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Query: UMLS:C0027651 (tumor)
 685,946 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A series of 18 patients with odontoid fractures due to metastatic cancer were treated at Memorial Sloan-Kettering Cancer Center between 1974--1980. The primary source of cancer was breast (12 cases), lung (two cases), nasopharynx (one case), multiple myeloma (one case), colon (one case), and rhabdomyosarcoma (one case). The clinical features consisted of severe neck pain and neck stiffness in 17 patients; signs of cord compression were noted in only four patients. Tomography and computerized tomography were useful in identifying both the osseous and soft-tissue involvement by tumor. Initial treatment in all patients except those with myelopathy consisted of high-dose steroids, and immobilization in a hard collar. Ten patients were treated with radiation therapy alone; six patients underwent surgical fusion (four before and two after radiation therapy); and two patients died before completion of treatment. Conservatively treated patients were allowed to walk with the support of only a collar following radiation therapy. We believe that the initial management of patients with odontoid fractures secondary to cancer should be high-dose steroids and radiation therapy, unless displacement is marked. Assessment for surgical fusion should be made following radiation therapy, since conservative treatment may suffice in most patients. Early recognition is important so that treatment can be instituted before C1--2 subluxation becomes severe.
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PMID:Treatment of odontoid fractures in cancer patients. 745 32

From 1985 through 1990, 19 patients with tumorous conditions of the cervical spine and the first two thoracic vertebrae were treated with anterior, posterior, or combined anterior/posterior surgical techniques. Breast metastases were by far the most common condition (42%). Patients usually experienced severe pain, which resisted conservative treatment, sometimes associated with radiculopathies (42%) or neurological deficits (31%). To date, the treatment of spinal tumors is only palliative, and surgery must be considered for cases with unremitting neck pain, major vertebral destruction with loss, or impending loss of cervical spine stability and neurological deficits due to local tumor compression. Contrary to the commonly used posterior wiring stabilizations, we preferred stabilization techniques more closed to those used in traumatology. Our findings suggest anterior surgery alone with vertebrectomy and stabilization with plate and bone cement for tumors involving only one vertebra and localized between C3 and T1. Posterior approach and stabilization is advocated for atlantoaxial lesions. A combined anterior and posterior technique should be reserved for extended tumoral conditions where an anterior fixation does not offer enough stability or where more radical surgery is required. In the present series, immediate good spinal stabilization and neck pain relief was obtained in every case, allowing early mobilization. Improvement of the neurologic deficit was noted in 65% of our patients.
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PMID:Surgical treatment of tumors of the cervical spine and first two thoracic vertebrae. 751 May 49

A 42-year-old male presented with a rare extracranial meningioma manifesting as right facial swelling, facial nerve paresis, and hearing disturbance. Neurological imaging revealed a primarily extra-axial tumor extending from the temporal base to the subcutaneous space in the parietal region, and partially into the intra-axial region of the temporal lobe through the dura mater, with a small intracerebral hematoma and a small mass in the porus acusticus destroying the temporal bone, the floor of the middle fossa, zygomatic arch, and porus acusticus. Malignant meningioma was confirmed by histological examination after subtotal tumor removal via the transzygomatic approach. Subdural fluid accumulation like hematoma occurred 5 days after surgery and malignant cells were found in the fluid drained by skull trephination. Subsequently, radiation therapy with a total dose of 60 Gy was administered. One year later, he complained of head and neck pain with motor and sensory disturbances in the right upper extremity, and then developed tetraparesis. Cervical x-ray films demonstrated a compression fracture of the C3 vertebral bone and radiolucent areas at C2-4 levels, while computed tomography showed the tumor invading the subcutaneous space and compressing the spinal cord. He died of respiratory distress. Autopsy revealed that the tumor originated in the temporal region and had directly extended to the cervical region.
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PMID:Extradural temporal meningioma directly extended to cervical bone--case report. 769 24

Nasopharyngeal carcinoma is a tumor that is uncommon in children and adolescents. Presenting symptoms may be subtle and may include epistaxis, neck pain, hearing impairment, otorrhea, rhinorrhea, and, most likely, painless cervical adenopathy. The tumor is curable, but late diagnosis makes this possibility much less likely. Diagnosis of this tumor requires a high index of suspicion on the part of clinicians treating the pediatric population.
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PMID:Nasopharyngeal carcinoma: early warning signs and symptoms. 784 56

Between 1974 and 1991, hearing preservation surgery was attempted on 161 of 476 patients with a variety of cerebellopontine (CPA) tumors, at New York University School of Medicine. This included 146 unilateral acoustic neuromas, seven meningiomas, and six cases of neurofibromatosis. The suboccipital/retrosigmoid approach was used almost exclusively. The cochlear nerve was anatomically preserved in 131 cases, 32 percent of whom had successful hearing preservation. In the most successful group, hearing was preserved in 9 of 12 patients (75%). Success was defined as a postoperative pure-tone average (PTA) or speech reception threshold (SRT) of no more than 50 dB, and a speech discrimination score (SDS) of at least 50 percent. In those patients whose preoperative hearing was worse that this, success was based on a loss of no more than 10 dB in PTA or SRT, and 10 percent in SDS. Success was dependent mostly on extracanalicular (EC) tumor size, with the smallest tumors yielding the best results. When controlled for EC size, intracanalicular size and preoperative hearing were statistically significant variables. Origin from the superior vestibular nerve was also a favorable prognostic indicator. The character and duration of hearing loss, the patient's age, and the histology of the tumor did not have prognostic value. Auditory monitoring with either auditory brainstem response (ABR) or direct eighth nerve electrodes did not have a significant impact on success. Complications were somewhat increased by attempted hearing preservation. Facial nerve function was type I or II in 93 percent of patients. Cerebrospinal fluid leaks occurred in 15 percent of cases, but only 4 percent required surgical repair. There was one death, a patient with a 2.5-cm tumor. Early in the series, when a classic long vertical nuchal incision was used, headache and neck pain were common.
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PMID:Hearing preservation in cerebellopontine angle tumor surgery: the NYU experience 1974-1991. 812 2

Between 1987 and 1991, 20 patients with symptomatic postlaminectomy kyphosis were treated with anterior decompression, bone graft, and anterior cervical plate. The patients were predominantly male (14:6) with a mean age of 58 years. The initial laminectomy was performed for either spondylosis (80%) or spinal tumor (20%). All patients had anterior compressive pathology, which was associated with instability (45%), neck pain (75%), myeloradiculopathy (90%), or severe neck deformity (30%). The mean degree of kyphosis was 38 degrees. Treatment consisted of a trial of cervical traction (75%), anterior corpectomy (95%), intersegmental decompression (5%), bone fusion (100%), and fixation with either Caspar (85%) or Synthes (15%) anterior plating at a mean of 3.8 levels. Halo fixation was used in 10% of patients. Postoperative complications included vocal cord paresis (15%), pneumonia (10%), wound dehiscence (5%), and screw pull-out (5%). At follow-up evaluation, a mean of 28 months after treatment, all patients had a solid fusion and a mean curvature improvement to 16 degrees residual kyphosis. Neurologically, 10% were cured, 55% were improved and returned to premorbid function, 30% were stable, and 5% had late progression. These data suggest that immediate fixation with anterior plating facilitates solid fusion, maintains spinal curvature, and promotes neurological improvement.
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PMID:Cervical corpectomy and plate fixation for postlaminectomy kyphosis. 818 76

Postlaminectomy kyphosis is rarely encountered as a sequela of decompression of the upper cervical spine, especially in adults. We present a case of disabling cervical kyphosis which developed after laminectomy for excision of a foramen magnum tumor and was treated successfully by occipito-vertebral fusion. A sixty-one-year old female was treated by laminectomy of the first through to the third cervical spine for a foramen magnum meningioma. One year later, the laminectomy was extended downward to include the fourth through to the seventh cervical spine because of neurological deterioration. Seven years after the first laminectomy, she was referred to our spinal service because of severe neck pain, numbness and muscle weakness of both upper extremities. Lateral X-ray of her cervical spine presented a severe kyphosis. Roentgenogram two months after the first laminectomy already showed slight deformity and, timewise, it corresponded with the time when the patient experienced neurological deterioration. Subsequent X-rays showed progression of kyphosis. After we confirmed a lessening of the pain and improvement of the neurological symptoms during an axial traction using a halo-vest, posterior occipito-cervico-thoracic fusion was performed using Luque segmental spinal instrumentation and autogenous bone graft. After surgery the pain decreased and neurological symptoms improved. It is important to be aware of the complication of kyphotic deformity after laminectomy and once it has developed, it is recommended to stabilize the progression by early spinal fusion.
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PMID:[Postlaminectomy kyphosis of the cervical spine complicating spinal cord tumor in the foramen magnum]. 819 37

Benign spinal neoplasm (b.s.n.) represented 11% (8 cases) of all histopathologically verified spinal neoplasm in 85 patients operated on between 1975 and 1990. Local back or neck pain were first clinical symptoms of b.s.n. On admission all the patients presented with bone lesions on X-ray plain radiograms of the spine. Surgical management included removal of the tumour and stabilization using bone grafts. Excellent results (complete pain relief and improvement of motor function making the patients ambulatory and independent) were obtained in all the cases. All the patients presented with solid fusion of bone grafts and good spinal stability at the last follow-up.
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PMID:[Benign spinal neoplasms: results of treatment and clinical aspects]. 824 40

A 19-year-old girl was admitted with a history of difficulty in moving her neck for several years and a sudden onset of neck pain three months before. Plain radiographs of the cervical spine revealed destruction of the left half of the 6th cervical body with an expansive soap-bubble appearance. Neurological examination on admission was within normal limits. The angiography and bone scintigraphy revealed no abnormality. MRI of T1-weighted image showed a cystic lesion with various signal intensities. T2-weighted image demonstrated a hyperintense balloon-like lesion in the vertebral body and left lamina. At surgery, a cystic tumor was fully extirpated by the posterior approach and the bony defect was packed with apatite granules. She was discharged without any neurological deficits. This disease should be considered as one of the etiologies when a patient with difficulty in neck movement is encountered in young generation.
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PMID:[Aneurysmal bone cyst of the sixth cervical spine: case report]. 825 81

We described two patients of thyroid cancer with tracheal invasion. A 54-aged female visited our hospital with complaint of the neck pain. Echography showed a tumor in the right lobe of the thyroid. In operation the thyroid tumor invaded the trachea and right recurrent nerve. A 24-aged male visited our hospital with complaint of a mass of the left side neck. Echography showed a tumor in the left lobe of the thyroid. In operation the thyroid tumor invaded the trachea, lymph node and left recurrent nerve. In these two cases we could find thyroid tumors invaded into the trachea by echography. We re-evaluated the utility of echography.
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PMID:[Two cases of thyroid cancer resected with trachea]. 830 71


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