RESUMEN
A unique case of amyloidoma presenting as a dumbbell-shaped tumor of a spinal root without bony erosion is described. Amyloid was also present in the facial nerve. DNA analysis for transthyretin was negative. Isolated amyloid fibers contained lambda light chains, and although plasma and urine immunoelectrophoresis performed by immunofixation was normal, it is possible the tumor may have been derived from an isolated plasmacytoma.
Asunto(s)
Amiloidosis/patología , Síndromes de Compresión Nerviosa/etiología , Raíces Nerviosas Espinales/patología , Secuencia de Aminoácidos , Amiloidosis/complicaciones , Amiloidosis/diagnóstico , Amiloidosis/cirugía , Vértebras Cervicales/cirugía , Descompresión Quirúrgica , Errores Diagnósticos , Enfermedades del Nervio Facial/patología , Enfermedades del Nervio Facial/cirugía , Parálisis Facial/etiología , Humanos , Hipoestesia/etiología , Cadenas lambda de Inmunoglobulina/química , Laminectomía , Masculino , Persona de Mediana Edad , Datos de Secuencia Molecular , Esclerosis Múltiple/diagnóstico , Síndromes de Compresión Nerviosa/diagnóstico , Síndromes de Compresión Nerviosa/cirugía , Homología de Secuencia de Aminoácido , Nervio Trigémino/fisiopatologíaRESUMEN
Malignant myeloid blast cells may occasionally form a solid mass in tissues outside the haemopoietic system. These tumours are known as chloromas or granulocytic sarcomas. Chloromas occur most commonly in the context of acute myelogenous leukaemia but, rarely, they occur in the absence of other haematological disease, and may be misdiagnosed as lymphoma. A case of a previously well 35-year-old woman presenting with rapidly progressive triplegia caused by a paraspinal and extradural cervical chloroma with no evidence of bone marrow or other haematological involvement is described. Few cases of spinal cord compression caused by chloroma in otherwise healthy patients have been reported. Morphological features of myeloid differentiation, histochemistry and immunohistochemistry, may all aid in rapid diagnosis and allow early and appropriate therapy.
Asunto(s)
Vértebras Cervicales/patología , Leucemia Mieloide Aguda/diagnóstico , Paraplejía/diagnóstico , Sarcoma Mieloide/diagnóstico , Neoplasias de la Columna Vertebral/diagnóstico , Adulto , Biomarcadores de Tumor/metabolismo , Vértebras Cervicales/cirugía , Diagnóstico Diferencial , Femenino , Citometría de Flujo , Humanos , Técnicas para Inmunoenzimas , Imagen por Resonancia Magnética , Sarcoma Mieloide/metabolismo , Sarcoma Mieloide/cirugía , Compresión de la Médula Espinal/diagnóstico , Compresión de la Médula Espinal/etiología , Neoplasias de la Columna Vertebral/metabolismo , Neoplasias de la Columna Vertebral/cirugía , Resultado del TratamientoRESUMEN
Endovascular embolization techniques have increased the complexity of aneurysm surgery in those lesions that have been incompletely obliterated. We report a case of giant cerebral aneurysm initially treated with Guglielmi detachable coils which required cardiopulmonary bypass for successful endoaneurysmorrhaphy.
RESUMEN
OBJECTIVE: To examine the presentation, investigative findings, treatment and outcome in patients with spinal epidural abscess. DESIGN AND SETTING: The study was a retrospective analysis of all patients with this condition presenting to the Neurosurgical Units at the Royal Prince Alfred Hospital and Westmead Hospital, Sydney, during the period September 1984 to September 1987. PATIENTS: There was a total of 21 patients with an age range from 7-87 years (mean 47 years). Eleven cases were acute and ten chronic. The causative organism was Staphylococcus aureus in 15 of the 21 cases, the other organisms involved were Mycobacterium tuberculosis, Escherichia coli, Streptococcus and Pseudomonas aeruginosa. INTERVENTIONS: All patients were treated with a combination of surgery (decompression with or without fusion) and prolonged antibiotic administration. RESULTS: Of the 21 patients 11 had a good to excellent outcome while 10 had a poor outcome. CONCLUSION: The main determinant of outcome was the neurological state at presentation emphasising the importance of early diagnosis and prompt treatment.