scholarly journals Solitary Spinal Epidural Metastasis from Gastric Cancer

2016 ◽  
Vol 2016 ◽  
pp. 1-4 ◽  
Author(s):  
Taisei Sako ◽  
Yasuaki Iida ◽  
Yuichirou Yokoyama ◽  
Shintaro Tsuge ◽  
Keiji Hasegawa ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Epidural Space ◽  
Malignant Tumor ◽  
Metastatic Tumor ◽  
Spinal Tumor ◽  
Whole Body ◽  
Thoracic Spinal ◽  
Epidural Metastasis ◽  
Metastatic Spinal Tumor ◽  
Spinal Epidural

Solitary epidural space metastasis of a malignant tumor is rare. We encountered a 79-year-old male patient with solitary metastatic epidural tumor who developed paraplegia and dysuria. The patient had undergone total gastrectomy for gastric cancer followed by chemotherapy 8 months priorly. The whole body was examined for suspected metastatic spinal tumor, but no metastases of the spine or important organs were observed, and a solitary mass was present in the thoracic spinal epidural space. The mass was excised for diagnosis and treatment and was histopathologically diagnosed as metastasis from gastric cancer. No solitary metastatic epidural tumor from gastric cancer has been reported in English. Among the Japanese, 3 cases have been reported, in which the outcome was poor in all cases and no definite diagnosis could be made before surgery in any case. Our patient developed concomitant pneumonia after surgery and died shortly after the surgery. When a patient has a past medical history of malignant tumor, the possibility of a solitary metastatic tumor in the epidural space should be considered.

scholarly journals Two cases of hemolymphangioma in the thoracic spinal canal and spinal epidural space on MRI

Medicine ◽  
2017 ◽  
Vol 96 (52) ◽  
pp. e9524
Author(s):  
Xingchen Pan ◽  
Yutong Dong ◽  
Tingting Yuan ◽  
Yuzhu Yan ◽  
Dan Tong
Keyword(s):  
Epidural Space ◽  
Spinal Canal ◽  
Thoracic Spinal ◽  
Spinal Epidural

scholarly journals Primary Extraskeletal Ewing Sarcoma of the Thoracic Spinal Epidural Space: A Case Report

2007 ◽  
Vol 1 ◽  
pp. CMO.S332
Author(s):  
Yasuhiro Yamamoto ◽  
Osuke Washimi ◽  
Daisuke Ishimura ◽  
Harumoto Yamada ◽  
Makoto Kuroda ◽  
...  
Keyword(s):  
Epidural Space ◽  
Ewing Sarcoma ◽  
Chromosomal Translocation ◽  
Fusion Transcript ◽  
Complete Excision ◽  
Thoracic Spinal ◽  
Polymerase Chain ◽  
Spinal Epidural ◽  
Extraskeletal Ewing Sarcoma ◽  
Disease Free

Cases of extraskeletal Ewing sarcoma (EES) originating primarily within the spinal epidural space, are very rare and have a very poor prognosis. There is no standard therapy for this disease. We report the case of a 23-year-old man presenting with symptoms of back pain and numbness of both legs for 10 days. Imaging studies revealed a dorsal soft-tissue, extradural mass at the T8–9 vertebral level. The patient underwent a laminectomy and complete excision of the tumor. The EES diagnosis was confirmed by histologic analysis including immunohistochemistry and by presence of the EWS-ERG due to the t (21: 22) (q22: q12) chromosomal translocation by a reverse transcriptase-polymerase chain reaction (RT-PCR). This is the first report of spinal epidural EES with presence of the EWS-ERG fusion transcript. Post-operatively, the patient received aggressive adjuvant chemotherapy and radiotherapy. At 63 months after surgery, the patient is without clinical or radiological evidence of recurrent or metastatic disease. Early discovery of EES and a complete resection followed by the aggressive treatment with radiation and chemotherapy may improve disease-free and overall survival.

scholarly journals Mixed adenoneuroendocrine carcinoma with loss of HER2 positivity after trastuzumab-based chemotherapy for HER2-positive gastric cancer: a case report

2020 ◽  
Vol 6 (1) ◽  
Author(s):  
Hiromi Nagata ◽  
Hironori Tsujimoto ◽  
Yoshihisa Yaguchi ◽  
Keita Kouzu ◽  
Yujiro Itazaki ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Rare Case ◽  
Metastatic Tumor ◽  
Endoscopic Biopsy ◽  
Her2 Status ◽  
Resected Specimen ◽  
Her2 Positive ◽  
Standard Regimen ◽  
Mixed Adenoneuroendocrine Carcinoma ◽  
Her2 Positivity

Abstract Background Trastuzumab (T-mab)-based chemotherapy is a standard regimen for human epithelial growth factor 2 (HER2)-positive gastric cancer. However, some patients have demonstrated a change in HER2 status after T-mab-based treatment of breast cancer. We report a rare case of mixed adenoneuroendocrine carcinoma with loss of HER2 positivity after T-mab-based chemotherapy for HER2-positive gastric cancer. Case presentation A 60-year-old man presented with a mass of the upper abdomen, which was diagnosed as adenocarcinoma with a HER2 score of 3+ by endoscopic biopsy. He received seven cycles of combination chemotherapy with capecitabine, cisplatin, and T-mab. Subsequently, he underwent open total gastrectomy, distal pancreatosplenectomy, and extended left hepatic lobectomy as a conversion surgery. The surgically resected specimen demonstrated both adenocarcinoma and neuroendocrine components; therefore, it was diagnosed as HER2-negative mixed adenoneuroendocrine carcinoma. Although the patient received additional chemotherapy, multiple liver metastases appeared at 3 months postoperatively and he died at 6 months postoperatively because of the rapidly progressing metastatic tumor. Conclusions We encountered a rare case of rapidly progressive mixed adenoneuroendocrine carcinoma that was negative for HER2 expression after T-mab treatment combined with chemotherapy.

scholarly journals Incidence and Risk Factors for Symptomatic Spinal Epidural Hematoma Following Posterior Thoracic Spinal Surgery in a Single Institute

2020 ◽  
pp. 219256822097914
Author(s):  
Longjie Wang ◽  
Hui Wang ◽  
Zhuoran Sun ◽  
Zhongqiang Chen ◽  
Chuiguo Sun ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cerebrospinal Fluid ◽  
Spinal Surgery ◽  
Cerebrospinal Fluid Leakage ◽  
Sectional Area ◽  
Kyphosis Angle ◽  
Cross Sectional ◽  
Thoracic Spinal ◽  
Local Kyphosis ◽  
Spinal Epidural

Study Design: Case-control study. Objectives: To investigate the incidence of symptomatic spinal epidural hematoma (SSEH) and recognize its risk factors in a cohort of patients undergoing posterior thoracic surgery in isolation. Methods: From January 2010 to December 2019, patients who developed SSEH after posterior thoracic surgery and underwent hematoma evacuation were enrolled. For each SSEH patient, 2 or 3 controls who did not develop SSEH and underwent the same procedures with similar complexity at the same section of the thoracic spine in the same period were collected. The preoperative and intraoperative factors, blood pressure-related factors and radiographic parameters were collected to identify possible risk factors by comparing between the 2 groups. Results: A total of 24 of 1612 patients (1.49%) were identified as having SSEH after thoracic spinal surgery. Compared to the control group (53 patients), SSEH patients had significant differences in the APTT (p = 0.028), INR (p = 0.009), ratio of previous spinal surgery (p = 0.012), ratio of cerebrospinal fluid leakage (p = 0.004), thoracic kyphosis (p<0.05), local kyphosis angle (p<0.05), epidural fat ratio at T7 (p = 0.003), occupying ratio of the cross-sectional area (p<0.05) and spinal epidural venous plexus grade (p<0.05). Multiple logistic regression analysis revealed 3 risk factors for SSEH: cerebrospinal fluid leakage, the local kyphosis angle (>8.77°) and the occupying ratio of the cross-sectional area (>49.58%). Conclusions: The incidence of SSEH was 1.49% in posterior thoracic spinal surgeries. Large local kyphosis angle (>8.77°), high occupying ratio of cross-sectional area (>49.58%) and cerebrospinal fluid leakage were identified as risk factors for SSEH.

scholarly journals Just the Facts: Risk stratifying non-traumatic back pain for spinal epidural abscess in the emergency department

CJEM ◽  
2020 ◽  
Vol 22 (6) ◽  
pp. 753-755
Author(s):  
Zoe Polsky ◽  
Shawn K. Dowling ◽  
W. Bradley Jacobs
Keyword(s):  
Emergency Department ◽  
Back Pain ◽  
Epidural Abscess ◽  
Spinal Epidural Abscess ◽  
Thoracic Spinal ◽  
Life Threatening ◽  
History Of ◽  
Magnetic Resonance Imaging Mri ◽  
Whole Spine ◽  
Spinal Epidural

A 65-year-old male with a history of hypertension presents to the emergency department (ED) with new onset of non-traumatic back pain. The patient is investigated for life-threatening diagnoses and screened for “red flag symptoms,” including fever, neurologic abnormalities, bowel/bladder symptoms, and a history of injectiondrug use (IVDU). The patient is treated symptomatically and discharged home but represents to the ED three additional times, each time with new and progressive symptoms. At the time of admission, he is unable to ambulate, has perineal anesthesia, and 500 cc of urinary retention. Whole spine magnetic resonance imaging (MRI) confirms a thoracic spinal epidural abscess. This case, and many like it, prompts the questions: when should emergency physicians consider the diagnosis of a spinal epidural abscess, and what is the appropriate evaluation of these patients in the ED? (Figure 1).

Extraosseous multiple myeloma mimicking spinal epidural metastasis

2012 ◽  
Vol 19 (10) ◽  
pp. 1448-1450 ◽  
Author(s):  
Jong-myung Jung ◽  
Sang Hoon Yoon ◽  
Seung-Jae Hyun ◽  
Ki-Jeong Kim ◽  
Kyoung Un Park ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Epidural Metastasis ◽  
Spinal Epidural ◽  
Spinal Epidural Metastasis

scholarly journals Thoracic spine schwannoma presenting with traumatic spinal cord injury: A case report

2021 ◽  
Vol 12 ◽  
pp. 251
Author(s):  
Daniela Matos ◽  
Ricardo Pereira
Keyword(s):  
Case Report ◽  
Thoracic Spine ◽  
Spinal Tumor ◽  
High Impact ◽  
Good Recovery ◽  
Motor Rehabilitation ◽  
Thoracic Spinal ◽  
Cord Injury ◽  
Early Diagnose ◽  
Dural Opening

Background: The presentation of a thoracic spinal tumor due to high-impact trauma is quite rare and we found no other case reported. Case Description: This is a case report and literature review. A patient presented with severe paraparesis on day 4 after trauma. Thoracic MRI showed an oval image centered to T4-T5 suggestive of hemorrhage. The patient underwent a bilateral T4 and T5 laminectomy and microsurgically assisted intradural exploration. After laminectomy, we found no extradural lesions, so we proceeded to dural opening, after which we found a large extramedullary lesion which was completely removed. Pathology revealed a schwannoma. The patient had a very good recovery after surgery and motor rehabilitation. At 6 months after surgery, inferior limbs muscle strength was completely normal. We found no other case reported. Conclusion: Thoracic spine schwannomas are difficult to early diagnose unless there is a clinical suspicion. Initial presentation as bleeding after trauma was not described before. This presentation should be kept in the differential diagnosis of any patient with an acute neurological deficit without trauma signs on admission imaging.

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