[Coexistence of syringomyelia and extramedullary intradural meningioma]. / Coexistencia de siringomielia y meningioma intradural extramedular.

INTRODUCTION: The coexistence of non-communicating syringomyelia with extramedullary intradural tumours in surgical series is extremely rare. CASE REPORT: We report the case of a 68-year-old female who had been suffering from predominantly proximal asymmetrical progressive paraparesis, with no involvement of the sphincters; the clinical exploration revealed a band of thermal hypaesthesia D7-D8. Magnetic resonance imaging (MRI), following the administration of gadolinium, confirmed the coexistence of an extramedullary intradural expansive lesion, which had features suggesting it could be a meningioma, and a dorsal syringomyelia. The cavity involved two medullary segments situated above the tumour and there were no associated anomalies at the junction of the medulla and upper spinal cord. Following complete resection of the tumour, which was diagnosed histologically as being a transitional meningioma with abundant psammoma bodies, the patient recovered the ability to walk independently. CONCLUSIONS: MRI with contrast is the best diagnostic means available for the detection and delimitation of the two components in this rare association, although its capacity to detect signs suggesting turbulences in the intracavity fluid, especially in small cavities, has still to be confirmed. The variations in the size and situation of the cavity with respect to the seat of the tumour, and the fact that progress is seldom monitored with MRI in the cases published to date, do not allow us to identify the pathogenic mechanism responsible for this association or to suggest the best type of shunt to prevent a possible expansion of the syringomyelic cavity.

Coexistencia de siringomielia y meningioma intradural extramedular / Coexistence of syringomyelia and extramedullary intradural meningioma

Introducción. La coexistencia de siringomielia no comunicante con tumores intradurales extramedulares en series quirúrgicas es extremadamente rara. Caso clínico. Se describe el caso de una mujer de 68 años, con paraparesia progresiva, asimétrica, de predominio proximal, sin afectación de los esfínteres, de cuatro meses de evolución, en la que la exploración clínica delimitaba una banda de hipoestesia térmica D7-D8. El estudio con resonancia magnética (RM), tras la administración de gadolinio, demostró la coexistencia de una lesión expansiva intradural extramedular, que por sus características sugería un meningioma, y de una siringomielia dorsal. La cavidad afectaba a dos segmentos medulares situados por encima del tumor y no había anomalías asociadas en la unión bulbomedular. Tras la resección completa del tumor, cuyo diagnóstico histológico fue de meningioma transicional con abundantes cuerpos de psamoma, la paciente ha recuperado la marcha independiente. Conclusiones. La RM con contraste es el mejor medio diagnóstico disponible para la detección y delimitación de los dos componentes de esta rara asociación, aunque su capacidad para detectar signos sugerentes de turbulencias en el líquido intracavitario, especialmente en cavidades pequeñas, se debe contrastar. La variabilidad de tamaño y de situación de la cavidad respecto al asiento del tumor, y la falta de controles evolutivos con RM en los casos publicados, no permiten identificar el mecanismo patogénico responsable de esta asociación, ni proponer el tipo de derivación de elección para prevenir una eventual ampliación de la cavidad siringomiélica (AU)

Introduction. The coexistence of non-communicating syringomyelia with extramedullary intradural tumours in surgical series is extremely rare. Case report. We report the case of a 68-year-old female who had been suffering from predominantly proximal asymmetrical progressive paraparesis, with no involvement of the sphincters; the clinical exploration revealed a band of thermal hypaesthesia D7-D8. Magnetic resonance imaging (MRI), following the administration of gadolinium, confirmed the coexistence of an extramedullary intradural expansive lesion, which had features suggesting it could be a meningioma, and a dorsal syringomyelia. The cavity involved two medullary segments situated above the tumour and there were no associated anomalies at the junction of the medulla and upper spinal cord. Following complete resection of the tumour, which was diagnosed histologically as being a transitional meningioma with abundant psammoma bodies, the patient recovered the ability to walk independently. Conclusions. MRI with contrast is the best diagnostic means available for the detection and delimitation of the two components in this rare association, although its capacity to detect signs suggesting turbulences in the intracavity fluid, especially in small cavities, has still to be confirmed. The variations in the size and situation of the cavity with respect to the seat of the tumour, and the fact that progress is seldom monitored with MRI in the cases published to date, do not allow us to identify the pathogenic mechanism responsible for this association or to suggest the best type of shunt to prevent a possible expansion of the syringomyelic cavity (AU)

[T-type primary lymphoma of the central nervous system in immunocompetent patients]. / Linfoma primario tipo T del sistema nervioso central en pacientes inmunocompetentes.

INTRODUCTION: The primary lymphoma of the central nervous system is an infrequent neoplasia, which represents 1,5% of all primary neoplasias in adult patients. In the last decade its frequency has increased threefold, both in immunodepressed as well as in immunocompetent patients. The non Hodgkin lymphoma of B cells being the most frequent histological type, the primary T cell lymphoma of the CNS is a rare clinical entity. CASE REPORTS: In this study we present three cases of immunocompetent patients with primary lymphoma of the central nervous system of T cells seen during the 6 last years in our hospital, the diagnostic imaging by computerized tomography and magnetic resonance showed the tumorations, but the definitive diagnosis was by stereotaxic cerebral biopsy. CONCLUSIONS: The lymphomas are radiosensitive to radiotherapy with survivals of approximately 26 months, the combined treatment of surgery and chemotherapy, prior to radiotherapy, may increases survival up to 48 months. Certain aspects of the patient or of the tumor itself are determining factors with respect to the prognosis of survival. We review the relevant literature and study the clinical manifestation, their value of imaging techniques and differential diagnostic and prognosis of survival

[Incidence of glioblastoma multiforme in Aragon and La Rioja. An epidemiological survey]. / Incidencia de glioblastoma multiforme en Aragón y La Rioja. Estudio epidemiológico.

The aim of this work has been to evaluate the epidemiologic data in a series of 157 patients operated for glioblastoma multiforme in Aragón and La Rioja, during a period of 15 years. We haven't analyzed the cases that weren't operated on, because of the localization of the tumor or the bad situation of the patient. All the patients have an anatomopathologic confirmation. We have studied a total of 795 patients operated for a cerebral or cerebellar tumor. The glioblastoma multiforme was the third type of tumor in frequency, after the meningioma and the astrocytoma. In the different groups of age the peak incidence was between the 50 and 59 years old, followed the group between 60 to 69. 153 cases appeared in adults and only 4 cases were found below the age of 20. The right hemisphere was the most frequently affected. Males were more often affected than females, with 96 cases (61.14%) in males and 61 cases (38.85%) in females. We couldn't find a significative relation between the presence of the tumor and the profession or another personal antecedent of the patients.