ABSTRACT
INTRODUCTION: Metastatic epiduritis is the most frequent extrinsic epidural cause of spinal cord compression. Although neurosurgery is essential to its management, the exact role of this discipline in the treatment of spinal cancer in sub-Saharan Africa has not yet been assessed. AIM: To analyze recent hospital data of patients with metastatic epiduritis managed in the Abidjan neurosurgery department. METHODOLOGY: We conducted a retrospective analysis of files of 56 patients admitted from January 2007 through December 2012. Our data are discussed in the light of the literature. RESULTS: The primary cancers in men were mostly lung (16%) and prostate (34%) cancers, and in women, breast cancer (23%). The two age brackets mainly involved were those aged 31-45 years (21%) and 46-60 years (39%). The reason for admission in all cases was functional disability of the lower limbs. Magnetic resonance imaging (MRI) was performed for 57%. The thoracic topography was dominant (60%), and vertebral damage was often associated with epiduritis (78%). This metastatic epiduritis was the initial sign leading to cancer diagnosis for 39%. Decompressive laminectomy with biopsy or lesionectomy was performed for 62%. Postoperative neurologic improvement was noted for 36%, and remained satisfactory at one year for 14 patients. Prostate-specific hormone therapy was performed for 30%. CONCLUSION: This study underlines the crucial importance of neurosurgery in management of metastatic epiduritis in our center. Our findings emphasize the need to improve access to neuroradiologic diagnostic resources and optimize surgical treatment in the sub-Saharan region.
Subject(s)
Epidural Neoplasms/secondary , Epidural Neoplasms/surgery , Neurosurgical Procedures , Adult , Cote d'Ivoire , Female , Hospitals, Teaching , Humans , Male , Middle Aged , Retrospective Studies , Time FactorsABSTRACT
We describe an unusual case of malignant transformation of benign cranial nerves schwannoma eleven months after surgery and five months post radiotherapy. There has been no evidence of recurrence after 5 years follow-up. This early malignant transformation of a schwannoma involved cranial nerves IX, X, XI. Due to the uncommon presentation and the uncertainty of the actual role of the radiation on the tumor behavior, the report of this case was considered clinically important.
ABSTRACT
Pneumosinus dilatans is a rare disease characterized by progressive development of high pressure in the facial sinuses. The etiology remains unknown. We report a case which developed in the anterior ethmoidal cell and was expressed by exophtalmia.