• Asian Pacific Journal of Cancer Prevention
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• 제16권3호
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• pp.1047-1049
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• 2015

Background: This systematic analysis was conducted to investigate pathological diagnosis of vertebral tumor metastasis with unknown primaries. Methods: Clinical studies conducted to pathologically investigate vertebral tumor metastasis were identified using a predefined search strategy. Pooled diagnosis (PD) of each pathological confirmation was calculated. Results: For vertebral tumor metastasis, 5 clinical studies which included 762 patients were considered eligible for inclusion. Systematic analysis suggested that, for all patients with vertebral tumor metastasis, dominant PD was pathologically confirmed with lung cancer in 21.7% (165/762), with breast cancer in 26.6% (203/762) and with prostate cancer in 19.2% (146/762). Other diagnosis that could be confirmed included lymphoma, multiple myeloma, renal cancer, for example, in this cohort of patients. Conclusions: This systemic analysis suggested that breast, lung and prostate lesions could be the most common pathological types of cancer for vertebral tumor metastasis formunknown primaries, and other common diagnoses could include lymphoma, multiple myeloma, renal cancer.

• Journal of Korean Neurosurgical Society
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• 제42권1호
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• pp.46-48
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• 2007

Distant metastasis of squamous cell carcinoma from the anal canal is an uncommon event. However, hematogenous spread to the vertebrae may occur in the course of this disease. The route of metastasis from the anal canal seems to be Batson's vertebral venous system. A 52-year-old female patient presented with lower back and right leg pain of one-week history. She has undergone radiotherapy and chemotherapy for squamous cell carcinoma of the anal canal and then was followed by surgical resection. Three months later, magnetic resonance images of the lumbar spine disclosed a well-enhanced mass of L5 vertebral body compressing the thecal sac. Surgical decompression and biopsy were performed. Histopathological study confirmed carcinoma of the squamous cell origin. We report a ra re case of vertebral metastasis from squamous cell carcinoma of the anal canal with a pertinent review of literature.

• Journal of Yeungnam Medical Science
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• 제15권2호
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• pp.254-262
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• 1998

골수의 손상정도률 민감하게 반영하는 Tc-99m 표지 항과립구항체 면역신티그라피를 이용하여 척추압박골절의 원인을 감별할 수 있는지를 알아보기 위하여, 척추압박골절 환자중에서 병리조직학적(수술 혹은 생검) 혹은 3개월 이상의 임상경과를 추적 관찰하여 원인이 밝혀진 16명의 환자를 대상으로 Tc-99m 표지 항과립구항체 면역신티그라피의 결과를 분석하였다. 16명의 환자중 외상이나 골다공증에 의한 압박골절 부위가 16부위 (8명), 전이암에 의한 압박골절이 3부위 (3명), 결핵에 의한 압박골절이 6부위 (5명) 이었다. 외상이나 골다공증과 같은 양성원인에 의한 척추압박골절 16 부위 모두 척추뿌리, 추궁판, 가시돌기의 섭취는 정상이었고, 척추체는 섭취저하가 7례, 섭취결손이 8례, 섭취정상이 2례에서 관찰되었다. 결핵에 의한 압박골절 6례에서 척추체의 섭취결손이 6례 모두, 척추뿌리의 섭취결손이 5례에서 관찰되었고, 가시돌기와 추궁판의 섭취결손은 발견되지 않았다. 전이암에 의한 3례의 경우는 2례에서 척추체, 척추뿌리, 추궁판, 가시돌기의 섭취결손이 보였고, 1례에서는 척추체와 가시돌기에만 섭취결손이 관찰되었다. Tc-99m 표지 항과립구항체 면역신티그라피의 단층영상에서 섭취결손부위를 평가함으로서 양성원인과 병적원인에 의한 척추압박골절의 원인의 감별에 도움이 될 수 있을 것으로 사료된다.

• The Korean Journal of Pain
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• 제20권2호
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• pp.213-218
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• 2007

Percutaneous vertebroplasty and balloon kyphoplasty have been accepted as effective treatment modalities for vertebral compression fractures in patients with vertebral metastasis. However, when these procedures are conducted in patients with lytic lesions of the vertebral pedicle, polymethylmethacrylate leakage through the lytic lesions that occurs during percutaneous pediculoplasty can increase the procedural risks due to the immediate vicinity of neural structures. In spite of this risk, there are not many available reports on safer methods of pediculoplasty. Here we report a case of vertebral metastasis in which the pedicle infiltration of cancer was successfully treated by pediculoplasty using a bone filler device that contained thick bone cement during a balloon kyphoplasty procedure.

• Journal of Korean Neurosurgical Society
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• 제40권1호
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• pp.47-50
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• 2006

This 51-year-old man suffered from paraparesis of 1-week history. On preoperative images, spinal cord compression by infiltrative vertebral mass was shown at T3 and T4 level. Several months earlier, he underwent surgical resection of left 2nd to 4th ribs, due to painful growing chest wall mass, which was proved to be hepatocellular carcinoma. All available diagnostic procedure failed to uncover origin of malignancy. Operation was followed by adjuvant irradiation and chemotherapy to the vertebral mass, however he only to die in 3 months after operation. This is an extremely rare case of ectopic hepatocellular carcinoma at thoracic vertebrae which showed very aggressive clinical course. Possible pathogenic process is presented and discussed.

• Journal of Korean Neurosurgical Society
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• 제30권5호
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• pp.666-669
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• 2001

We report a case of meningeal hemangiopericytoma presenting as metastasis in the vertebral body and pedicle of the thoracic spine. Hemangiopericytoma is a rare vascular neoplasm. Although the tumor has a strong propensity for both local recurrence and extracranial metastasis, metastasis to thoracic spine is very rare and only two cases were found in the literature. A 44-year-old woman with paraparesis and pain in the thoracic and lower legs was examined by plain radiographs and magnetic resonance imaging. The intracranial hemangiopericytoma was operated 3 years ago. Magnetic resonance imaging demonstrated a tumor invading the left vertebral body and pedicle of the 11th thoracic spine, and compressing the dural sac. The patient was gradually improved after surgical removal of the lesions and the histologic findings were characteristics of hemangiopericytoma.

• The Korean Journal of Pain
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• 제21권3호
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• pp.197-201
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• 2008

Background: Kyphoplasty is a minimally invasive procedure that can stabilize osteoporotic and neoplastic vertebral fractures. We retrospectively evaluated the clinical outcomes of kyphoplasty for the treatment of vertebral compression fractures in cancer patients. Methods: We reviewed the clinical data of 27 cancer patients who were treated with kyphoplasty (55 vertebral bodies) between May 2003 and Feb 2008. The clinical parameters, using a visual analog 10 point scale (VAS) and the mobility scores, as well as consumption of analgesic, were evaluated preoperatively and at 1 week after kyphoplasty. Results: A total 55 cases of thoracic and lumbar kyphoplasties were performed without complications. The mean age of the patients was 66 years. All the patients experienced a significant improvement in their subjective pain and mobility immediately after the procedures. The pain scores (VAS), mobility scores and other functional evaluations using the Oswestry disability score and the SF-36 showed significant differences between the pre- and postoperational conditions. Conclusions: Kyphoplasty is an effective, minimally invasive procedure that can relieve the pain of patients with vertebral compression fractures and these fractures are the result of metastasis.

• Journal of Korean Neurosurgical Society
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• 제47권2호
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• pp.143-147
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• 2010

We report here on an uncommon case of metastatic choriocarcinoma to the lung, brain and lumbar spine. A 33-year-old woman was admitted to the pulmonary department with headache, dyspnea and hemoptysis. There was a history of cesarean section due to intrauterine fetal death at 37-weeks gestation and this occurred 2 weeks before admission to the pulmonary department. The radiological studies revealed a nodular lung mass with hypervascularity in the left upper lobe and also a brain parenchymal lesion in the parietal lobe with marginal bleeding and surrounding edema. She underwent embolization for the lung lesion, which was suspected to be an arteriovenous malformation according to the pulmonary arteriogram. Approximately 10 days after discharge from the pulmonary department, she was readmitted due to back pain and progressive paraparesis. The neuroradiological studies revealed a hypervascular tumor occupying the entire L3 vertebral body and pedicle, and the tumor extended to the epidural area. She underwent embolization of the hypervascular lesion of the lumbar spine, and after which injection of polymethylmethacrylate in the L3 vertebral body, total laminectomy of L3, subtotal removal of the epidural mass and screw fixation of L2 and L4 were performed. The result of biopsy was a choriocarcinoma.

• The Korean Journal of Pain
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• 제10권2호
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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.

• Journal of Korean Neurosurgical Society
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• 제51권3호
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• pp.141-143
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• 2012

The authors describe a case of choriocarcinoma that metastasized to the cerebral cortex, vertebral body, and intramedullary spinal cord. A 21-year-old woman presented with sudden headache, vomiting and a visual field defect. Brain computed tomography and magnetic resonance examinations revealed an intracranial hemorrhage in the left temporo-parietal lobe and two enhancing nodules in the left temporal and right frontal lobe. After several days, the size of the hemorrhage increased, and a new hemorrhage was identified in the right frontal lobe. The hematoma and enhancing mass in the left temporo-parietal lobe were surgically removed. Choriocarcinoma was diagnosed after histological examination. At 6 days after the operation, her consciousness had worsened and she was in a state of stupor. The size of the hematoma in the right frontal lobe was enlarged. We performed an emergency operation to remove the hematoma and enhancing mass. Her mental status recovered slowly. Two months thereafter, she complained of paraplegia with sensory loss below the nipples. Whole spine magnetic resonance imaging revealed a well-enhancing mass in the thoracic intramedullary spinal cord and L2 vertebral body. Despite chemotherapy and radiotherapy, the patient died 13 months after the diagnosis.