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

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

The authors report a rare case of a large cystic cervical neurinoma. A 45-year-old female was admitted to our clinic because of motor weakness of the right upper extremity, numbness of the right fingers and right posterior cervical pain. Metrizamide CT myelography demonstrated the outline of a low density mass. MRI showed a mass revealing low signal intensity on T1-weighted image, high signal intensity on T2-weighted image and marginal enhancement on contrast image with Gd-DTPA. The mass which was diagnosed as cystic tumor, was located in the intradural extramedullary space between C4 to C5 segments. After C4 through C5 laminectomy, the tumor was found to originate from the C5 anterior motor root. The tumor consisted mostly of a cystic part with a very thin solid compartment beneath the capsule. Postoperative course of the patient was uneventful. Although spinal neurinoma is one of the most common spinal tumors, an almost completely degenerated large cystic spinal neurinoma is extremely rare. MRI with Gd-DTPA was useful for the diagnosis of the cystic neurinoma by clearly enhancing the margin of the tumor.
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PMID:[A case of macrocystic cervical neurinoma diagnosed by MRI with Gd-DTPA]. 825 27

Magerl's technique of combining C1-C2 posterior screw fixation with a supplemental bone-wire fusion has been advocated for the management of atlanto-axial instability. Between October 1990 and August 1992, a modification of this technique was used in the treatment of 22 patients with this disorder. In the absence of spinal deformity or neoplastic disease, screw fixation and bony fusion were used alone without associated wiring, thus avoiding the risk of neural injury resulting from the sublaminar passage of wire and the retrodisplacement of ventral structures. Patient ages ranged from 30 months to 80 years; follow-up ranged from 5 to 27 months, with a mean of 14.9 months. The causes of the instabilities were as follows: eight cases of nonunion of Type II odontoid fracture, four cases of rheumatoid arthritis, three cases of tumor, two cases of ligamentous instability, two cases of pseudoarthrosis after bone-wire fusion, two cases of halo noncompliance, and one case of Os odontoideum. All 20 patients who underwent fusion were placed in a Philadelphia collar for 12 weeks. Nineteen of 20 (95%) patients achieved solid fusion. Twenty-one of 22 (95%) had significant reduction in preoperative pain. No patient developed myelopathy or bulbar findings. The one intraoperative complication was an inability to achieve secure screw purchase on one side that required unilateral screw placement with a Gallie fusion-using cable. Postoperative complications included one patient with a superficial wound infection that resolved after local debridement and antibiotics and suboccipital numbness in two patients. Progression of spinal deformity, screw pullout or breakage, and neurological or vascular complications did not occur.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Atlanto-axial stabilization with posterior transarticular screw fixation: technical description and report of 22 cases. 832 97

The patient was a 55-year-old man. He was well until eleven months earlier, when he noticed the onset of numbness in his right fingers. Over the next three months, the numbness spread up the right arm and involved the right leg, left arm and left leg in succession. Six months before admission, sensory impairment of the trunk appeared progressively. Mild diffuse muscle weakness occurred gradually. Swelling of the right lateral cervical lymph node was found just before admission. On neurological examination, sensory disturbance involving all modalities of sensation was recognized in the extremities and trunk. The sensory findings were asymmetric and predominant at the lower extremities and distal parts. A positive Romberg's sign and poor coordination was recognized. All the deep tendon reflexes were absent without pathological reflexes. Motor weakness, which was less severe than sensory findings, was present. There was no sphincter disturbance nor orthostatic hypotension. Routine laboratory findings were within normal limits. The protein level of cerebrospinal fluid was slightly increased. The electrophysiological studies and histological evaluation of the biopsied peroneal muscle and sural nerve showed degeneration and reduction of large myelinated fibers of sensory nerves with minimal motor nerve changes. Histological study also revealed the increase of regenerating fibers. Squamous cell carcinoma of epipharynx with metastasis of neck lymph nodes was found. Radiotherapy without chemotherapy resulted in a complete tumor remission and probably suppressed the progression of neurological disturbances. After two years from the onset, diffuse high intensity area was noted in the posterior spinal column on T2 weighted MRI.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[A case of carcinomatous neuropathy with degeneration of posterior spinal column on MRI]. 839 18

Multiple spinal meningiomas are relatively rare and account for from only 2 to 3.5% of all spinal meningiomas. Two cases of multiple meningiomas of the thoracic spinal cord were reported. Case 1. A 73-year-old woman was admitted with a 5 month history of progressive motor weakness and sensory disturbance in the legs bilaterally. Neurological findings on admission revealed paraparesis, hypesthesia and hypalgesia under the Th10 level, hyperreflexia of both legs, and urinary incontinence. Myelography and MRI revealed two intradural extramedullary lesions at the Th7 and Th10 level. Both tumors were removed completely. Histopathological examination showed psammomatous meningiomas. Case 2. A 52-year-old man was admitted with a 2 month history of progressive motor weakness and numbness of both legs. Neurological findings on admission revealed paraparesis, hypesthesia and hypalgesia under the Th10 level, hyperreflexia of both legs, and genitourinary incontinence. Lumbar myelography showed complete block at the Th9 level. MRI showed stenosis of the spinal canal at the Th8/9 level, and a deviation of the spinal cord. MRI with Gd-DTPA showed that the spinal cord was compressed by intradural extramedullary tumors. However, myelography and MRI could not detect the multiplicity of tumors. CT myelography demonstrated three separate tumors from the Th7 to the Th9. Three tumors were totally removed. Histopathologically, they were meningotheliomatous meningiomas. These cases were considered as being multiple meningiomas of the spine. Both patients showed no manifestations of von Recklinghausen's disease. The cause of the multiplicity in these cases was uncertain. Multiple spinal tumor is very difficult to diagnose because of unusual clinical symptoms.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Multiple meningiomas of thoracic spinal cord: report of two cases]. 842 95

The application of magnetic resonance imaging (MRI) scanning in the diagnosis of acoustic neuroma (AN) has increased the relative incidence of smaller tumors and has impacted on the typical clinical presentation of AN patients. The charts of 126 patients treated at the University of California, San Francisco for newly diagnosed AN from 1986 to 1990 were reviewed. Twenty-four percent of tumors fell into the smallest size category (< 1 cm); this was a substantial improvement over earlier series. However, 16% of tumors remained undiagnosed until they achieved large size (> 3 cm). The incidence of hearing loss, dysequilibrium, headache, facial numbness, and diplopia all increased with increasing tumor size, while the incidence of vertigo decreased. Diagnosticians should not overemphasize "typical" symptom complexes, as substantial variability in clinical manifestations exists. An improved awareness by clinicians of the variability of AN presentation will improve diagnostic efficiency and continue the trend toward earlier diagnosis of these lesions.
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PMID:The changing clinical presentation of acoustic tumors in the MRI era. 845 53

A 39-year-old woman who had been diagnosed as having von Recklinghausen's disease came to our hospital due to numbness of the right fingers. A chest roentgenogram indicated a mass in the right upper thoracic cavity and MRI showed this mass to be a dumbbell shaped tumor connected to the spinal canal. Because we could secured the extension and invasion of the tumor by MRI, we could remove the tumor by a one-stage operation.
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PMID:[A case of giant dumbbell tumor treated by one-stage operation]. 846 65

We reported a case of subacute sensory neuropathy. A 78-year-old woman was admitted to Kenwakai Hospital because of progressive numbness in her hands and feet. Four months before admission, numbness and tingling sensations appeared in her hands and feet, and subsequently she felt difficulty in skilled finger movement. On general examination, she was found to have a mass in the right lower abdomen. Neurological examination revealed marked loss of position sense and vibratory sense in the distal extremities, and mild reduction of sensation to pinprick and light touch in the distal extremities. Stretch reflexs were depressed in the upper limbs and absent in the lower limbs. Her gait was unsteady and Romberg's sign was positive. She showed no cranial nerve dysfunction, cerebellar ataxia, muscle weakness, and autonomic dysfunction. Blood examination revealed high TTT (11.3Kunkel U), high ZTT (16.4Kunkel U) titer. Tumor markers were normal except for CA125 (93 U/ml). The cerebrospinal fluid showed 48 mg/dl of protein, 10.6 mg/dl of IgG. and an almost normal cell count (5.3/mm3). Serum was tested by immunohistochemical staining. Only the cytoplasm of neurons in the dentate nucleus and brain stem was stained on a rat's brain. Sural nerve biopsy showed a severe loss of large myelinated fibers. An exploratory laparotomy revealed a peritoneal tumor, 5 cm in diameter, and it was removed. During the surgery, other than a few rice-sized nodules in the cul-de-sac, there was no evidence of tumor in bilateral ovaries. The tumor was proven to be a serous papillary adenocarcinoma with psammoma bodies resembling ovarian cancer.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[A case of subacute sensory neuropathy associated with extraovarian serous papillary adenocarcinoma of the peritoneum]. 852 39

The effects of relatively low dose gamma knife irradiation on acoustic schwannoma were evaluated. The signal intensity change and tumor shrinkage on magnetic resonance (MR) images, change in hearing, and complications in 28 patients (mean age 47.0 +/- 13.6 yrs) were studied. Three patients had bilateral tumors. Six were already deaf when treated. The maximum tumor diameter was 35 mm. The mean dose delivered to the tumor was 12.1 +/- 1.6 Gy at the periphery, and 25.2 +/- 4.3 Gy at the center. The mean follow-up time was 16 months and the longest 24 months. Lowering of the MR signal intensity in the tumor center appeared after 3 months at earliest but generally after 6 months. Signs of tumor shrinkage appeared within 12 months on average. Cyst in the tumor enlarged rapidly after treatment in two patients. The percentage of hearing preservation was 85% (17/20) at 3 months, 80% (16/20) at 6 months, 72% (13/18) at 9 months, 75% (12/16) at 12 months, 67% (8/12) at 15 months, 60% (6/10) at 18 months, and 50% (2/4) at 24 months. Subtle changes in hearing were detected by speech tone audiometry. Temporary facial numbness and weakness was seen in one patient each. No patient had lower cranial nerve paresis. Relatively low dose gamma knife radiosurgery is effective in suppressing growth of acoustic schwannoma with preservation of hearing.
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PMID:Gamma knife radiosurgery for acoustic schwannoma: early effects and preservation of hearing. 853 29

A 62-year-old male was admitted because of numbness and twitching of both hands. Hypocalcemia with positive Trousseau's sign was noted. Chest X-ray and computed tomography (CT) showed an anterior mediastinal mass. Skull X-ray and whole body bone scan could not rule out bony metastasis to the left parietal bone, causing an anterior mediastinal tumor with bony metastasis to be suspected initially. Median sternotomy and extended thymectomy were done, and Stage II thymoma with negative calcitonin staining was noted. However, hypocalcemia persisted after thymectomy and the results of pre-operative and post-operative intact-parathyroid hormone (intact-PTH) were less than the detection limit (<13.3 pg/ml). Tumor markers and gallium tumor scan were all negative. Brain CT disclosed calcification over the bilateral basal ganglia and bilateral dentate nuclei of the cerebellum; the supposed metastatic osteolytic lesions of parietal bone were considered to result from pacchionion arachnoid granulation tissues. The coexistence of late-onset idiopathic hypoparathyroidism and thymoma has not been reported before. Long-term replacement therapy with vitamin D and calcium was necessary for this case.
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PMID:Late-onset idiopathic hypoparathyroidism with thymoma: a case report. 863 30


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