Malignant spinal cord compression (MSCC) rarely presents in patients with endometrial cancer. It usually occurs months or years after the diagnosis of the primary tumor. A 65-year-old woman presented with a huge uteri...Malignant spinal cord compression (MSCC) rarely presents in patients with endometrial cancer. It usually occurs months or years after the diagnosis of the primary tumor. A 65-year-old woman presented with a huge uterine tumor suspecting leiomyosarcoma. She underwent total abdominal hysterectomy and bilateral salpingo-oophorectomy. Histopathological examination revealed mixed carcinoma (small cell carcinoma and endometrioid adenocarcinoma) of the endometrium. She presented with upper abdominal pain, back pain, cystoplegia and paraplegia of lower extremities postoperatively. Magnetic resonance imaging revealed bone metastasis with destruction of the eighth thoracic vertebral body as the sites of metastasis. Vertebrectomy and irradiation therapy were performed for the lesion. Although she received systemic chemotherapy consisting of paclitaxel and carboplatin, she died 4 months after hysterectomy.展开更多
Background: Intramedullary spinal cord metastasis (ISCM) from breast cancer is a relatively rare disease. We present this disease. Case presentation: The patient was a 67-year-old woman with lung metastasis appearing ...Background: Intramedullary spinal cord metastasis (ISCM) from breast cancer is a relatively rare disease. We present this disease. Case presentation: The patient was a 67-year-old woman with lung metastasis appearing 3 years after breast cancer surgery. Complete remission was achieved for the metastatic lesion with chemotherapy, but multiple cerebellar metastases were found 3 months after the completion of chemotherapy. Whole-brain irradiation was administered, resulting in symptomatic improvement. Approximately 6 months later, the patient experienced weakness in the lower extremities and difficulty walking. Magnetic resonance imaging detected a well-defined intraspinal tumor measuring 13 × 13 × 30 mm at the level of Th12-L1. After 20-Gy irradiation to the tumor, oral steroid administration, and rehabilitation, the patient regained the ability to walk. Eight months have passed, to date, since these interventions and the patient is currently receiving treatment for metastases to bones, including the spine, but is still capable of walking without difficulty. We herein report this case with a review of the relevant literature. Conclusion: ISCM in the breast cancer is relatively rare. But, it is the clinical condition which it should always place in the mind.展开更多
Intramedullary spinal cord tumors are rare. The improved survival resulting from more effective treatments formany cancers has led to an increased number of publications concerning intramedullary spinal cord metastasi...Intramedullary spinal cord tumors are rare. The improved survival resulting from more effective treatments formany cancers has led to an increased number of publications concerning intramedullary spinal cord metastasis(ISCM), including case reports and literature reviews; however, ISCM remains extremely rare in renal cancer. A 69-year-old man with a medical history of renal cell carcinoma(RCC) presented with urinary retention and bilateral paralysis of the lower extremities. A neurological examination revealed bilateral paraparesis below L1. Although brain magnetic resonance imaging(MRI), bone scintigraphy, and abdominal contrast-enhanced computed tomography revealed no abdominal findings, the thracolumbar MRI indicated a spot on the spinal cord at the Th12 level that exhibited hyperintensity on T2-weighted imaging and gadolinium diethylenetriaminepentaacetic acid enhancement on T1-weighted imaging. Accordingly, an ISCM of RCC was diagnosed. The patient rejected all treatments for these metastases except the steroid therapy. The patient's condition deteriorated owing to metastatic progression, and he died 3 mo after the appearance of ISCM symptoms. The prognosis of this condition was poor. The mean survival durations were 8 mo with surgical treatment, 4 mo with irradiation, and 2 mo with palliative treatments. In cases involving neurological features and if brain or bone metastasis or spinal cord compression is not clearly observed, gadolinium-enhanced MRI should be performed to determine the existence of ISCM. Recently, some authors have reported the efficacy of ISCM resection. Surgical treatment could potentially yield improvements in the nervous symptoms or a longer survival after treatment. Although the prognosis was poor in most cases of ISCM, surgical treatment may improve the patient's quality of life.展开更多
Background: Radiation-induced gliomas of the spinal cord are rare late complications of spinal cord irradiation that typically occur in patients treated at younger ages. Aim: Raise awareness of radiation induced high ...Background: Radiation-induced gliomas of the spinal cord are rare late complications of spinal cord irradiation that typically occur in patients treated at younger ages. Aim: Raise awareness of radiation induced high grade gliomas with a case presentation and a review of the literature. Case Presentation: A 50-year-old male with Stage IVA squamous cell carcinoma of the oropharynx was treated with external beam radiotherapy with a complete response. Seven years later, he presented with a cervical spinal cord mass on MRI. An open biopsy was performed. Pathology revealed an intramedullary WHO grade IV astrocytoma, (i.e., glioblastoma multiforme) of the cervical spine that fulfilled the criteria for a radiation-induced malignancy. Conclusions : Review of the literature suggests that radiation-induced gliomas tend to be high grade and may occur at the periphery of an irradiated field. Radiation-induced gliomas of the spinal cord are a serious complication of radiotherapy that may occur in older patients with head and neck cancers, but are so rare that it should not affect treatment decisions.展开更多
High?grade gliomas of the spinal cord represent a rare entity in children.Their biology,behavior,and controversial treatment options have been discussed in a few pediatric cases.These tumors are associated with severe...High?grade gliomas of the spinal cord represent a rare entity in children.Their biology,behavior,and controversial treatment options have been discussed in a few pediatric cases.These tumors are associated with severe disability and poor prognosis.We report a case of a 4?year?old child diagnosed with an isolated glioblastoma multiforme of the conus medullaris.The patient underwent subtotal surgical excision,followed by adjuvant radiotherapy and oral chem?otherapy.He is alive with mild neurologic deficits at 52 months after diagnosis.We describe the peculiar characteris?tics of this rare condition in pediatric oncology.We also provide an overview of current multidisciplinary therapeutic approaches and prognostic factors for this disease.展开更多
A lower risk of prostate cancer has been reported in men with spinal cord injury （SCI） as compared to that observed in able-bodied subjects. As injury-related consequences can have opposite effects on prostate patho...A lower risk of prostate cancer has been reported in men with spinal cord injury （SCI） as compared to that observed in able-bodied subjects. As injury-related consequences can have opposite effects on prostate pathophysiology, this meta-analysis aimed to （1） establish the existence/quantify the extent of decreased prostate cancer risk following SCI and （2） find out if there is any statistically significant difference in prostate-specific antigen （PSA） levels between SCI and able-bodied subjects. MEDLINE, Cochrane Library, Scopus, CINAHL, and ScienceDirect databases were used. Only studies reporting a prostate cancer diagnosis and/or PSA levels following SCI and in able-bodied controls were included. Five studies provided information about prostate cancer on 35 293 subjects with SCI and 158 140 controls. Six studies were included in PSA analysis which reported information on 391 men with SCI and 1921 controls. Pooled estimates indicated that SCI reduced the prostate cancer risk by approximately 50% as compared to controls, whereas differences in PSA levels were not statistically significant. Funnel plots suggested the presence of publication bias only in PSA analysis. Between-study heterogeneity was established and when, according to meta-regression models, analysis was restricted to studies including men with mean age over 55 years, prostate cancer risk in SCI decreased up to 65.0% than that in controls with no heterogeneity （P= 0.33, Iz = 9%）. In conclusion, in men over 55 years old, SCI decreases the prostate cancer risk up to 65.0% than that in controls. The large between-study heterogeneity on PSA confirms its poor reliability as a screening tool for prostate cancer in SCI.展开更多
目的:探讨独活寄生汤对骨癌痛小鼠痛行为及脊髓星形胶质细胞神经胶质纤维酸性蛋白(GFAP)表达的影响。方法:随机将雄性小鼠分为模型组、假手术组、正常组、中药A、B、C组和溶媒组。中药组和溶媒组分别灌胃含0.1、0.3、0.9 g独活寄生汤生...目的:探讨独活寄生汤对骨癌痛小鼠痛行为及脊髓星形胶质细胞神经胶质纤维酸性蛋白(GFAP)表达的影响。方法:随机将雄性小鼠分为模型组、假手术组、正常组、中药A、B、C组和溶媒组。中药组和溶媒组分别灌胃含0.1、0.3、0.9 g独活寄生汤生药/0.4 m L的制剂和0.4 m L生理盐水,于造模14 d开始连续灌胃7 d,每天1次。热辐射刺激仪检测各组小鼠行为学指标(PWTL),21 d后取小鼠脊髓腰膨大处,检测GFAP m RNA和蛋白的表达情况。结果:对比正常组和假手术组的PWTL值,模型组小鼠的PWTL值随时间的推移显著下降(P<0.05),而在14 d时间点,模型组、中药A、B、C组和溶媒组之间PWTL值的差异并没有统计学意义(P>0.05),在21 d的时间点,对比模型组和溶媒组的数据,中药B、C组的PWTL值显著性升高(P<0.05)。对比溶媒组和模型组小鼠,中药B、C组的脊髓组织GFAP m RNA及GFAP蛋白表达水平显著降低(P<0.05)。但是溶媒组、模型组以及中药A组小鼠之间GFAP m RNA及GFAP蛋白表达水平比较,差异并没有统计学意义(P>0.05)。结论:独活寄生汤对骨癌痛具有显著的镇痛作用,并能够使脊髓星形胶质细胞的活化受到抑制。展开更多
文摘Malignant spinal cord compression (MSCC) rarely presents in patients with endometrial cancer. It usually occurs months or years after the diagnosis of the primary tumor. A 65-year-old woman presented with a huge uterine tumor suspecting leiomyosarcoma. She underwent total abdominal hysterectomy and bilateral salpingo-oophorectomy. Histopathological examination revealed mixed carcinoma (small cell carcinoma and endometrioid adenocarcinoma) of the endometrium. She presented with upper abdominal pain, back pain, cystoplegia and paraplegia of lower extremities postoperatively. Magnetic resonance imaging revealed bone metastasis with destruction of the eighth thoracic vertebral body as the sites of metastasis. Vertebrectomy and irradiation therapy were performed for the lesion. Although she received systemic chemotherapy consisting of paclitaxel and carboplatin, she died 4 months after hysterectomy.
文摘Background: Intramedullary spinal cord metastasis (ISCM) from breast cancer is a relatively rare disease. We present this disease. Case presentation: The patient was a 67-year-old woman with lung metastasis appearing 3 years after breast cancer surgery. Complete remission was achieved for the metastatic lesion with chemotherapy, but multiple cerebellar metastases were found 3 months after the completion of chemotherapy. Whole-brain irradiation was administered, resulting in symptomatic improvement. Approximately 6 months later, the patient experienced weakness in the lower extremities and difficulty walking. Magnetic resonance imaging detected a well-defined intraspinal tumor measuring 13 × 13 × 30 mm at the level of Th12-L1. After 20-Gy irradiation to the tumor, oral steroid administration, and rehabilitation, the patient regained the ability to walk. Eight months have passed, to date, since these interventions and the patient is currently receiving treatment for metastases to bones, including the spine, but is still capable of walking without difficulty. We herein report this case with a review of the relevant literature. Conclusion: ISCM in the breast cancer is relatively rare. But, it is the clinical condition which it should always place in the mind.
文摘Intramedullary spinal cord tumors are rare. The improved survival resulting from more effective treatments formany cancers has led to an increased number of publications concerning intramedullary spinal cord metastasis(ISCM), including case reports and literature reviews; however, ISCM remains extremely rare in renal cancer. A 69-year-old man with a medical history of renal cell carcinoma(RCC) presented with urinary retention and bilateral paralysis of the lower extremities. A neurological examination revealed bilateral paraparesis below L1. Although brain magnetic resonance imaging(MRI), bone scintigraphy, and abdominal contrast-enhanced computed tomography revealed no abdominal findings, the thracolumbar MRI indicated a spot on the spinal cord at the Th12 level that exhibited hyperintensity on T2-weighted imaging and gadolinium diethylenetriaminepentaacetic acid enhancement on T1-weighted imaging. Accordingly, an ISCM of RCC was diagnosed. The patient rejected all treatments for these metastases except the steroid therapy. The patient's condition deteriorated owing to metastatic progression, and he died 3 mo after the appearance of ISCM symptoms. The prognosis of this condition was poor. The mean survival durations were 8 mo with surgical treatment, 4 mo with irradiation, and 2 mo with palliative treatments. In cases involving neurological features and if brain or bone metastasis or spinal cord compression is not clearly observed, gadolinium-enhanced MRI should be performed to determine the existence of ISCM. Recently, some authors have reported the efficacy of ISCM resection. Surgical treatment could potentially yield improvements in the nervous symptoms or a longer survival after treatment. Although the prognosis was poor in most cases of ISCM, surgical treatment may improve the patient's quality of life.
文摘Background: Radiation-induced gliomas of the spinal cord are rare late complications of spinal cord irradiation that typically occur in patients treated at younger ages. Aim: Raise awareness of radiation induced high grade gliomas with a case presentation and a review of the literature. Case Presentation: A 50-year-old male with Stage IVA squamous cell carcinoma of the oropharynx was treated with external beam radiotherapy with a complete response. Seven years later, he presented with a cervical spinal cord mass on MRI. An open biopsy was performed. Pathology revealed an intramedullary WHO grade IV astrocytoma, (i.e., glioblastoma multiforme) of the cervical spine that fulfilled the criteria for a radiation-induced malignancy. Conclusions : Review of the literature suggests that radiation-induced gliomas tend to be high grade and may occur at the periphery of an irradiated field. Radiation-induced gliomas of the spinal cord are a serious complication of radiotherapy that may occur in older patients with head and neck cancers, but are so rare that it should not affect treatment decisions.
文摘High?grade gliomas of the spinal cord represent a rare entity in children.Their biology,behavior,and controversial treatment options have been discussed in a few pediatric cases.These tumors are associated with severe disability and poor prognosis.We report a case of a 4?year?old child diagnosed with an isolated glioblastoma multiforme of the conus medullaris.The patient underwent subtotal surgical excision,followed by adjuvant radiotherapy and oral chem?otherapy.He is alive with mild neurologic deficits at 52 months after diagnosis.We describe the peculiar characteris?tics of this rare condition in pediatric oncology.We also provide an overview of current multidisciplinary therapeutic approaches and prognostic factors for this disease.
文摘A lower risk of prostate cancer has been reported in men with spinal cord injury （SCI） as compared to that observed in able-bodied subjects. As injury-related consequences can have opposite effects on prostate pathophysiology, this meta-analysis aimed to （1） establish the existence/quantify the extent of decreased prostate cancer risk following SCI and （2） find out if there is any statistically significant difference in prostate-specific antigen （PSA） levels between SCI and able-bodied subjects. MEDLINE, Cochrane Library, Scopus, CINAHL, and ScienceDirect databases were used. Only studies reporting a prostate cancer diagnosis and/or PSA levels following SCI and in able-bodied controls were included. Five studies provided information about prostate cancer on 35 293 subjects with SCI and 158 140 controls. Six studies were included in PSA analysis which reported information on 391 men with SCI and 1921 controls. Pooled estimates indicated that SCI reduced the prostate cancer risk by approximately 50% as compared to controls, whereas differences in PSA levels were not statistically significant. Funnel plots suggested the presence of publication bias only in PSA analysis. Between-study heterogeneity was established and when, according to meta-regression models, analysis was restricted to studies including men with mean age over 55 years, prostate cancer risk in SCI decreased up to 65.0% than that in controls with no heterogeneity （P= 0.33, Iz = 9%）. In conclusion, in men over 55 years old, SCI decreases the prostate cancer risk up to 65.0% than that in controls. The large between-study heterogeneity on PSA confirms its poor reliability as a screening tool for prostate cancer in SCI.
文摘目的:探讨独活寄生汤对骨癌痛小鼠痛行为及脊髓星形胶质细胞神经胶质纤维酸性蛋白(GFAP)表达的影响。方法:随机将雄性小鼠分为模型组、假手术组、正常组、中药A、B、C组和溶媒组。中药组和溶媒组分别灌胃含0.1、0.3、0.9 g独活寄生汤生药/0.4 m L的制剂和0.4 m L生理盐水,于造模14 d开始连续灌胃7 d,每天1次。热辐射刺激仪检测各组小鼠行为学指标(PWTL),21 d后取小鼠脊髓腰膨大处,检测GFAP m RNA和蛋白的表达情况。结果:对比正常组和假手术组的PWTL值,模型组小鼠的PWTL值随时间的推移显著下降(P<0.05),而在14 d时间点,模型组、中药A、B、C组和溶媒组之间PWTL值的差异并没有统计学意义(P>0.05),在21 d的时间点,对比模型组和溶媒组的数据,中药B、C组的PWTL值显著性升高(P<0.05)。对比溶媒组和模型组小鼠,中药B、C组的脊髓组织GFAP m RNA及GFAP蛋白表达水平显著降低(P<0.05)。但是溶媒组、模型组以及中药A组小鼠之间GFAP m RNA及GFAP蛋白表达水平比较,差异并没有统计学意义(P>0.05)。结论:独活寄生汤对骨癌痛具有显著的镇痛作用,并能够使脊髓星形胶质细胞的活化受到抑制。
