ABSTRACT
A giant meningocelic sac has not been usually described in adult patients, due to the fact that it shows a low incidence and few newborn have survived to date though the malformation is benign. We report two cases of patients born with the described malformation and who were not operated at that time, so they reached adulthood with bigger sacs. They needed surgery to remove the sacs, for a different reason. The older one had a fistulous abcess but the LCR did not come out, and it did not improved by the application of topic and antibiotic treatment. The other patient showed a progressive growth of the malformation during the last year, skin hardening and pain. The histological study of the dried sacs proved the existence of a carcinomatous degeneration. In the patients we have treated, it seems that a chronic irritation of the LCR and the appearance of multipotent cells in the meningocele may favour the malignancy of the tissues surrounding the sac. This possible malignancy, already described in the bibliography, suggests a prompt elective surgical treatment of the patients with these congenital lesions as soon as possible.
Subject(s)
Carcinoma, Squamous Cell/etiology , Meningeal Neoplasms/etiology , Meningioma/etiology , Meningocele/complications , Sarcoma/etiology , Teratocarcinoma/etiology , Aged , Brain Neoplasms/secondary , Carcinoma, Squamous Cell/diagnosis , Carcinoma, Squamous Cell/embryology , Carcinoma, Squamous Cell/pathology , Carcinoma, Squamous Cell/secondary , Cell Transformation, Neoplastic , Epidermal Cyst/etiology , Epidermal Cyst/pathology , Fatal Outcome , Female , Humans , Incidental Findings , Ischemia/etiology , Lumbar Vertebrae/abnormalities , Male , Meningeal Neoplasms/diagnosis , Meningeal Neoplasms/embryology , Meningeal Neoplasms/pathology , Meningioma/diagnosis , Meningioma/embryology , Meningioma/pathology , Meningocele/embryology , Meningocele/pathology , Meningocele/surgery , Middle Aged , Multipotent Stem Cells/pathology , Paraplegia/etiology , Sacrum/abnormalities , Sarcoma/diagnosis , Sarcoma/embryology , Sarcoma/pathology , Sarcoma/secondary , Spinal Cord/blood supply , Spinal Dysraphism/complications , Teratocarcinoma/diagnosis , Teratocarcinoma/embryology , Teratocarcinoma/pathologyABSTRACT
A case of a lumbar aneurysmal bone cyst is presented in a 5 year-9 month old girl. The characteristics of this tumor are described, specifically in the spinal area, with particular reference to the diagnostic and therapeutic difficulties referred, taking into account the existing bibliography. The partial resection has been curative, as it has been frequently written about in publication worldwide and which suggest that surgery does not have to be aggressive in unapproachable cases and that radiotherapy is unnecessary.
