Cases reported "Spinal Cord Neoplasms"

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1/206. Successful therapy with methotrexate of a multicentric mixed lymphoma of the central nervous system.

    Primary lymphoma of the central nervous system (CNS) is extremely rare. A case of mixed histiocytic lymphocytic lymphoma of the CNS that initially occurred in the spinal cord is reported. Multicentric recurrence following radiotherapy was successfully treated with intrathecal methotrexate and the patient remains free of disease after 4 years. The role of intrathecal methotrexate as alternative therapy following irradiation failure is discussed.
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2/206. Diffuse neonatal hemangiomatosis with extensive involvement of the brain and cervical spinal cord.

    BACKGROUND: Diffuse neonatal hemangiomatosis (DNH) is a rare disorder first recognized at birth or during the neonatal period. DNH is characterized by numerous cutaneous and visceral hemangiomas involving three or more organ systems. MATERIALS AND methods: Although the skin and liver are most frequently affected, we present a case of DNH demonstrating an unusual predilection for the central nervous system (CNS). RESULTS AND CONCLUSION: We report the imaging findings in a patient with this disorder, paying particular attention to the features seen on cranial sonography and spinal MR imaging.
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3/206. Infectious meningitis mimicking recurrent medulloblastoma on magnetic resonance imaging. Case report.

    This report and the accompanying review of the literature address the challenges, when using surveillance magnetic resonance (MR) imaging, of establishing the origin of newly detected central nervous system lesions. Routine surveillance MR imaging in a 16-year-old boy, whose medulloblastoma had been successfully treated, demonstrated asymptomatic nodular leptomeningeal enhancement of the brain and spinal cord, which was consistent with recurrent disease. Examination of the cerebrospinal fluid, however, led to the diagnosis of bacterial meningitis. Two weeks after completion of antibiotic therapy, the original MR imaging findings were seen to have resolved. This case illustrates the importance of considering clinical and laboratory data, including results from a complete examination of the cerebrospinal fluid, when interpreting the origin of new lesions revealed by MR imaging.
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4/206. Angiotropic large B-cell lymphoma with clinical features resembling subacute combined degeneration of the cord.

    Angiotropic large cell lymphoma is a rare neoplastic disorder associated with a high mortality. The hallmark of the disease is lymphoid proliferation confined to the intravascular compartment without local tissue or vessel wall infiltration [1]. This feature is so striking that the disease was originally thought to arise from endothelial tissue and early cases were described as malignant angioendotheliomatosis. However, application of immunohistochemical methods for detection of lymphoid markers such as the CD45 and CD20 cell surface markers has confirmed its lymphoid origin, usually of B-cell lineage [2]. Clinical manifestations of the disease are protean and are due to multifocal medium and small vessel occlusion by tumour cells [3]. Characteristic sites of involvement are skin and central nervous system and although an ante-mortem diagnosis can be made from a biopsy specimen, it is often unsuspected [4]. We present a case of angiotropic large B-cell lymphoma in a 74-year-old man who presented with urinary symptoms and had a neurological picture resembling subacute combined degeneration of the cord.
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5/206. Solitary fibrous tumor of the thoracic spine. Case report and review of the literature.

    Solitary fibrous tumor (SFT) is a neoplasm first described as a tumor of mesenchymal origin involving soft tissues. The authors provide a review of the literature with detailed pathological analysis and radiological description of SFTs involving the central nervous system. The authors report a rare case of a SFT of the thoracic spine in an adult man presenting with myelopathy. magnetic resonance imaging revealed a well-circumscribed, intradural, extramedullary mass at the T2-3 level. Histological examination demonstrated a proliferation of predominantly spindle-shaped cells with a collagen-matrix background. Immunohistochemical staining was positive for vimentin and CD34 and negative for S-100 and epithelial membrane antigen with an MIB-1 labeling index of 2.6%. review of the literature revealed 10 cases in which this tumor, frequently found in the pleura, was involved in the central nervous system. Although rare and their clinical significance as yet unknown, SFTs may be considered in the differential diagnosis of intradural spinal cord lesions. The natural history is also unknown, but these tumors appear to be biologically benign.
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6/206. Simultaneous development of a pineal tumor and an intradural spinal mass during remission of acute lymphocytic leukemia.

    A small percentage of children with acute lymphocytic leukemia experience relapse in the central nervous system in spite of prophylaxis. Diffuse leptomeningeal infiltration is common but an intracranial leukemic mass or spinal cord involvement is a rare manifestation. We report a child with acute lymphocytic leukemia who simultaneously developed a pineal tumor and an intradural spinal cord mass as her first relapse. She was successfully managed by comprehensive combined treatment including peripheral blood stem cell transplantation. She remains in continuous complete remission for more than 5 years without further evidence of neurological sequelae.
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7/206. Late intramedullary spinal cord metastasis in a patient with lymphoblastic lymphoma: case report.

    Late intramedullary spinal cord metastasis of lymphoblastic lymphoma (LBL) is unreported in the literature. The central nervous system (CNS) sites of metastasis previously documented include the spinal leptomeninges causing epidural spinal cord compression or brain praenchymal sites within a year of primary diagnosis. This report represents the first case of intramedullary spinal cord LBL as a late recurrence. The method consists of a case study of one patient with retrospective analysis of tumour tissues from biopsies at ages 5, 9 and 26. The results show that late spinal cord recurrence was microneurosurgically subtotally debulked and later treated with radiotherapy with improvement in neurological deficit. Investigations revealed no evidence of systemic disease and this recurrence appears to be an isolated sanctuary site tumour. A medline search (1966 - present) of the literature failed to reveal similar reported cases and the authors believe this to be the first late intramedullary spinal cord metastasis in a patient with LBL.
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8/206. Spinal atypical teratoid/rhabdoid tumor in an infant.

    Atypical teratoid/rhabdoid tumor of the central nervous system in infancy and childhood was established as an entity based on histological, immunohistochemical, and cytogenetic studies. We report the case of a 7-month-old girl who presented with progressive paraplegia and hypesthesia of her legs. Imaging studies revealed a spinal cord mass occupying the entire spinal canal below the T(7) level. Through a T(12)-L(3) laminectomy, the intramedullary tumor was partially debulked. Histologically, the tumor specimen had rhabdoid cells, and immunostaining showed vimentin and cytokeratin positivity. No abnormality of chromosome 22q was detected with the fluorescence in situ hybridization method.
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keywords = nervous system
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9/206. Capillary hemangioma of the spinal cord. Report of four cases.

    The authors describe the clinicopathological features of four cases of capillary hemangioma of the spinal cord. All occurred in adult patients. The presenting symptoms were similar to those of more common intramedullary tumors. Radiologically, they resemble other vascular spinal cord tumors. All patients underwent surgery, and the outcomes varied. Histologically, the lesions resembled capillary hemangioma of skin or of soft tissue that is composed of lobules of small capillaries with associated feeding vessels, all enveloped by a delicate fibrous capsule. Capillary hemangiomas of the central and peripheral nervous system are extremely rare. Although examples of these lesions have been described as occurring in the dura mater and in peripheral nerve, including spinal nerve roots, none has occurred within the spinal cord. knowledge of their existence may help practitioners to avoid misdiagnosis of tumor and resultant overtreatment of these benign lesions.
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10/206. Primary intradural extramedullary ependymoma: case report and review of the literature.

    STUDY DESIGN: The authors report the ninth case in the literature of a primary intradural extramedullary ependymoma of the spinal cord. OBJECTIVE: To discuss surgical treatment and the physiopathologic hypothesis of this localization on the basis of the results of the present study and a review of the literature. SUMMARY OF BACKGROUND DATA: ependymoma is a glial tumor known to arise in the central nervous system. Intradural extramedullary location of this neoplasm has been exceptionally described previously. methods: A 43-year-old woman was admitted to the authors' institution with an history of progressive paraplegia. neurologic examination showed sensory loss below T1 and bladder disturbances. magnetic resonance imaging revealed an enhanced thoracic intradural extramedullary tumor, extending from T1-T8. No other lesion in the central nervous system was found. Emergency surgical resection was performed. RESULTS: Surgery gave confirmation of an encapsulated extramedullary tumor without attachment to the spinal cord or to the dura mater. Total removal was achieved under microscope. The postoperative course was uneventful, with complete neurologic recovery 3 months later. The patient has been well for 24 months of follow-up evaluation, without evidence of recurrence on magnetic resonance images. Histologic examination revealed the tumor as a benign ependymoma. CONCLUSION: The encapsulated feature, the lack of attachment to the central nervous system, and the absence of other neoplastic processes within the brain or the spinal cord suggested that this lesion is a primary tumor developed from ectopic ependymal cells.
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