 key muscles which were documented a day before ($Motor_{pre}$), 48 h ($Motor_{48h}$) and 4 weeks ($Motor_{4wk}$) after the surgery were reviewed. Results: Difference of $Motor_{48h}$ from $Motor_{pre}$ ($Motor_{48h-pre}$) and $Motor_{4wk}$ from $Motor_{pre}$ ($Motor_{4wk-pre}$) positively correlated with $MEP_{min}$, suggesting that smaller the difference of MEPs amplitude, less recovery of muscle strength. There was a negative correlation between the amount of bleeding and $MEP_{min}$, indicating that the greater the amount of bleeding, the smaller the $MEP_{min}$, implying that MEPs amplitude is less likely to improve when the amount of bleeding is large. It also showed significant difference between patients with improved or no change of motor status and patients with motor deterioration after surgery according to anatomical tumor types. Conclusion: Improve of muscle strength was less when the increase of MEPs amplitude was small, and improvement of MEPs amplitude was less when the amount of bleeding was large. Correlation between changes of status of muscle strength after surgery and tumor types was observed. With amplitude increase in MEPs monitoring, restoration of muscle strength can be expected.

• Journal of Korean Neurosurgical Society
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• 제45권5호
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• pp.312-314
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• 2009

Brown-Sequard syndrome may be the result of penetrating injury to the spine, but many other etiologies have been described. This syndrome is most commonly seen with spinal trauma and extramedullary spinal neoplasm. A herniated cervical disc has been rarely reported as a cause of this syndrome. We present a case of a 28-year-old male patient diagnosed as large C3-C4 disc herniation with spinal cord compression. He presented with left hemiparesis and diminished sensation to pain and temperature in the right side below the C4 dermatome. Microdiscectomy and anterior cervical fusion with carbon fiber cage containing a core of granulated coralline hydroxyapatite was performed. After the surgery, rapid improvement of the neurologic deficits was noticed. We present a case of cervical disc herniation producing acute Brown-Sequard syndrome with review of pertinent literature.

• 한국수의병리학회:학술대회논문집
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• 한국수의병리학회 2003년도 추계학술대회초록집
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• pp.8-8
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• 2003

Schwannoma is a neoplasm of the Schwann cells of the neural sheath [1]. Malignant schwannoma is most commonly seen in the subcutis of the flank or neck area near the salivary glands [2]. It also occurs in the thoracic and abdominal cavities, spinal cord, cranial cavity, the heart, etc. Here, we incidentally found a good case of malignant schwannoma in the subcutis of the lumbar and lumbosacral region in male F344 rat during the carcinogenicity study with diisodecyl phthalate (DIDP). Therefore, we tried to report this case as a good reference of malignant schwannoma. (omitted)

• 한국임상수의학회지
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• 제31권5호
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• pp.439-444
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• 2014

체중 2.7 kg의 5세령 암컷 말티즈 견이 양측 슬개골 탈구와 후지 파행으로 지역동물병원에 내원하였다. 도르레절제술과 슬개골의 외측 보강 봉합법을 이용하여 슬개골 탈구 정복술을 실시하였으나, 수술 3주 후 등을 굽힌 자세의 보행과 후지의 운동실조, 흉요추부의 압통, 간헐적인 경련증상으로 재 내원하였다. 자기공명영상 촬영 결과, 우측 전두엽의 종괴와 경수에서부터 3번 요수까지의 공동성 변화가 확인되었다. 병리조직학적 소견으로 뇌종양은 느슨한 망상구조 또는 레이스 모양의 수막세포들로 구성되었으며, 세포 외부에 다양한 크기와 형태의 많은 낭포성 공간이 관찰되었다. 면역조직화학염색 결과 종양세포들은 vimentin 양성, 신경원 특이 에놀라제 및 신경교 섬유질 산성 단백질에는 음성을 나타내었다. 경수와 흉수 부위에는 부정형의 확장된 중심관 유사 동공이 관찰되었다. 이 증례는 개에서 특이적인 두개강 내 소낭성 뇌수막종과 연관되어 2차적으로 발생한 척수공동증의 임상소견과 영상학적 및 병리조직학적 특징을 보여주고 있다.

• 척추신경추나의학회지
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• 제4권1호
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• pp.95-102
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• 2009

Objectives : We studied in order to compare the differences between the symptoms of patients and findings of MRI and X-Ray of patients with herniated disc which has been diagnosed often recently. Methods : We randomly selected among the 301 patients with X-Ray and L-spine MRI films who have visited Jaseng Hospital with low-back pain and lumbar and low extremity pain from Jan.1st of 2009 to Jan.28. We used SPSS 13.0 for Windows I in analyzing statistical data of study results and the level of significance were below 0.05. Results and Conclusions : 1. If there were radiating pain, based on MRI findings, the amount of herniation was more severe(P>0.05). 2. If the finding of a X-ray showed narrowing, based on MRI findings, the amount of herniation was more severe(P>0.05). 3. There were no significant differences between the presence of radiating pain and the findings of X-Ray(P>0.05). 4. Among the 301 cases, cases which showed findings beside HIVD were 79. 7 cases of hemanggioma(2.3%), 24 cases of spinal neoplasm(cord cyst, tumor etc)(8%), 7 cases of spondylitis(2.3%), 16 cases of spinal canal stenosis(5,3%) 9 cases of ligamentum flavum thickening(3%) and 16 cases of facet syndrome(5.3%).

• Asian Pacific Journal of Cancer Prevention
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• 제14권6호
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• pp.3979-3985
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• 2013

Background: Although primary malignant CNS tumors are registered in the national cancer registry (NCR) of Iran, there are no available data on the incidence of the primary malignant or benign CNS tumors and their common histopathologies in the country. This study analyzed the 10-year data of the Iranian NCR from March 21, 2000 to March 20, 2010, including a systematic review. Materials and Methods: The international and national scientific databases were searched using the search keywords CNS, tumor, malignancy, brain, spine, neoplasm and Iran. Results: Of the 1,086 primary results, 9 papers were selected and reviewed, along with analysis of 10-year NCR data. The results showed that primary malignant brain tumors have an overall incidence of 2.74 per 100,000 person-years. The analysis of the papers revealed a benign to malignant ratio of 1.07. The most common histopathologies are meningioma, astrocytoma, glioblastoma and ependymoma. These tumors are more common in men (M/F=1.48). Primary malignant spinal cord tumors constitute 7.1% of the primary malignant CNS tumors with incidence of 0.21/100,000. Conclusions: This study shows that CNS tumors in Iran are in compliance with the pattern of CNS tumors in developing countries. The NCR must include benign lesions to understand the definitive epidemiology of primary CNS tumors in Iran.

• Tuberculosis and Respiratory Diseases
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• 제75권4호
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• pp.165-169
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• 2013

An inflammatory myofibroblastic tumor (IMT) is a rare disease entity reported to arise in various organs. It is thought to be a neoplastic or reactive inflammatory condition, controversially. The treatment of choice for myofibroblastic tumor is surgery, and recurrence is known to be rare. The optimal treatment method is not well-known for patients ineligible for surgery. We report a 47-year-old patient with aggressive recurrent IMT of the lungs. The patient had been admitted for an evaluation of back-pain two years after a complete resection of pulmonary IMT. Radiation therapy was performed for multiple bone recurrences, and the symptoms were improved. However the patient presented again with aggravated back-pain six months later. High-dose steroid and non-steroidal anti-inflammatory drugs were administered, but the disease progressed aggressively, resulting in spinal cord compression and metastasis to intra-abdominal organs. This is a very rare case of aggressively recurrent pulmonary IMT with multi-organ metastasis.