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OBJECTIVE: This study was conducted to systematically analyze the data on the clinical features, surgical treatment, and outcomes of spinal schwannomas. METHODS: We conducted a systematic review and meta-analysis under the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A search of bibliographic databases from January 1, 2001, to May 31, 2021, yielded 4489 studies. Twenty-six articles were included in our final qualitative systematic review and quantitative meta-analysis. RESULTS: Analysis of 2542 adult patients' data from 26 included studies showed that 53.5% were male, and the mean age ranged from 35.8 to 57.1 years. The most common tumor location was the cervical spine (34.2%), followed by the thoracic spine (26.2%) and the lumbar spine (18.5%). Symptom severity was the most common indicator for surgical treatment, with the most common symptoms being segmental back pain, sensory/motor deficits, and urinary dysfunction. Among all patients analyzed, 93.8% were treated with gross total resection, which was associated with better prognosis and less chance of recurrence than subtotal resection. The posterior approach was the most common (87.4% of patients). The average operative time was 4.53 hours (95% confidence interval [CI], 3.18-6.48); the average intraoperative blood loss was 451.88 mL (95% CI, 169.60-1203.95). The pooled follow-up duration was 40.6 months (95% CI, 31.04-53.07). The schwannoma recurrence rate was 5.3%. Complications were particularly low and included cerebrospinal fluid leakage, wound infection, and the sensory-motor deficits. Most of the patients experienced complete recovery or significant improvement of preoperative neurological deficits and pain symptoms. CONCLUSIONS: Our analysis suggests that segmental back pain, sensory/motor deficits, and urinary dysfunction are the most common symptoms of spinal schwannomas. Surgical resection is the treatment of choice with overall good reported outcomes and particularly low complication rates. gross total resection offers the best prognosis with the slightest chance of tumor recurrence and minimal risk of complications.
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Recurrencia Local de Neoplasia , Neurilemoma , Adulto , Humanos , Masculino , Persona de Mediana Edad , Femenino , Resultado del Tratamiento , Recurrencia Local de Neoplasia/epidemiología , Recurrencia Local de Neoplasia/cirugía , Recurrencia Local de Neoplasia/etiología , Neurilemoma/cirugía , Procedimientos Neuroquirúrgicos/efectos adversos , Dolor de Espalda/etiología , Dolor de Espalda/cirugía , Estudios RetrospectivosRESUMEN
Background: Lumbar plexus schwannomas are a rare occurrence in neurosurgery, with few reported cases and no standard surgical approach. This study describes a successful surgical resection with no complications using the Wiltse approach. Methods: Patient presented with an intra-psoas tumor suggesting schwannoma. We described the surgical technique involved step by step. Results: The patient recovered from the surgery with no complications. The anatomopathological examination confirmed the schwannoma diagnosis. The post operatory magnetic resonance imaging showed complete resection. Conclusion: This study shows that the use of Wiltse approach, mainly used for classical herniated disc extraforaminal, can be used successfully on Lumbar plexus schwannomas.
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Resumen El complejo de Carney es una enfermedad caracterizada por lesiones en la piel, tumores endocrinos, cardiacos, gonadales y en otros órganos, que está asociada con mutaciones del gen PRKAR1A. Presentamos el caso clínico de una paciente con varias de las manifestaciones más características de este síndrome. Finalmente, se hace una revisión de la literatura.
Abstract Carney complex is a disease characterized by skin lesions, endocrine, cardiac, gonadal and other organ tumors, associated with mutations of the PRKAR1A gene. We present the clinical case of a patient with several of the most characteristic manifestations of this syndrome. Finally, there will be a review of the literature.
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Vestibular schwannomas are the most common benign tumors of the pontocerebellar angle,1,2 their microsurgical complexity is related to their size and neurovascular relationships. The purpose of this work is to analyze the clinical, anatomic characteristics, microsurgical treatment, and the postoperative results according to the Hannover gradual scale in 4 patients with vestibular schwannomas. The 4 patients gave their consent to the procedure and all consented to the use of their surgical videos, preoperative and postoperative studies, and postoperative pictures. Case 1: A 39-yr-old woman, with left ear hearing loss. Magnetic resonance imaging (MRI) showed small Intracanalicular schwannoma (T1 classification by Hannover). Microsurgery was performed and resection through a retrosigmoid approach2,3 with anatomic and functional preservation of the facial and cochlear nerve. Case 2: A 40-yr-old woman, with left ear hypoacusia. MRI showed an extrameatal schwannoma reaching the brainstem (T3b Hannover classification). The complete re-section through retrosigmoid approach were performed. Case 3: A 69-yr-old woman, without hearing in the right ear. RM: Medium schwannoma (T4a classification of Hannover). Microsurgery was performed with anatomic and functional preservation of the facial nerve.4-6 Case 4: A 32-yr-old woman, without hearing in the left ear. In addition, cerebellar syndrome and headache. RM: Large schwannoma (T4b classification of Hannover). Sur-gery was performed, anatomic preservation of the facial nerve, with moderate paresis in the postoperative period. Microsurgical resection with functional preservation of the facial and cochlear nerve is the main objective7 when addressing this pathology.
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Neuroma Acústico , Adulto , Anciano , Nervio Coclear , Nervio Facial/cirugía , Femenino , Humanos , Imagen por Resonancia Magnética , Microcirugia , Neuroma Acústico/diagnóstico por imagen , Neuroma Acústico/cirugíaRESUMEN
La neurofibromatosis (NF) comprende un grupo de enfermedades genéticas de herencia autosómica dominante, que se clasifican de la siguiente manera: neurofibromatosis tipo 1 (NF1), neurofibromatosis tipo 2 (NF2) y schwannomatosis (también conocida como neurofibromatosis tipo 3). Esta última es una enfermedad muy infrecuente, con una prevalencia aproximada de 1/126 000 personas, por lo que solo profundizaremos las dos primeras. La NF1, también conocida como la enfermedad de Von Recklinghausen, es la más frecuente de las tres y afecta principalmente la piel y el sistema nervioso periférico. Se caracteriza por la presencia de máculas "café con leche", pecas axilares o inguinales, nódulos de Lisch (hamartomas en el iris) y neurofibromas (tumores de la vaina de nervios periféricos). Otras manifestaciones menos frecuentes, aunque de mayor gravedad, incluyen gliomas del nervio óptico, meningiomas, neurofibromas malignos, escoliosis y displasia de la tibia. Su diagnóstico se suele realizar al nacimiento o durante los primeros años de vida, y se estima que un 50% de quienes la padecen presenta dificultades cognitivas. No hay datos concluyentes sobre la mortalidad en los pacientes con NF1, aunque se sabe que la expectativa de vida es menor que en la población general. La NF2 tiene una prevalencia considerablemente menor que la NF1 y su inicio es más tardío, afectando principalmente a adultos jóvenes. La presentación clínica típica se caracteriza por acúfenos, hipoacusia y ataxia en contexto de la presencia de schwannomas vestibulares bilaterales. Otros hallazgos menos frecuentes incluyen schwannomas de nervios periféricos, meningiomas, ependimomas o astrocitomas. La esperanza de vida es de unos 36 años, con una supervivencia media desde el momento del diagnóstico de 15 años. (AU)
Neurofibromatosis (NF) includes a group of genetic diseases with an autosomal-dominant inheritance pattern, and they are classified as follows: Neurofibromatosis type 1 (NF1), neurofibromatosis type 2 (NF2) and Schwannomatosis (also known as neurofibromatosis type 3). This last one is a very rare disease, with an approximate prevalence of 1/126000, so we will only deepen in the first two. NF1, also known as von Recklinghausen disease, is the most frequent, and mainly affects the skin and peripheral nervous system. Its typical manifestations are the presence of café-au-lait macules, axillary or inguinal freckles, Lisch nodules (hamartomas in the iris) and neurofibromas (peripheral nerve sheath tumors). Less frequent manifestations, although more serious, include optic nerve gliomas, meningiomas, malignant neurofibromas, scoliosis and tibial dysplasia. The diagnosis is usually made at birth or during the first years of life, and approximately 50% of patients present cognitive difficulties. There is no conclusive data on mortality in patients with NF1, although it is known that life expectancy is lower than in general population. NF2 has a considerably lower prevalence than NF1, and its onset is later in life, mainly affecting young adults. Its typical clinical presentation is characterized by tinnitus, hearing loss and ataxia in the context in the presence of bilateral vestibular schwannomas. Less frequent findings include peripheral nerve schwannomas, meningiomas, ependymomas or astrocytomas. Life expectancy is about 36 years old, with a median survival from the moment of diagnosis of 15 years. (AU)
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Humanos , Masculino , Femenino , Recién Nacido , Lactante , Adulto , Adulto Joven , Neurofibromatosis 2/etiología , Neurofibromatosis 1/etiología , Neurofibromatosis/clasificación , Astrocitoma/fisiopatología , Ataxia , Escoliosis/fisiopatología , Tibia/anomalías , Acúfeno , Enfermedades del Desarrollo Óseo/fisiopatología , Neuroma Acústico/complicaciones , Esperanza de Vida , Neurofibromatosis 2/epidemiología , Neurofibromatosis 1/fisiopatología , Neurofibromatosis 1/mortalidad , Neurofibromatosis 1/epidemiología , Neurofibromatosis/diagnóstico , Glioma del Nervio Óptico/fisiopatología , Ependimoma/fisiopatología , Pérdida Auditiva , Enfermedades del Iris/fisiopatología , Melanosis/fisiopatología , Meningioma/fisiopatología , Neurilemoma/etiología , Neurilemoma/fisiopatología , Neurofibroma/fisiopatología , Neurofibroma/patologíaRESUMEN
Introduction Schwannomas are benign tumors originating from the cells, which wrap around axons that are usually encapsulated and solitary. These tumors usually lead to little or no symptomatology. They are usually the most common peripheral nerve tumors in adults, with their highest incidence between the third and fifth decades of life. Objective To perform a review about schwannoma of the peripheral nerves, presenting its definition, epidemiology, diagnosis, symptomatology and treatment. Methodology This is a descriptive work, based on a review of articles available in the PubMed database with the descriptors schwannoma and peripheral nerves. Results and Discussion Only papers published between 1981 and 2019, describing studies in humans, and that were available as full articles were selected. A total of 391 articles were included; after reading the titles, we noted that 67 articles fit the topic of the present study. Among the articles selected for reading, 33 fit the objectives of the present work, and were considered for the writing of the present article. Conclusion Schwannomas are benign myelin sheath tumors that develop with local symptomatology or asymptomatic and present a good surgical prognosis with generally reduced rates of surgical complications.
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Neurilemoma/cirugía , Neurilemoma/etiología , Neurilemoma/fisiopatología , Neurilemoma/epidemiología , Neurilemoma/diagnóstico por imagen , Enfermedades del Sistema Nervioso PeriféricoRESUMEN
Neurilemmomas are rare benign tumors derived from the peripheral nerve sheath and composed of perineural Schwann cells proliferating in a characteristic pattern. They are usually benign, slow-growing and often detected incidentally or by local symptoms secondary to compression of neighboring organs. These solitary tumors are located mainly in head and neck, frequently along the path of peripheral nerves, and are particularly rare as retroperitoneal and pelvic tumors. They represent less than 1% of pelvic tumors, and can reach large dimensions. Degenerated or ancient neurilemmomas present typical degenerative characteristics secondary to aging and decreased vascularization. These characteristics can lead to misinterpretation and confusion with a malignant lesion. Tumors are well encapsulated and recurrences are rare following complete surgical excision. The potential risk of surgical excision is neurological injury. We present the case of a degenerated benign pelvic neurilemmoma.
Los neurilemomas son tumores raros y benignos derivados de la vaina nerviosa periférica, compuesto por la proliferación de las células de Schwann perineurales con un patrón característico. Generalmente son benignos, de crecimiento lento y, con frecuencia, se les detecta de forma incidental o con síntomas locales secundarios a compresión de órganos vecinos. Estos tumores solitarios se localizan principalmente en cabeza y cuello, a menudo a lo largo del trayecto de los nervios y son particularmente raros entre los tumores retroperitoneales y de la pelvis. Los tumores pélvicos representan menos del 1% de todos los casos, pudiendo alcanzar grandes dimensiones. El neurilemoma degenerado o antiguo presenta características degenerativas típicas secundarias al envejecimiento y disminución de la vascularización. Todas estas características pueden llevar a la interpretación errónea y confundirlo con una lesión maligna. Los tumores están bien encapsulados y las recurrencias después de una escisión quirúrgica completa son poco frecuentes. La escisión quirúrgica conlleva el riesgo potencial de lesión neurológica. Presentamos un caso de neurilemoma pélvico benigno degenerado.
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Extramedullary intradural tumors constitute up to 25% of the spinal tumors. Commonly, schwannomas that presents with extradural and intradural compromise are called dumbbell-shaped tumor. The thoracic spine is a common localization for these tumors, especially in pediatric population. Given this surgically difficult localization, some classic approaches for spine tumors can be mixed with modified approaches like the costotransversectomy. The main objective of this report is expose three different pediatric cases in which mixed approach (costotransversectomy plus hemilaminectomy) was implemented for thoracic spine dumbbell-shaped schwannoma resection. It was achieved complete surgical resection without major perioperative complications in the three cases.
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Schwannomas of the female genital tract are extremely uncommon. They are usually benign, and simple excision is the adequate treatment. The case of a 57-year-old woman with a cellular schwan-noma of the vagina is described, in addition to a summarized literature review of schwannomas in the female genital tract. Complete excision was performed, and the histological report confirmed to be a vaginal Schwannoma. Due to its possibility to occur, even if in a very low incidence scenario, Schwan-nomas should not be excluded from the differential diagnosis of a vaginal mass. (AU)
Schwannomas do trato genital feminino são extremamente raros. São tumores geralmente benignos e a excisão simples é o tratamento adequado. Neste artigo descreve-se o caso de uma mulher de 57 anos com Schwannoma vaginal, além de uma revisão resumida da literatura sobre schwannomas no trato genital feminino. A excisão completa foi realizada e o estudo histológico confirmou o diagnóstico de Schwannoma vaginal. Devido à sua possibilidade de ocorrer, mesmo num cenário de incidência muito baixa, os Schwannomas não devem ser excluídos do diagnóstico diferencial de massas vaginais (AU)
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Humanos , Femenino , Persona de Mediana Edad , Nervios Periféricos , Neoplasias , NeurilemomaRESUMEN
Introducción: La gran mayoría de lesiones que comprometen el conducto auditivo interno corresponden a schwannomas vestibulares (90%). Dentro de las nuevas pruebas diagnósticas del sistema vestibular aparece la prueba de impulso cefálico y su registro con el video Head Impulse Test (v-HIT) que permite el estudio de todos los canales semicirculares. Objetivo: Comparar el v-HIT para canales semicirculares laterales con las pruebas calóricas clásicas registradas mediante videonistagmografía en el comportamiento de los neurinomas intracanaliculares y evaluar su utilidad como test diagnóstico. Material y método: Dieciocho pacientes fueron reclutados con diagnóstico de neurinomas, confirmado mediante resonancia magnética y estudios con pruebas calóricas clásicas y v-HIT para canal horizontal. Resultados: Los resultados anormales de asimetría de ganancia y de sacadas correctivas fue de 13 pacientes (72%) y con hipoexcitabilidad en la prueba calórica fue de 9 pacientes (50%), con una sensibilidad de la prueba de 72% para vHIT y de 50% para la prueba calórica al compararlo con la resonancia magnética. Conclusión: El v-HIT es una herramienta complementaria a las pruebas calóricas y debe ser incluida como test diagnóstico dentro de la batería de exámenes para evaluar el sistema vestibular en forma completa mediante un vestibulograma.
Introduction: The majority of injuries involving the internal auditory canal correspond to vestibular schwannomas (90%). Within the new diagnostic tests for the vestibular system appears the Head Impulse test and the video head impulse test (v-HIT) which allows the studying of all the semicircular canals. Aim: Compare the v-HIT lateral semicircular canals with classical caloric tests recorded by videonistagmography (VNG) in the behavior of intracanalicular neuroma and evaluate its usefulness as a diagnostic test. Material and method: Eigtheen patients were enrolled with a diagnosis of schwannomas, confirmed by MRI and studied classical caloric tests and v-HIT for horizontal channel. Results: Abnormal results of asymmetry gain and corrective saccades was 13 patients (72%) and hypoexcitability in the caloric test was 9 patients (50%), with a test sensitivity of 72% for vHIT and 50% for caloric test compared with MRI. Conclusions: The v-HIT is a complementary tool to caloric tests and should be included as a diagnostic test within the battery of tests to evaluate the vestibular system in complete form by vestibulogram.
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Humanos , Masculino , Femenino , Adulto , Persona de Mediana Edad , Anciano , Neuroma Acústico/diagnóstico , Prueba de Impulso Cefálico/métodos , Grabación en Video , Pruebas Calóricas/métodos , Canales Semicirculares , Neuroma Acústico/fisiopatología , Estudios ProspectivosRESUMEN
Objetivo. Presentar nuestra experiencia en el tratamiento de los Schwannomas vestibulares quísticos comparándolos con lesiones sólidas. Material y método. Se evaluaron en forma retrospectiva los síntomas de presentación clínica, tasas de preservación facial, grado de resección quirúrgica, complicaciones postoperatorias y hallazgos histológicos de los Schwannomas quísticos pareados en base al tamaño tumoral con un grupo de lesiones sólidas. Resultados. Durante el período junio 1995 julio 2010, 27 pacientes con Schwannomas quísticos se operaron en nuestro Departamento. El diámetro promedio fue de 29,6 mm. Los síntomas de presentación clínica más frecuentes fueron la hipoacusia, inestabilidad en la marcha y parestesias faciales. Al año de cirugía, el 74% de los pacientes tenían función facial HB I-III sin diferencias significativas con el grupo de lesiones sólidas. La remoción completa fue 55,5% y 85% de los pacientes en las lesiones quísticas ysólidas respectivamente. Conclusión. Los Schwannomas quísticos deben ser evaluados en forma separada de las lesiones sólidas debido a que pueden crecer rápidamente, presentar mayor complejidad quirúrgica y desarrollar complicaciones postoperatorias con mayor frecuencia.(AU)
Objective. To present our experience treating this rare tumor variant.Material and Method. Retrospective evaluation of an institutional cystic vestibular schwannoma series, based on initial symptoms, rate of facial preservation, extent of surgical resection, postoperative complication rate and cystic lesion quantificationon histology in comparison to solid tumor type. Results. During the period June 1995-July 2010, 27 cysticschwannomas were operated on at the FLENI neurological Institute. Mean tumor diameter was 29,6mm. The most frequent presenting symptoms included hypoacusia, unsteadiness and facial paresthesias. One year after surgery, 74% of patients presented facial function HB I-III, showing no statistical difference in comparison to solid lesions. Complete surgical resectionwas possible in 55, 5% of the cystic and 85% of the solid tumor groups, respectively. Conclusion. Cystic vestibular schwannomas should be identified separately from vestibular schwannomas in general, particularlybecause they often undergo more rapid expansion, and may present greater surgical risk as well as higher rates ofpostoperative complications.(AU)
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Neuroma Acústico , Quistes , Cirugía GeneralRESUMEN
Objetivo. Presentar nuestra experiencia en el tratamiento de los Schwannomas vestibulares quísticos comparándolos con lesiones sólidas. Material y método. Se evaluaron en forma retrospectiva los síntomas de presentación clínica, tasas de preservación facial, grado de resección quirúrgica, complicaciones postoperatorias y hallazgos histológicos de los Schwannomas quísticos pareados en base al tamaño tumoral con un grupo de lesiones sólidas. Resultados. Durante el período junio 1995 julio 2010, 27 pacientes con Schwannomas quísticos se operaron en nuestro Departamento. El diámetro promedio fue de 29,6 mm. Los síntomas de presentación clínica más frecuentes fueron la hipoacusia, inestabilidad en la marcha y parestesias faciales. Al año de cirugía, el 74% de los pacientes tenían función facial HB I-III sin diferencias significativas con el grupo de lesiones sólidas. La remoción completa fue 55,5% y 85% de los pacientes en las lesiones quísticas ysólidas respectivamente. Conclusión. Los Schwannomas quísticos deben ser evaluados en forma separada de las lesiones sólidas debido a que pueden crecer rápidamente, presentar mayor complejidad quirúrgica y desarrollar complicaciones postoperatorias con mayor frecuencia.
Objective. To present our experience treating this rare tumor variant.Material and Method. Retrospective evaluation of an institutional cystic vestibular schwannoma series, based on initial symptoms, rate of facial preservation, extent of surgical resection, postoperative complication rate and cystic lesion quantificationon histology in comparison to solid tumor type. Results. During the period June 1995-July 2010, 27 cysticschwannomas were operated on at the FLENI neurological Institute. Mean tumor diameter was 29,6mm. The most frequent presenting symptoms included hypoacusia, unsteadiness and facial paresthesias. One year after surgery, 74% of patients presented facial function HB I-III, showing no statistical difference in comparison to solid lesions. Complete surgical resectionwas possible in 55, 5% of the cystic and 85% of the solid tumor groups, respectively. Conclusion. Cystic vestibular schwannomas should be identified separately from vestibular schwannomas in general, particularlybecause they often undergo more rapid expansion, and may present greater surgical risk as well as higher rates ofpostoperative complications.
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Quistes , Cirugía General , Neuroma AcústicoRESUMEN
Objective. To present and evaluate the surgical results in the treatment of intracranial schwannomas. Method. We present 26 patients with intracranial schwannomas for a period of 10 years treated with surgery, analyze kind ofpresentation and postoperative results. Results. One of the cases corresponded to schwanoma of III pair, another case to schwanoma of the V pair, two other cases corresponded to schwanoma of the IX pair and twenty two cases corresponded to schwanomas of the VIII pair. Average age was 51,95 años (19-73). Total resection was made in 25 patients, partial resection was made in other. Facial nerve preservation was made in the remaining 22 patients. Preservation auditory nerve function was made in all the cases. We had 3 cases of cerebrospinal fluid leak.There were no mortal cases associated to the surgical procedure. Conclusion. The goal of treatment of intracranial schwanomas is total resection with anatomical and functional preservation of neurological structures around. This could be accomplished by retrosigmoid approach by experienced neurosurgeons.(AU)
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Nervio Facial , Neurilemoma , Interpretación Estadística de DatosRESUMEN
Objective. To present and evaluate the surgical results in the treatment of intracranial schwannomas. Method. We present 26 patients with intracranial schwannomas for a period of 10 years treated with surgery, analyze kind ofpresentation and postoperative results. Results. One of the cases corresponded to schwanoma of III pair, another case to schwanoma of the V pair, two other cases corresponded to schwanoma of the IX pair and twenty two cases corresponded to schwanomas of the VIII pair. Average age was 51,95 años (19-73). Total resection was made in 25 patients, partial resection was made in other. Facial nerve preservation was made in the remaining 22 patients. Preservation auditory nerve function was made in all the cases. We had 3 cases of cerebrospinal fluid leak.There were no mortal cases associated to the surgical procedure. Conclusion. The goal of treatment of intracranial schwanomas is total resection with anatomical and functional preservation of neurological structures around. This could be accomplished by retrosigmoid approach by experienced neurosurgeons.
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Nervio Facial , Neurilemoma , Interpretación Estadística de DatosRESUMEN
Introducción: Los tumores de la columna son lesiones poco comunes que afectan a una porción menor de la población, sin embargo, pueden causar morbilidad significativa y estar asociados a mortalidad. Representan 15 % de los tumores craneoespinales. El objetivo del presente trabajo fue definir la frecuencia de tumores intradurales extramedulares de columna vertebral en el Servicio de Cirugía de Columna Vertebral del Instituto Nacional de Rehabilitación, y su diagnóstico histopatológico definitivo. Material y métodos: Estudio retrospectivo de una serie de pacientes tratados quirúrgicamente entre 1996 y 2006 por diagnóstico de tumor intradural extramedular. Se evaluó sexo, edad, localización, sintomatología y tipo de tumor. Resultados: Se revisaron 27 pacientes, 11 hombres y 16 mujeres, con edad promedio de 47.33 años. Los síntomas principales fueron dolor y pérdida de la fuerza. La localización más frecuente fue la torácica seguida de la lumbar; el diagnóstico histopatológico indicó meningioma en 12 casos, schwannoma en 12 y neurofibroma en tres. Conclusiones: La sintomatología, localización y predominio de sexo son similares a los informados en la literatura. A diferencia de otras series, los tumores más frecuentes en la nuestra fueron schwannomas y meningiomas. Es importante el diagnóstico oportuno y tratamiento adecuado, que en nuestros pacientes consistió en resección total con laminoplastia, para evitar secuelas neurológicas permanentes.
BACKGROUND: Spine tumors are uncommon injuries affecting a low percentage of the population; however, these tumors can cause significant morbidity and may be related to mortality. They represent 15% of craniospinal tumors. The objective of this study is to determine the frequency of intradural extramedullary spine tumors treated in our Service and to report the definitive histopathological diagnosis. METHODS: This was a retrospective study in a series of patients treated surgically with a diagnosis of intradural extramedullary tumor in the Spine Service of the National Rehabilitation Institute (Mexico) from 1996 to 2006. The following variables were evaluated: gender, age, tumor localization, symptomatology and type of tumor. RESULTS: Files of 27 patients were reviewed. There were 11 men and 16 women with an average age of 47.33 years. The main symptoms were pain and motor weakness. The most frequent localization was thoracic followed by lumbar. Histopathological diagnosis reported 12 cases of meningioma, 12 cases of schwannoma and 3 cases of neurofibroma. CONCLUSIONS: Symptomatology, localization and gender predominance are similar to that reported in the literature. Different from other series, schwannomas and meningiomas were the most frequent tumors in our study. Appropriate diagnosis and opportune treatment consisting of total resection with laminoplasty are crucial in order to avoid permanent neurological consequences.
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Humanos , Masculino , Femenino , Adulto , Persona de Mediana Edad , Neoplasias de la Médula Espinal , México , Neoplasias de la Médula Espinal/epidemiología , Neoplasias de la Médula Espinal/patología , Neoplasias de la Médula Espinal/cirugía , Centros de Rehabilitación , Estudios Retrospectivos , Adulto JovenRESUMEN
Doze casos de tumores do sistema nervoso periférico, sete schwannomas e cinco neurofibromas foram diagnosticados entre 1964 e 2004, em caninos e bovinos. Histologicamente, as células predominantes nos schwannomas eram fusiformes organizavam-se em paliçada ou em feixes aleatórios. Nos neurofibromas as células neoplásicas eram fusiformes e se originavam da periferia dos nervos formando ninhos e feixes. O tecido conjuntivo era mais abundante nos neurofibromas e os colágenos dos tipos I e III eram os principais constituintes desses neoplasmas. Os neurofibromas foram caracterizados por uma concentração alta e difusa de mastócitos, provavelmente devido à origem das células neoplásicas do perineuro e epineuro. A coloração de AgNOR não se mostrou eficiente como indicador de prognóstico nos neoplasmas analisados. Imunoistoquímicamente houve forte marcação para vimentina (100 por cento) e S100 (100 por cento) em ambos os tipos de tumor. A maioria dos schwannomas (75 por cento) foi positiva para a proteína ácida fibrilar glial; os neurofibromas só apresentaram marcação nas células de Schwann dos fascículos nervosos
A retrospective study of peripheral nerve tumors was made from 1964 to 2004. The tumors summed up 12, being seven schwannomas and five neurofibromas. Schwannomas were composed of spindle-shaped cells either in a palisading pattern or random bundles loosely textured and neurofibromas by spindle cells. The connective tissue components were more prevalent in neurofibromas with a characteristic deployment of collagens type I and III. In AgNOR techniques, both benign and malignant schwannomas and neurofibromas did not show differences. Mast cells stained by toluidine blue were more prevalent in neurofibromas which are rich in reactive endoneurium. Schwannomas (100 percent) and neurofibromas (100 percent) were positive for vimentin and S100 protein, so they prove to be reliable for the diagnosis of peripheral nerve tumors. GFAP marked cells were found in three schwannomas and in Schwann cells within neurofibromas
Asunto(s)
Animales , Bovinos , Perros , Inmunohistoquímica , Neoplasias del Sistema Nervioso Periférico/diagnóstico , Neoplasias del Sistema Nervioso Periférico/veterinaria , Neurilemoma/microbiología , Neurofibroma/microbiología , Sistema Nervioso Periférico/anatomía & histologíaRESUMEN
Doze casos de tumores do sistema nervoso periférico, sete schwannomas e cinco neurofibromas foram diagnosticados entre 1964 e 2004, em caninos e bovinos. Histologicamente, as células predominantes nos schwannomas eram fusiformes organizavam-se em paliçada ou em feixes aleatórios. Nos neurofibromas as células neoplásicas eram fusiformes e se originavam da periferia dos nervos formando ninhos e feixes. O tecido conjuntivo era mais abundante nos neurofibromas e os colágenos dos tipos I e III eram os principais constituintes desses neoplasmas. Os neurofibromas foram caracterizados por uma concentração alta e difusa de mastócitos, provavelmente devido à origem das células neoplásicas do perineuro e epineuro. A coloração de AgNOR não se mostrou eficiente como indicador de prognóstico nos neoplasmas analisados. Imunoistoquímicamente houve forte marcação para vimentina (100 por cento) e S100 (100 por cento) em ambos os tipos de tumor. A maioria dos schwannomas (75 por cento) foi positiva para a proteína ácida fibrilar glial; os neurofibromas só apresentaram marcação nas células de Schwann dos fascículos nervosos(AU)
A retrospective study of peripheral nerve tumors was made from 1964 to 2004. The tumors summed up 12, being seven schwannomas and five neurofibromas. Schwannomas were composed of spindle-shaped cells either in a palisading pattern or random bundles loosely textured and neurofibromas by spindle cells. The connective tissue components were more prevalent in neurofibromas with a characteristic deployment of collagens type I and III. In AgNOR techniques, both benign and malignant schwannomas and neurofibromas did not show differences. Mast cells stained by toluidine blue were more prevalent in neurofibromas which are rich in reactive endoneurium. Schwannomas (100 percent) and neurofibromas (100 percent) were positive for vimentin and S100 protein, so they prove to be reliable for the diagnosis of peripheral nerve tumors. GFAP marked cells were found in three schwannomas and in Schwann cells within neurofibromas(AU)