• Title/Summary/Keyword: Spinal neoplasm

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Treatment outcome of radiation therapy and concurrent targeted molecular therapy in spinal metastasis from renal cell carcinoma

  • Park, Sangjoon;Kim, Kyung Hwan;Rhee, Woo Joong;Lee, Jeongshim;Cho, Yeona;Koom, Woong Sub
    • Radiation Oncology Journal
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    • v.34 no.2
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    • pp.128-134
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    • 2016
  • Purpose: To evaluate the clinical outcomes of patients who underwent radiation therapy with or without targeted molecular therapy for the treatment of spinal metastasis from renal cell carcinoma (RCC). Materials and Methods: A total of 28 spinal metastatic lesions from RCC patients treated with radiotherapy between June 2009 and June 2015 were retrospectively reviewed. Thirteen lesions were treated concurrently with targeted molecular therapy (concurrent group) and 15 lesions were not (nonconcurrent group). Local control was defined as lack of radiographically evident local progression and neurological deterioration. Results: At a median follow-up of 11 months (range, 2 to 58 months), the 1-year local progression-free rate (LPFR) was 67.0%. The patients with concurrent targeted molecular therapy showed significantly higher LPFR than those without (p = 0.019). After multivariate analysis, use of concurrent targeted molecular therapy showed a tendency towards improved LPFR (hazard ratio, 0.13; 95% confidence interval, 0.01 to 1.16). There was no difference in the incidence of systemic progression between concurrent and nonconcurrent groups. No grade ${\geq}2$ toxicities were observed during or after radiotherapy. Conclusion: Our study suggests the possibility that concurrent use of targeted molecular therapy during radiotherapy may improve LPFR. Further study with a large population is required to confirm these results.

Intraosseous Hemangioblastoma Mimicking Spinal Metastasis in the Patient with Renal Cell Carcinoma

  • Cho, Hee-Cheol;Lee, Sun-Ho;Kim, Eun-Sang;Eoh, Whan
    • Journal of Korean Neurosurgical Society
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    • v.49 no.6
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    • pp.381-383
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    • 2011
  • Sporadic osseous hemangioblastomas in the vertebra are extremely rare and they can be misdiagnosed as a vertebral hemangioma or metastasis in imaging studies. We report an intraosseous hemangioblastoma that arose from the 11 th thoracic vertebra and was diagnosed initially as a metastasis in a patient with renal cell carcinoma. Diagnosis, surgical treatment and adjuvant radiosurgery of such case in reference to the literature are discussed.

Clinical Analysis of the Mediatinal Neurogenic Tumor -18 case report- (종격동에 빈발하는 신경종에 대한고찰 -18례 임상 경험-)

  • 최영호
    • Journal of Chest Surgery
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    • v.27 no.11
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    • pp.938-941
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    • 1994
  • Neurogenic tumors of the mediastinum may have an intraspinal component connected by a narrowed segment of tumor in the intervertebral foramen, then have symptoms of back pain,lower extremity tingling sensation. CT scan or MRI demonstrated a Dumbbell-shaped mass density compressing spinal canal, enlargement of the foramen, erosion of bone, and intervertebral widening. We report the analysis of the 18 cases of neurogenic tumors on posterior mediastinum and Dumbbell type tumors are 3 cases among the 18 cases. The neurilemmomas were 12 cases[67%], the ganglioneuroma were 5 cases[28%], and neuroblastoma was one case[5%]. The successful removal was done in all cases, a standard thoracotomy and laminectomy was done in Dumbbell type tumors.There was no postoperative neurological complications.

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Cauda Equina Syndrome following Caudal Anesthesia in a Patient with Metastatic Spine Tumor -A case report- (척추 암전이 환자에서 미추마취후 발생한 마미증후군 -증례 보고-)

  • Lee, Jun-Hak;Park, Seung-Hee;Lee, Ki-Nam;Moon, Jun-Il
    • The Korean Journal of Pain
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    • v.10 no.1
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    • pp.134-137
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    • 1997
  • We report a case of cauda equine syndrome following caudal anesthesia possibly caused by metastatic spine tumor. Male, 80-year-old, who had prostatic carcinoma with $L_3$ and $L_4$ spine metastasis was scheduled for bilateral orchiectomy. Twenty two-gauge needle was introduced at sacral hiatus and 15 ml of 2% lidocaine administered. The next morning, patient complained of perineal numbness and urination difficulty. During the next several day patient had episodes of fecal incontinence and motor weakness on both lower extremities. This case reminded us that neuroaxial blocks such as spinal, epidural and caudal anesthesia, should be used with extreme care in patients having neoplasm with high incidence of spine metastasis.

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Increased Intraoperative Motor Evoked Potentials and Motor Recovery after Spinal Cord Tumor Removal (척수 종양 제거 술 중 운동유발전위의 호전과 근력 호전의 관계)

  • Pyo, Soeun;Park, Yoon Ghil;Park, Jinyoung;Ko, Eu Jeong
    • Journal of Electrodiagnosis and Neuromuscular Diseases
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    • v.20 no.2
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    • pp.98-105
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    • 2018
  • Objective: To evaluate whether the increase of the amplitude of motor evoked potentials (MEPs) during surgery can imply favorable prognosis postoperatively in spinal cord tumor surgery. Method: MEPs were monitored in patients who underwent spinal cord tumor surgery between March 2016 and March 2018. Amplitude changes at the end of monitoring compared to the baselines in limb muscle were analyzed. Minimum and maximum changes were set to $MEP_{min}$ (%) and $MEP_{max}$ (%). Strengths of bilateral 10 key muscles which were documented a day before ($Motor_{pre}$), 48 h ($Motor_{48h}$) and 4 weeks ($Motor_{4wk}$) after the surgery were reviewed. Results: Difference of $Motor_{48h}$ from $Motor_{pre}$ ($Motor_{48h-pre}$) and $Motor_{4wk}$ from $Motor_{pre}$ ($Motor_{4wk-pre}$) positively correlated with $MEP_{min}$, suggesting that smaller the difference of MEPs amplitude, less recovery of muscle strength. There was a negative correlation between the amount of bleeding and $MEP_{min}$, indicating that the greater the amount of bleeding, the smaller the $MEP_{min}$, implying that MEPs amplitude is less likely to improve when the amount of bleeding is large. It also showed significant difference between patients with improved or no change of motor status and patients with motor deterioration after surgery according to anatomical tumor types. Conclusion: Improve of muscle strength was less when the increase of MEPs amplitude was small, and improvement of MEPs amplitude was less when the amount of bleeding was large. Correlation between changes of status of muscle strength after surgery and tumor types was observed. With amplitude increase in MEPs monitoring, restoration of muscle strength can be expected.

Correlation Analysis Between Radiological Result and Radiating Pain in Lumbosacral Pain (요통환자에 있어서 방사통과 영상의학검사 소견상의 연관성 분석)

  • Kim, Han-Kyum;Kim, Seok;Bahn, Hyo-Jung;Yoon, Hyun-seok;Yeom, Sun-kyu;Hong, Soon-Sung
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.4 no.1
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    • pp.95-102
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    • 2009
  • Objectives : We studied in order to compare the differences between the symptoms of patients and findings of MRI and X-Ray of patients with herniated disc which has been diagnosed often recently. Methods : We randomly selected among the 301 patients with X-Ray and L-spine MRI films who have visited Jaseng Hospital with low-back pain and lumbar and low extremity pain from Jan.1st of 2009 to Jan.28. We used SPSS 13.0 for Windows I in analyzing statistical data of study results and the level of significance were below 0.05. Results and Conclusions : 1. If there were radiating pain, based on MRI findings, the amount of herniation was more severe(P>0.05). 2. If the finding of a X-ray showed narrowing, based on MRI findings, the amount of herniation was more severe(P>0.05). 3. There were no significant differences between the presence of radiating pain and the findings of X-Ray(P>0.05). 4. Among the 301 cases, cases which showed findings beside HIVD were 79. 7 cases of hemanggioma(2.3%), 24 cases of spinal neoplasm(cord cyst, tumor etc)(8%), 7 cases of spondylitis(2.3%), 16 cases of spinal canal stenosis(5,3%) 9 cases of ligamentum flavum thickening(3%) and 16 cases of facet syndrome(5.3%).

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Extraosseous Epidural Ewing's Sarcoma Arising in the Lumbar Area - A Case Report- (요추부에 발생한 경막외 유잉육종 - 증례 보고 -)

  • Ahn, Myun-Hwan;Shin, Duk-Seop;Jung, Kwang-Am;Hah, Jeong-Ok
    • The Journal of the Korean bone and joint tumor society
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    • v.5 no.3
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    • pp.183-189
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    • 1999
  • Ewing's sarcoma is an uncommon malignant neoplasm of the long bone and it has a poor prognosis due to its early metastasis and aggressive local spread. It is mostly found before the age of 30 and it is rare in extraskeletal sites. Extraskeletal Ewing's sarcoma has been reported to occur in various sites including the larynx, scalp, nasal fossa, neck, chest wall, lung, pelvis, perineum, arm, finger, leg and toe, but it is extremely rare as a primary epidural tumor of the spine. We experienced a case of extraosseous epidural Ewing's sarcoma arising in the lumbar spinal canal at L3-L5 level in a 9-year-old boy. Following total laminectomy from L3 to L5 with a lumbar vertebrae and mass excision, he received chemotherapy with complete remission.

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Posterior Mediastinal Chordoma - 1 case report- (후종격동 종양으로 나타난 척삭종(Chordoma) 1예)

  • 이승훈;최용수;김관민;김진국;심영목
    • Journal of Chest Surgery
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    • v.36 no.9
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    • pp.707-710
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    • 2003
  • Chordomas are slowly growing and rare malignant tumors arising from the remnants of the notochord. Furthermore, intrathoracic chordomas presenting as a posterior mediastinal tumor account for only 1∼2% of all reported chordomas. Incomplete resection of these tumors can lead to local recurrence, distant metastasis and result in a poor outcome, but complete remission can be expected with complete resection and adjuvant radiotherapy. We report a case of thoracic chordoma presenting as a posterior mediastinal tumor which was successfully treated with complete resection and adjuvant radiotherapy without recurrence and distant metastasis for 2 years.

Malignant Schwannoma in F344 Rat

  • Kim, Bang-hyun;Nam, Ki-taek;Han, Beom-seok;Park, Ki-dae;Cho, Wan-seob;Jang, Dong-deuk;Lee, Kook-kyung;Kim, Dae-yong;Yang, Ki-hwa
    • Proceedings of the Korean Society of Veterinary Pathology Conference
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    • 2003.10a
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    • pp.8-8
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    • 2003
  • Schwannoma is a neoplasm of the Schwann cells of the neural sheath [1]. Malignant schwannoma is most commonly seen in the subcutis of the flank or neck area near the salivary glands [2]. It also occurs in the thoracic and abdominal cavities, spinal cord, cranial cavity, the heart, etc. Here, we incidentally found a good case of malignant schwannoma in the subcutis of the lumbar and lumbosacral region in male F344 rat during the carcinogenicity study with diisodecyl phthalate (DIDP). Therefore, we tried to report this case as a good reference of malignant schwannoma. (omitted)

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Newly-Diagnosed, Histologically-Confirmed Central Nervous System Tumours in a Regional Hospital in Hong Kong : An Epidemiological Study of a 21-Year Period

  • He, Zhexi;Wong, Sui-To;Yam, Kwong-Yui
    • Journal of Korean Neurosurgical Society
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    • v.63 no.1
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    • pp.119-135
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    • 2020
  • Objective : To investigate the epidemiology of newly-diagnosed, histologically-confirmed (NDHC) central nervous system (CNS) tumours and its changes over a 21-year period in a regional hospital in Hong Kong. Methods : This is a single-institute retrospective descriptive study of patients undergoing surgery for CNS tumours in a regional hospital of Hong Kong in the period from January 1996 to December 2016. The histological definition of CNS tumours was according to the World Health Organization classification, while the site definition for case ascertainment of CNS tumours was as set out by the Central Brain Tumour Registry of the United States. Patients of any age, who had NDHC CNS tumours, either primary or secondary, were included. The following parameters of the patients were retrieved : age at diagnosis, gender, tumour location, and histological diagnosis. Population data were obtained from sources provided by the Government of Hong Kong. The incident rate, estimated by the annual number of cases per 100000 population, for each histology grouping was calculated. Statistical analyses, both including and excluding brain metastases, were performed. Statistical analysis was performed with Microsoft Excel, 2016 (Microsoft, Redmond, WA, USA). Results : Among the 2134 cases of NDHC CNS tumours, there were 1936 cases of intracranial tumours and 198 cases of spinal tumours. The annual number of cases per 100000 population of combined primary intracranial and spinal CNS tumours was 3.6 in 1996, and 11.1 in 2016. Comparing the 5-year average annual number of cases per 100000 population of primary CNS tumours from the period 1996-2000 to 2011-2015, there was an 88% increase, which represent an increase in the absolute number of cases by 4.52 cases/100000 population. This increase was mainly contributed by benign histologies. In the aforementioned periods, meningiomas increased by 1.45 cases/100000 population; schwannomas by 1.05 cases/100000 population, and pituitary adenomas by 0.91 cases/100000 population. While gliomas had a fluctuating 5-year average annual number of cases per 100000 population, it only had an absolute increase of 0.51 cases/100000 population between the 2 periods, which was mainly accounted for by the change in glioblastomas. Conclusion : This retrospective study of CNS tumour epidemiology revealed increasing trends in the incidences of several common CNS tumour histologies in Hong Kong, which agrees with the findings in large-scale studies in Korea and the United States. It is important for different geographic locations to establish their own CNS tumour registry with well-defined and structured data collection and analysis system to meet the international standards.