• Clinical Pain
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• 제20권1호
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• pp.39-42
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• 2021

A 29-year-old woman had 1-month history of back pain radiating into lower extremities, motor weakness, and sensory abnormalities in both lower extremities. Contrast-enhanced spinal magnetic resonance imaging (MRI) revealed a homogeneously enhancing mass at the T12~L1 and several intradural enhancing nodular lesions at L2~S1. Tumor resection surgery was performed and following histological examination showed that the tumor satisfied the diagnostic criteria for atypical choroid plexus papilloma (CPP). To find primary tumor sites, contrast-enhanced brain MRI, whole spine MRI, and PET-CT were carried out and additional lesions were detected at the fourth ventricle, right cerebellum, and upper thoracic spinal cord. This is a very rare case of metastatic atypical CPP that involves brain, upper thoracic spinal cord, and cauda equina with initial manifestation of radicular symptoms without clinical signs of primary brain lesion.

• The Korean Journal of Pain
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• 제18권2호
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• pp.255-258
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• 2005

Many patients with intractable chest pain visit pain clinics, two of which, with rare cases of an intraspinal tumor and malignant mesothelioma were experiences at our clinic. A 37-year old female patient presented with exacerbating chest pain, but without neurological manifestations, of 15-months duration. Her laboratory findings, such as blood tests, chest X-ray, EKG, abdominal ultrasonography and chest CT, were normal. MRI revealed an intradural extramedullary schwannoma at the T 5 and 6 levels of the thoracic spine. She completely recovered following a laminectomy, with removal of the tumor. The other case was a 65-year old male patient, who presented with chest and back pain in the thoracic area of 6 months duration. He had no cough and dyspnea, and was initially misdiagnosed with intercostal neuralgia; therefore, pain control medication was administered, but all trials were ineffective. Finally, chest CT revealed a malignant mesothelioma, with multiple spine metastases. In conclusion, patients with intractable chest pain should be re-examined both clinically and radiographically.

• 한방재활의학과학회지
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• 제30권4호
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• pp.187-194
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• 2020

The objective of this study is to report an accidental detection of colorectal cancer (CRC) metastasis to spine during conservative treatment for lumbar disc herniation. We treated a 65-year-old female who was diagnosed with lumbar disc herniation on September 2019 by acupuncture, pharmacopuncture, cupping treatment, chuna manual therapy, herbal medicine treatment, medicine treatment and physical therapy. After that we analyzed medical record from December 12, 2019 to February 11, 2020. The patient was diagnosed with CRC and received tumor resection in 2014. After 2 times of chemotherapy, she arbitrarily interrupted the treatment. Since she stated that CRC treatment was terminated, we had difficulty in finding connection between symptom and CRC. During the treatment period, compression fracture at L3 body was found, which was caused by CRC metastasis. Rigorous question, appropriate radiological and clinical tests are required to patients who have history of malignant tumor.

• Journal of Yeungnam Medical Science
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• 제30권2호
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• pp.116-119
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• 2013

A burnt-out prostate cancer tumor is a very rare clinical entity. The term 'burnt-out' refers to a primary tumor that has spontaneously and nearly completely regressed without treatment. Since metastasis of prostate cancer is usually encountered in the presence of advanced disease, distant metastasis with an undetectable primary tumor is very rare. We report herein a case of a burnt-out prostate cancer tumor that metastasized to the thoracic (T) spine and caused cord compression. A 66-year-old man visited the Emergency Department due to weakness of both legs for the past two days. His blood and urine tests were normal at the time. His spine magnetic resonance imaging (MRI) scans looked like bone metastasis that involved the T-7 vertebral body and a posterior element, and caused spinal cord compression. Other images, including from the brain MRI, neck/chest/abdomino-pelvic computed tomography (CT) scan and 18F-fluorodeoxyglucose (FDG)-positron emission tomography (PET) and endoscopy, revealed no lesions that suggested malignancy. After total corpectomy T-7 and screw fixation/fusion at T5 to T10, the pathology report revealed a metastatic carcinoma that was strongly positive for prostate-specific antigen (PSA). The serum PSA value was 1.5 ng/mL. The transrectal 12-core prostate biopsy and ultrasonography showed no definitive hypoechoic lesion, but one specimen had slight (only 1%) adenocarcinoma with a Gleason score of 6 (3+3). The final diagnosis was burned-out prostate cancer with an initial normal PSA value. Although metastatic disease with an unknown primary origin was confirmed, a more aggressive approach in seeking the primary origin could provide a more specific treatment strategy and greater clinical benefit to patients.

• Journal of Korean Neurosurgical Society
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• 제61권2호
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• pp.233-242
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• 2018

Objective : A spinal cord subependymoma is an uncommon, indolent, benign spinal cord tumor. It is radiologically similar to a spinal cord ependymoma, but surgical findings and outcomes differ. Gross total resection of the tumor is not always feasible. The present study was done to determine the clinical, radiological and pathological characteristics of spinal cord subependymomas. Methods : We retrospectively reviewed the medical records of ten spinal cord subependymoma patients (M : F=4 : 6; median 38 years; range, 21-77) from four institutions. Results : The most common symptoms were sensory changes and/or pain in eight patients, followed by motor weakness in six. The median duration of symptoms was 9.5 months. Preoperative radiological diagnosis was ependymoma in seven and astrocytoma in three. The tumors were located eccentrically in six and were not enhanced in six. Gross total resection of the tumor was achieved in five patients, whereas subtotal or partial resection was inevitable in the other five patients due to a poor dissection plane. Adjuvant radiotherapy was performed in two patients. Neurological deterioration occurred in two patients; transient weakness in one after subtotal resection and permanent weakness after gross total resection in the other. Recurrence or regrowth of the tumor was not observed during the median 31.5 months follow-up period (range, 8-89). Conclusion : Spinal cord subependymoma should be considered when the tumor is located eccentrically and is not dissected easily from the spinal cord. Considering the rather indolent nature of spinal cord subependymomas, subtotal removal without the risk of neurological deficit is another option.

• Journal of Korean Neurosurgical Society
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• 제44권5호
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• pp.334-337
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• 2008

Spinal intradural extramedullary teratoma is a rare condition that develops more commonly in children than in adults and may be associated with spinal dysraphism. We report a rare case of adult-onset intradural extramedullary teratoma in the thoracolumbar spinal cord with no evidence of spinal dysraphism and without the history of prior spinal surgery. The patient was a 38-year-old male whose chief complaint was urinary incontinence. X-ray images of the thoracolumbar spine showed the widening of the interpedicular distance and posterior marginal erosion of the vertebral bodies and pedicles at the T11, T12, and L1 level. Magnetic resonance imagings of the lumbar spine showed a lobulated inhomogeneous high signal intradural mass ($87{\times}29{\times}20mm$) between T11 and L1 and a high signal fluid collection at the T11 level. Laminectomy of the T11- L1 region was performed, and the mass was subtotally excised. The resected tumor was histopathologically diagnosed as a mature cystic teratoma. The patient's symptom of urinary incontinence was improved following the surgery.

• The Korean Journal of Pain
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• 제2권1호
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• pp.61-65
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• 1989

Chloroma is a localized myeloblastic tumor which may develop during the course of myelogenous leukemia or as a presenting sign of the disease. A 47-year-old female diagnosed as chronic myelogenous leukemia in her hematologic remission period complained of left lower leg pain. The lumbar-spine series showed multiple osteolytic changes in the left lateral border of the lumbar spine. An inhomogenous soft tissue mass involving left lateral aspects of lumbar vertebrae was identified by CT-scanning. At the first pain attack, lumbar epidural steroid and local anesthetic injection could abolish her pain and the patient could go a few days without pain. The following radiation therapy could also improve the symptom and retain the pain free interval. One month later, a second pain attack occurred and lumbar and caudal epidural steroid and local anesthetic injections could result only in an incidental relief of pain. Radiation and chemotherapy were started but failed to relieve pain. A neurolytic block was considered but the patient's general condition was aggravated and even verbal communication with her became impossible.

• Parasites, Hosts and Diseases
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• 제59권6호
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• pp.635-638
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• 2021

In this study, we intended to describe a human case of lumbosacral canal sparganosis in People's Republic of China (China). A 56-year-old man was admitted to Xiangya Hospital Central South University in Changsha, Hunan province, China after having an experience of perianal pain for a week. An enhancing mass, a tumor clinically suggested, was showed at the S1-S2 level of the lumbosacral spine by the examination of magnetic resonance imaging (MRI) with gadolinium contrast. The patient was received the laminectomy from S1 to S2, and an ivory-white living worm was detected in inferior margin of L5. In ELISA-test with cerebrospinal fluid (CSF) and serum samples, anti-sparganum antibodies were detected. He had a ingesting history of undercooked frog meat in his youth. By the present study, a human case of spinal sparganosis invaded in lumbosacral canal at the S1-S2 level was diagnosed in China. Although the surgical removal of larvae is known to be the best way of treatment for sparganosis, we administered the high-dosage of praziquantel, albendazole and dexamethasone to prevent the occurrence of another remain worms in this study.

• 척추신경추나의학회지
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• 제4권1호
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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%).

• Clinical Pain
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• 제18권2호
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• pp.70-75
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• 2019

Objective: The purpose of this study is to evaluate the usefulness of infrared thermography in patients with carpal tunnel syndrome by comparing with electrodiagnostic and ultrasonographic findings. Method: From January 2014 to October 2017, electrodiagnosis, ultrasound, and digital infrared thermal image (DITI) of unilateral carpal tunnel syndrome diagnosed in a single hospital were retrospectively analyzed. The subjects with bilateral symptoms of carpal tunnel syndrome, peripheral vascular disease, diabetes, thyroid disease, fibromyalgia, rheumatic disease, systemic infection, inflammation, malignant tumor, and other musculoskeletal disorders such as finger osteoarthritis, peripheral neuropathy, cervical radiculopathy, and the previous history of surgery were excluded. Results: Of 53 patients diagnosed with carpal tunnel syndrome, 11 were male and 42 were female. The visual analogue scale was 4.9 ± 1.9, and the duration of symptom was 11.8 ± 12.5 months. There was no statistically significant difference in the body surface temperature between the unaffected and affected sides. The severity of symptoms, electrodiagnostic findings, and cross-sectional area of the median nerve significantly correlates to each other. The temperature difference between the second fingers of the affected and unaffected sides showed a weak correlation with the amplitude of sensory nerve action potential and onset latency of compound muscle action potential, when there was no significant correlation with the other parameters. Conclusion: The difference in temperature on the surface of the body, which can be confirmed by DITI, is little diagnostic value when DITI is performed in unilateral carpal tunnel syndrome patients, especially when compared with ultrasonography.