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Dural metastasis in patients with malignant neoplasm and chronic subdural hematoma

Objectives  – Dural metastasis associated with chronic subdural hematoma (CSH) is rare in patients with malignant neoplasm. In this study, biopsy of the dura and cytological examination of the subdural hematoma was performed for patients with malignant neoplasm and chronic subdural hematoma to investigate the association of dural metastasis and CSH.

Primary hemangiopericytoma in the axis bone: case report and review of literature.

OBJECTIVE AND IMPORTANCE To the best of our knowledge, this is the first reported case of primary hemangiopericytoma in the axis bone. With this report, we attempt to better characterize this uncommon lesion in the vertebral column. CLINICAL PRESENTATION This report describes a case of primary heman-giopericytoma in the axis bone of a 16-year-old female patient who presented with acute torticollis. Her neurological status was unimpaired. A lateral radiograph of the cervical spine demonstrated an odontoid neck fracture and a C1-C2 rotatory deformity. The magnetic resonance imaging study showed a hypodense lesion with moderate enhancement on T1- and T2-weighted images on the dens and body of the axis with an odontoid neck fracture. Reviewing the literature, primary hemangiopericytoma in the spine is rare; 9 cases of hemangiopericytoma with vertebral bone involvement and 44 cases of this tumor with intraspinal meningeal involvement have been reported. INTERVENTION The patient was treated with odontoidectomy via the transoral approach, along with posterior fixation using the Halifax clamp. She was followed up 17 months after surgery, and no evidence of tumor recurrence was found. CONCLUSION The treatment for osseous hemangiopericytoma is still controversial. At present, adequate surgical removal with postoperative radio-therapy is recommended. In addition, although hemangiopericytoma is rare in the spine, it should be kept in mind in the differential diagnosis of spinal tumors.

Intramedullary cavernous haemangiomas: clinical features, imaging diagnosis, surgical resection and outcome

The diagnosis, surgical treatment and outcome of seven patients with histologically verified intramedullary cavernous haemangiomas are reported. Five males and two females, with progressive myelopathy were observed. The patients were aged between 7 and 61 years. The duration of their symptoms and signs before diagnosis varied from one month to 5 years. Magnetic resonance (MR) imaging was performed in all patients and spinal angiography was performed in five. All the patients underwent microsurgical resection of the cavernous haemangiomas. MR imaging diagnosed cavernous haemangiomas in all seven patients. T1-weighted images with or without contrast enhancement best defined the margins and size of the lesions. They also illustrated the exophytic components and the change in spinal cord surface well, and were important to surgical planning. T2-weighted images may be suboptimal due to their magnetic susceptibility artifacts. In all lesions, total removal was achieved. Postoperative neurological function improved in all patients in long term follow-up. With the advantages of MR examinations and more understanding about the pathological characteristics of intramedullary cavernous haemangiomas, total removal of the mass lesion should be attempted and the outcome is generally good. Copyright 1999 Harcourt Publishers Ltd.

Solitary cerebellar metastasis from Ewing's sarcoma: case report and review of the literature

A rare case of Ewings sarcoma metastatic to the cerebellum is presented. Neurosurgical intervention was required which played a significant role in the treatment of this patient. The incidence and treatment of central nervous system involvement from Ewings sarcoma is reviewed and discussed.