ABSTRACT
Synovial sarcoma is an uncommon malignant soft tissue neoplasm, occurring primarily in adolescents and young adults. It is prevalent in the periarticular soft tissues near large joints of the extremities and rarely involves the trunk. Metastases are not uncommon and usually involve the lungs; metastasis to the thoracic spine is rare. We report the case of a 47-year-old man with a history of synovial sarcoma of the lower back, with subsequent metastases to the lung, penis, and perineum (all previously resected), presenting with a 3-month history of low back pain and lower extremity paresthesias. Magnetic resonance imaging (MRI) demonstrated multiple lesions involving multiple contiguous vertebral bodies, with the mass at T12 compressing the spinal cord. The patient underwent T11-T12 laminectomy, transpedicular decompression, tumor debulking, and posterior fixation and fusion. The patient died six months later due to disease progression. Although not curative, decompression and stabilization of the spine are often necessary in patients who present spinal cord compression.
O sarcoma sinovial é uma neoplasia rara dos tecidos moles que afeta adolescentes e adultos jovens. A sua maior prevalência é nas grandes articulações das extremidades e raramente acomete o tronco. As lesões metastáticas são raras e geralmente acometem os pulmões, e as metástases para a coluna torácica são raras. Relata-se o caso de um paciente de 47 anos de idade com 3 meses de história de dor lombar e que apresentava metástase de sarcoma sinovial na coluna lombar. A ressonância magnética demonstrava lesões contíguas do corpo vertebral e compressão do canal vertebral ao nível de T12. O paciente foi submetido à laminectomia de T11-T12, descompressão transpedicular, remoção tecido tumoral e artrodese e fixação posterior. O paciente foi a óbito após seis meses devido à progressão da doença. Embora a descompressão e estabilização cirúrgica do canal vertebral não sejam curativas, esses procedimentos podem ser necessários em pacientes que apresentam compressão da medula espinhal.
El sarcoma sinovial es una neoplasia rara de los tejidos blandos que afecta adolescentes y adultos jóvenes. Su mayor prevalencia es en las grandes articulaciones de las extremidades y raramente ataca el tronco. Las lesiones metastásicas son raras y generalmente atacan los pulmones, siendo que las metástasis de columna torácica son raras. Será relatado el cuadro clínico de un paciente de 47 años de edad con tres meses de historia de dolor lumbar y presentando metástasis de sarcoma sinovial en la columna lumbar. La resonancia magnética demostraba lesiones contiguas del cuerpo vertebral y compresión del canal vertebral al nivel de T12. El paciente fue sometido a la laminectomía de T11-T12, descompresión transpedicular, remoción de tejido tumoral y artrodesis con fijación posterior. El paciente fue a óbito después de seis meses debido a la progresión de la enfermedad. Aunque la descompresión y estabilización quirúrgica del canal vertebral no sea curativa, ese procedimiento puede ser necesario en los pacientes que presentan compresión de la médula espinal.
Subject(s)
Humans , Adult , Laminectomy , Neoplasm Metastasis , Spinal Neoplasms/secondary , Sarcoma, Synovial , Spinal Cord Compression , Spinal Fusion , Thoracic Vertebrae/pathologyABSTRACT
With the advent of more aggressive antineoplastic combination chemotherapies, agents with fewer adverse effects, prophylactic central nervous system radiation treatments, and more efficacious antibiotics, the number of childhood cancer survivors is continually increasing. These patients place a new responsibility on clinicians; systematic follow-up with effective intervention is necessary to reduce the consequences of the treatments themselves. We report 2 patients who were diagnosed with pre-B-cell acute lymphoblastic leukemia and later presented with intracranial malignancies. Both patients were treated with radiation and with similar chemotherapeutic regimens. Each patient was in remission for leukemia at the time of diagnosis of the second malignancy. The possible causes of the brain tumors in association with acute lymphoblastic leukemia are discussed.
Subject(s)
Astrocytoma , Brain Neoplasms/secondary , Brain Neoplasms/therapy , Neoplasms, Second Primary , Neuroblastoma , Precursor Cell Lymphoblastic Leukemia-Lymphoma/pathology , Precursor Cell Lymphoblastic Leukemia-Lymphoma/therapy , Astrocytoma/secondary , Astrocytoma/therapy , Child, Preschool , Female , Humans , Male , Neoplasms, Second Primary/therapy , Neuroblastoma/secondary , Neuroblastoma/therapySubject(s)
Angiogenesis Inhibitors/therapeutic use , Brain Neoplasms/blood supply , Brain Neoplasms/drug therapy , Glioma/blood supply , Glioma/drug therapy , Neovascularization, Pathologic/drug therapy , Humans , Neovascularization, Pathologic/physiopathology , Vascular Endothelial Growth Factor A/drug effects , Vascular Endothelial Growth Factor A/metabolismABSTRACT
BACKGROUND: We report a case of a 7-year-old white female who presented with acute, progressive bilateral lower extremity weakness over 48 h. METHODS: Case report and presentation of clinical, radiological and pathological data on a single case of chondromyxoid fibroma (CMF) of the T2 vertebral body. RESULTS: Magnetic resonance imaging of the thoracic spine revealed an extensive mass invading the lamina of the second thoracic vertebra, causing extensive cord compression and progressive neurological deterioration. Surgical resection and pathologic study of the mass revealed a CMF. CONCLUSIONS: A thorough Medline search has revealed that only 25 cases of spinal CMF have been reported, making this lesion an extremely rare bone tumor.
