• Title/Summary/Keyword: Intradural-Extramedullary

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Spinal Schwannoma; Analysis of 40 Cases

  • Jeon, Jee-Ho;Hwang, Hyung-Sik;Jeong, Je-Hoon;Park, Se-Hyuk;Moon, Jae-Gon;Kim, Chang-Hyun
    • Journal of Korean Neurosurgical Society
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    • v.43 no.3
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    • pp.135-138
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    • 2008
  • Objective: This study is to report our experience of 40 cases of spinal schwannoma. Methods: From 1995 to 2006, medical records were retrospectively reviewed in 40 cases of spinal schwannoma. Results: We treated 40 spinal schwannomas in 38 (22 male and 16 female) patients. The mean age was 50.2. Four cases were sited in the cervical spine, 11 cases in the thoracic spine, and 25 cases in the lumbar spine. Two patients showed recurrences. Thirty-eight cases were intradural-extramedullary type and 2 cases were extradural. Two cases (5%) including 1 recurred case had no postoperative motor improvement. Ninety-five percents of patients improved on postoperative motor grade. Conclusion: Spinal schwannoma is mostly benign and extramedullary tumor. There were 2 recurred cases (5%) that had history of previous subtotal removal at first operation and had shown worse prognosis compared with the cases without recurrence. To reduce the recurrence of spinal schannoma, total excision of tumor mass should be done.

Primary Spinal Cord Melanoma

  • Kim, Min-Soo;Yoon, Do-Heum;Shin, Dong-Ah
    • Journal of Korean Neurosurgical Society
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    • v.48 no.2
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    • pp.157-161
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    • 2010
  • Primary central nervous system (CNS) melanoma is a rare condition that accounts for only 1% of all melanomas. A 34-year-old Korean female presented with a two-month history of progressive weakness in both legs. Spinal magnetic resonance image (MRI) revealed a spinal cord tumor at the level of T4, which was hyperintense on T1-weighted imaging and hypointense on T2-weighted imaging. The intradural and extramedullary tumor was completely resected and diagnosed as melanoma. There were no metastatic lesions. At three years after surgery, the patient is still alive, with no evidence of tumor recurrence. We present the details of this case along with a comprehensive review of spinal cord melanoma.

Intraventricular Malignant Meningioma with CSF-Disseminated Spinal Metastasis : Case Report and Literature Review

  • Eom, Ki-Seong;Kim, Hun-Soo;Kim, Tae-Young;Kim, Jong-Moon
    • Journal of Korean Neurosurgical Society
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    • v.45 no.4
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    • pp.256-259
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    • 2009
  • The authors report a case of 42-year-old woman with an intraventricular tumor in the trigone of the left lateral ventricle. The first operation achieved a microscopically complete resection. The tumor was histologically atypical meningioma. After 26 months, there were recurrences of intraventricular meningioma. Complete resection of the tumor and adjuvant radiation therapy were performed, and the histological diagnosis was malignant meningioma. Sixteen months after the second operation, spinal metastasis in cervicolumbar lesion was diagnosed and a subtotal removal of cervical intradural extramedullary mass was performed. We describe an unusual case of intraventricular malignant meningioma with cerebrospinal fluid-disseminated spinal metastases with review of the clinical courses of previous reports.

Multiple Spinal Cord Recurrences of an Intracranial Ependymoma after 14 Years

  • Hong, Semie;Choe, Woo Jin;Moon, Chang Taek
    • Journal of Korean Neurosurgical Society
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    • v.54 no.6
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    • pp.521-524
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    • 2013
  • Ependymoma can spread via cerebrospinal fluid, but late spinal recurrences of intracranial tumor are very rare. We describe a case of a 33-year-old male who presented with multiple, delayed, recurrent lesions in the spinal cord from an intracranial ependymoma. The patient underwent gross total resection and postoperative radiation therapy 14 years prior to visit for a low grade ependymoma in the 4th ventricle. The large thoraco-lumbar intradural-extramedullary spinal cord tumor was surgically removed and the pathologic diagnosis was an anaplastic ependymoma. An adjuvant whole-spine radiation therapy for residual spine lesions was performed. After completion of radiation therapy, a MRI showed a near complete response and the disease was stable for three years.

Non-Dura Based Intaspinal Clear Cell Meningioma

  • Ko, Jun-Kyeung;Choi, Byung-Kwan;Cho, Won-Ho;Choi, Chang-Hwa
    • Journal of Korean Neurosurgical Society
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    • v.49 no.1
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    • pp.71-74
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    • 2011
  • A 34-year-old female patient was presented with leg and hip pain for 6 months as well as voiding difficulty for 1 year. Magnetic resonance imaging revealed a well-demarcated mass lesion at L2-3. The mass was hypo-intense on T1- and T2-weighted images with homogeneous gadolinium enhancement. Surgery was performed with the presumptive diagnosis of intradural extramedullary meningioma. Complete tumor removal was possible due to lack of dural adhesion of the tumor. Histologic diagnosis was clear cell meningioma, a rare and newly included World Health Organization classification of meningioma usually affecting younger patients. During postoperative 2 years, the patient has shown no evidence of recurrence. We report a rare case of cauda equina clear cell meningioma without any dural attachment.

Anterior Surgical Approach in Recurrent Cervical Neurenteric Cyst - Case Report - (재발한 경추 신경장성 낭종의 전방경유 치험 - 증 례 보 고 -)

  • Bae, Kwang Ju;Kim, Il-Man
    • Journal of Korean Neurosurgical Society
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    • v.29 no.9
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    • pp.1258-1261
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    • 2000
  • Intraspinal neurenteric cyst is rare congenital lesion derived from disorder of notochord formation. Most of these are located ventral to the spinal cord and conventional posterior approach is considered to be effective method as initial treatment modality. This cyst can recur, but the risk of reccurence after partial removal through long term follow-up has not been determined. We experienced one case of cervical neurenteric cyst which recurred after partial removal through laminectomy. The magnetic resonance imaging and postmyelography computerized tomography revealed an intradural extramedullary cystic lesion anterior to the cervical cord at the fifth cervical vertebra level. We performed anterior cervical corpectomy and cyst was totally removed. The patient's neurological symptom was improved postoperatively. Neurenteric cyst located ventrally to the cervical spinal cord should be removed through anterior route for direct visualization of the relationship between the cyst wall and the spinal cord.

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Malignant Neurocutaneous Melanosis - A Case Report - (악성 신경피부흑색증 - 증례보고-)

  • Kim, Tae Young;Oh, Kwang Soo;Lee, Young Jin;Yun, Ki Jung;Kim, Jong Moon
    • Journal of Korean Neurosurgical Society
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    • v.29 no.3
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    • pp.389-395
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    • 2000
  • Arare case of primary malignant melanoma of central nervous system in 12-month-old infant with neuro-cutaneous melanosis is presented. Primary malignant melanomas in central nervous system are very rare in children, however, it is known that leptomeningeal melanosis is malignant in 40-50% with neurocutaneous melanosis. Spinal MRI, brain CT and MRI showed diffuse intradural extramedullary mass of entire spinal cord and enhancing mass in brain stem. CSF cytology revealed abnormal cells. Biopsy from leptomeninges of posterior fossa was compatible with malignant melanoma.

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Intramedullary Solitary Fibrous Tumor of Cervicothoracic Spinal Cord

  • Hwang, Ui Seung;Kim, Sung Bum;Jo, Dae Jean;Kim, Sung Min
    • Journal of Korean Neurosurgical Society
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    • v.56 no.3
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    • pp.265-268
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    • 2014
  • Solitary fibrous tumor is rare benign mesenchymal neoplasm. The spinal solitary fibrous tumor is extremely rare. The authors experienced a case of intramedullary solitary fibrous tumor of cervicothoracic spinal cord in a 48-year-old man with right lower extremity sensory disturbance. Spinal MRI showed intradural mass lesion in the level of C7-T1, the margin between the spinal cord and tumor was not clear on MRI. A Left unilateral laminectomy and mass removal was performed. Intra operative finding, the tumor boundary was unclear from spinal cord and it had intramedullary and extramedullary portion. After surgery, patient had good recovery and had uneventful prognosis. Follow up spinal MRI showed no recurrence of tumor.

Sparganosis Presenting as Cauda Equina Syndrome with Molecular Identification of the Parasite in Tissue Sections

  • Boonyasiri, Adhiratha;Cheunsuchon, Pornsuk;Srirabheebhat, Prajak;Yamasaki, Hiroshi;Maleewong, Wanchai;Intapan, Pewpan M.
    • Parasites, Hosts and Diseases
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    • v.51 no.6
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    • pp.739-742
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    • 2013
  • A 52-year-old woman presented with lower back pain, progressive symmetrical paraparesis with sensory impairment, and sphincter disturbance. Magnetic resonance imaging (MRI) of the whole spine revealed multiple intradural extramedullary serpiginous-mass lesions in the subarachnoid space continuously from the prepontine to the anterior part of the medulla oblongata levels, C7, T2-T8, and T12 vertebral levels distally until the end of the theca sac and filling-in the right S1 neural foramen. Sparganosis was diagnosed by demonstration of the sparganum in histopathological sections of surgically resected tissues and also by the presence of serum IgG antibodies by ELISA. DNA was extracted from unstained tissue sections, and a partial fragment of mitochondrial cytochrome c oxidase subunit 1 (cox1) gene was amplified using a primer set specific for Spirometra spp. cox1. After sequencing of the PCR-amplicon and alignment of the nucleotide sequence data, the causative agent was identified as the larva of Spirometra erinaceieuropaei.

A Case of Intramedullary Schwannoma at the Cervicomedullary Junction - A Case Report - (연수와 경수에 발생한 수내 신경초종 - 증 례 보 고 -)

  • Lee, Jong-Won;Park, Seung-Won;Kim, Young-Baeg;Hwang, Sung-Nam;Choi, Duck-Young
    • Journal of Korean Neurosurgical Society
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    • v.29 no.9
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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.

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