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Titolo:
THE SURGICAL-TREATMENT OF METASTATIC SPINAL TUMORS WITHIN THE INTRADURAL EXTRAMEDULLARY COMPARTMENT
Autore:
CHOW TSF; MCCUTCHEON IE;
Indirizzi:
UNIV TEXAS,MD ANDERSON CANC CTR,DEPT NEUROSURG,1515 HOLCOMBE BLVD,BOX64 HOUSTON TX 77030 UNIV TEXAS,MD ANDERSON CANC CTR,DEPT NEUROSURG HOUSTON TX 77030
Titolo Testata:
Journal of neurosurgery
fascicolo: 2, volume: 85, anno: 1996,
pagine: 225 - 230
SICI:
0022-3085(1996)85:2<225:TSOMST>2.0.ZU;2-9
Fonte:
ISI
Lingua:
ENG
Soggetto:
CEREBROSPINAL-FLUID CSF; MENINGEAL CARCINOMATOSIS; LEPTOMENINGEAL METASTASES; SYSTEMIC CANCER; CORD; NEOPLASMS; MR; CYTOLOGY; INFILTRATION; COMPRESSION;
Keywords:
SPINAL METASTASIS; SPINAL TUMOR; LEPTOMENINGEAL CARCINOMATOSIS; INTRADURAL SPINE SURGERY;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Science Citation Index Expanded
Science Citation Index Expanded
Citazioni:
46
Recensione:
Indirizzi per estratti:
Citazione:
T.S.F. Chow e I.E. Mccutcheon, "THE SURGICAL-TREATMENT OF METASTATIC SPINAL TUMORS WITHIN THE INTRADURAL EXTRAMEDULLARY COMPARTMENT", Journal of neurosurgery, 85(2), 1996, pp. 225-230

Abstract

The authors retrospectively reviewed the surgical outcomes in 10 cases of symptomatic intradural extramedullary spinal metastases of nonneurogenic origin because the collective experience in treating this raremanifestation of systemic cancer is limited. Pain and weakness were the presenting complaints in 70% of the patients and sensory changes were found in all cases. Cytological tests on one specimen of cerebrospinal fluid (CSF) from each of seven patients showed malignant cells in two cases. Gadolinium contrast-enhanced biplanar magnetic resonance (MR) imaging was effective in localizing the lesion and showed evidence of leptomeningeal carcinomatosis in two cases; myelography showed leptomeningeal carcinomatosis in one case and erroneously identified the lesion as intramedullary in the other. Eight of 10 cases had antecedentintracranial metastatic foci with the interval from presentation of the intracranial lesion to appearance of the spinal disease ranging from 3 to 51 months. The majority of the spinal lesions occurred in the thoracolumbar area. The most frequent histological type was adenocarcinoma and the most frequent source was the lung. In all cases laminectomies, intradural exploration, and biopsy or subtotal excision aided by microscopy and ultrasonography were performed. Results of surgical decompression were poor with only 30% of the patients showing improvement, at a 20% risk of perioperative mortality and a 60% risk of morbidity. Plans for surgical intervention in patients with intradural extramedullary metastases from a distant nonneurogenic source should be weighed against the high association with intracranial lesions, overall poorprognosis, and modest symptomatic results of decompression. Comprehensive evaluation including multiple specimens of CSF for cytology and contrast-enhanced MR imaging should be undertaken to exclude patients with diffuse leptomeningeal involvement, who should be treated by meansother than surgery.

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Documento generato il 19/01/20 alle ore 11:35:19