European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society
-
Tenosynovial giant cell tumor of the diffuse type (TGCT-D) involving the spine is rare. Its differential diagnosis includes metastatic disease; however, there have been few reports of spinal TGCT-D mimicking spinal metastasis in patients with a history of malignancy. ⋯ TGCT-D can mimic metastasis in PET/CT and should be included in the differential diagnosis if a lytic lesion affecting the posterior elements of the vertebrae involves the facet joints. CT-guided biopsy is recommended for accurate diagnosis when an occult tumor, such as TGCT, is incidentally detected on PET-CT, even in patients with a history of malignant neoplasm. Frozen recapping laminoplasty is useful for complete resection of a spinal tumor, preventing local recurrence, and preservation of the posterior spinal elements.
-
Review Case Reports
Remarkable efficacy of temozolomide for relapsed spinal myxopapillary ependymoma with multiple recurrence and cerebrospinal dissemination: a case report and literature review.
Myxopapillary ependymomas are intradural tumors which grow from the terminal filum of the spinal cord. Although they are classified as WHO grade I, they sometimes cause cerebrospinal fluid dissemination or local recurrence. In this report, we describe a case in that temozolomide (TMZ) showed remarkable efficacy on a recurrent spinal myxopapillary ependymoma. ⋯ TMZ is usually used in the treatment of glioblastoma and, recently, it has been reported to be effective for the lower grade spinal gliomas including spinal intramedullary ependymomas. However, for myxopapillary ependymomas, there has been no report that TMZ is effective. According to our results, TMZ could be one of the possible candidates for adjuvant therapy in multiple recurrent myxopapillary ependymomas.
-
Review Case Reports
Cervicothoracic spine duplication: a 10-year follow up of a neurological intact boy.
Spine duplication is a very rare condition with the literature being composed of only case reports. All previously reported cases were thoracolumbar spine duplications. Here, we report cervicothoracic spine duplication in a neurological intact male. According to our knowledge, it is the first case in the literature of cervicothoracic spine duplication. ⋯ In the literature, spine duplication has been classified as a severe form of split cord malformation because of the concurrence of bone duplication with split spinal cord malformation (SCM). This case presents a distinct form of SCM which shows non-duplicated dural tube as unclassified and cervicothoracic duplication level without neurological deficitis. Treatment of SCM was based on removal of splitting fibrous/osseous process. Neurologic intact spine duplication could be followed up without surgical intervention.
-
Arteriovenous fistula (AVF) of the cauda equina (CE) fed by the proximal radicular artery (PRA) is very rare, and the differentiation from that of the filum terminale (FT) is important to avoid treatment-related injury to the CE when endovascular treatment is selected. The authors describe a case of AVF of the CE fed by the PRA, demonstrate the anatomical features and discuss the treatment precautions. ⋯ The authors described a case of AVF of the CE fed by the PRA and demonstrated the difficulty of the differentiation from that of the FT. The utmost precautions are necessary when endovascular treatment is selected.
-
Paget's disease of bone (PDB) is a common skeletal disorder that is associated with locally increased bone turnover, skeletal deformity and pain. We report a case of skeletal dissemination in PDB of the spine. ⋯ We outline skeletal dissemination as a possibly surgery-related complication in a patient with PDB in the lumbar spine. Bisphosphonates remain the treatment of first choice in PDB and surgical interventions should be considered very carefully.