Cases reported "Spinal Neoplasms"

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1/9. A deceptive cervical lymph node: a solitary spinal osteochondroma.

    INTRODUCTION: osteochondroma of the cervical spine is an uncommon bony tumour. CLINICAL PICTURE: We present a case which was misdiagnosed as a posterior cervical lymph node. The patient presented with a tender neck lump and was seen by two surgical departments. They eventually diagnosed it as an osteochondroma and referred the patient to our department. This exostosis arose from the lamina of C3 vertebra and extended posteriorly. The patient presented with persistent neck ache but had no neurological deficit. TREATMENT: It was excised uneventfully. CONCLUSION: From the literature review, this appears to be the first case where an exostosis arose from a spinal facet joint. A discussion of osteochondromas follows.
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keywords = exostosis
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2/9. Spinal osteochondroma presenting as atypical spinal curvature: a case report.

    STUDY DESIGN: The case of an 8-year-old girl with hereditary multiple exostosis presenting with atypical spinal curvature is reported. OBJECTIVE: To describe a case of spinal curvature caused by an osteochondroma, illustrating the need for careful evaluation of patients with hereditary multiple exostosis presenting with "scoliosis." SUMMARY OF BACKGROUND DATA: Osteochondromas have been known to arise in the spinal canal and to present with symptoms of neural compression. Spinal curvature is a rare presenting sign of osteochondromas. methods: The patient's medical and radiographic history is reviewed as well as the medical literature. RESULTS: An 8-year-old girl with hereditary multiple exostosis was referred for possible thoracotomy and anterior decompression of a T4 osteochondroma thought to be causing an atypical "scoliosis." Further examination, review of the radiographs, and computed tomography scan showed a large L4 osteochondroma encroaching on the neural elements. The patient's neurologic symptoms and spinal curvature resolved in the 2 years after surgical excision of the lumbar osteochondroma. CONCLUSIONS: patients with hereditary multiple exostosis and spinal curvature require further diagnostic evaluation to ensure that an osteochondroma in the spinal canal is not the cause of that curvature.
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ranking = 2
keywords = exostosis
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3/9. Cervical myelopathy caused by an exostosis of the posterior arch of C1.

    We report a case of vertebral osteochondroma of C1 causing cord compression and myelopathy in a patient with hereditary multiple exostosis. We highlight the importance of early diagnosis and the appropriate surgery in order to obtain a satisfactory outcome.
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ranking = 2.5
keywords = exostosis
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4/9. spinal cord compression due to vertebral osteochondroma: report of two cases.

    osteochondroma, or exostosis, is the most common of all benign bone tumors. Spinal osteochondromas are uncommon but may cause neurological compromise. We report two cases of spinal cord compression by osteochondromas. One patient was a 17-year-old man with hereditary multiple exostoses who was presented with spastic paraparesis, a sensory level at T3-T4, and a pyramidal syndrome. Vertebral exostosis was suspected by magnetic resonance imaging and confirmed by histological examination. Surgical decompression was followed by complete resolution of the neurological impairments. The other patient was a 19-year-old man with spastic paralysis of the right lower limb and a pyramidal syndrome. Whereas magnetic resonance imaging suggested a neurofibroma, histological features were those of osteochondroma. Nine months elapsed from symptom onset to surgery. This delay led to residual neurological impairments, which resolved almost completely after rehabilitation therapy. Vertebral osteochondromas contribute only 1.3-4.1% of all osteochondromas. The lesion may be solitary or a manifestation of hereditary multiple exostosis. magnetic resonance imaging shows the exact location of the lesion, most notably with relation to neighboring neurological structures. spinal cord compression is uncommon and usually has a favorable outcome provided surgical decompression is performed before major neurological damage develops.
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ranking = 1.5
keywords = exostosis
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5/9. Single cervical exostosis. Report of a case and review of the literature.

    The authors present a rare case of solitary cervical osteochondroma. Because of its rarity and its predilection for the atlantoaxial area, the diagnosis may be overlooked in evaluating patients having cervical myelopathy. Surgical decompression usually improves the patient's neurologic status.
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keywords = exostosis
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6/9. Bony exostosis of the atlas with resultant cranial nerve palsy.

    A case of tenth and twelfth nerve compression secondary to a bony exostosis of the first cervical vertebra is described. This uncommon phenomenon serves to outline the importance of imaging the course of a cranial nerve when no intracranial abnormality is demonstrable on CT or MRI. The radiologic features of spinal osteochondromas are reviewed.
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ranking = 2.5
keywords = exostosis
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7/9. Solitary osteochondroma of the cervical spine.

    OBJECTIVE: To discuss a case of cervical spine osteochondroma found incidentally during evaluation of a rib injury. To demonstrate diagnostic imaging, including plain film radiography, radionuclide bone scan, computed tomography and magnetic resonance imaging. CLINICAL FEATURES: This article presents the second reported case of osteochondroma associated with the C6 vertebral body. The classic imaging features of exostosis and a cartilaginous cap were identified. The osteochondroma was confluent with marrow of the C6 articular pillar. A biopsy was performed for confirmation of the lesion's histological character. INTERVENTION: Surgical resection was performed to remove the osteochondroma. CONCLUSION: Clinical examination, radiological evaluation and advanced diagnostic imaging helped detect and characterize an incidental cervical spine mass.
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ranking = 0.5
keywords = exostosis
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8/9. Diaphyseal aclasis with spinal cord compression. Report of two cases and review of the literature.

    In diaphyseal aclasis, the exostoses usually involve long bones, although occasionally the spine is also affected. Very few cases of osteochondroma causing spinal cord compression have been cited. The authors report their experience with two cases of diaphyseal aclasis. In the first case spinal cord compression caused by an exostosis of the lamina of C-2 occurred in a 9-year-old boy; in the second case a large osteochondroma of C-5 occurred in a 45- year-old man. Also included in this report is a review of the literature highlighting the incidence of diaphyseal aclasis, its clinical features and its excellent prognosis in treated cases.
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keywords = exostosis
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9/9. Surgical management of dumbbell and paraspinal tumors of the thoracic and lumbar spine.

    The lateral extracavitary approach was used for single-staged tumor resection in 12 patients with complex dumbbell or paraspinal tumors of the thoracic and lumbar spine. Six women and six men (age, 28-72 yr) were treated between August 1990 and January 1994. The tumors included schwannoma (6 patients), malignant meningioma (1 patient), hemangioma (1 patient), chondrosarcoma (1 patient), osteocartilaginous exostosis (1 patient), radiation-induced osteogenic sarcoma (1 patient), and metastatic renal carcinoma (1 patient). Gross total resection was achieved in 11 patients. Radical subtotal removal was performed in the remaining patient, who had a malignant osteogenic sarcoma. Concomitant spinal stabilization with internal fixation and anterior interbody strut grafting was performed on two patients. No significant perioperative complications occurred. Ten patients were alive and clinically stable at follow-up visits ranging from 14 to 55 months. Two patients died from systemic tumor dissemination during the follow-up period. The lateral extracavitary approach is useful when extensive or difficult spinal and paraspinal exposure is required. The surgical aspects of these neoplasms and the technique of lateral extracavitary approach are described in detail.
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