ABSTRACT
A 35-year-old Japanese man first visited the hospital for episodes of numbness in the right medial femoral region and loss of muscular strength in the right thigh. A CT scan of the abdomen showed a 10 x 9-cm well-circumscribed in homogeneous multilayered mass, in contact with the lumbar vertebrae. MRI demonstrated a hypodense and hyperdense mixed mass. Tumor extension into the L(2)/L(3) intravertebral foramen was shown. To avoid spinal cord damage, we chose enucleation of the tumor in the intravertebral foramen. A follow-up CT after 1 year showed no evidence of a recurrent mass. In conclusion, we advocate the nerve-sparing operation in cases like that of our patient.
Subject(s)
Neurilemmoma/surgery , Retroperitoneal Neoplasms/surgery , Spinal Cord Neoplasms/surgery , Adult , Humans , Lumbar Vertebrae , Male , Neoplasm Invasiveness , Neurilemmoma/pathology , Retroperitoneal Neoplasms/pathology , Spinal Cord Neoplasms/pathologyABSTRACT
OBJECTIVES: To investigate the role substance P (SP) plays in prostatic inflammation, we evaluated SP immunoreactivity within the spinal cord after irritation of the prostate. Because alpha-adrenergic blockade attenuates nociceptor-induced pain, the effects of an alpha-adrenergic blocker on SP immunoreactivity were also evaluated. SP is considered a mediator of nociception in the spinal cord. Immunoreactivity of SP is enhanced after acute chemical stimulation of somata. METHODS: Rats received chemical irritation of the prostate with or without pretreatment with tamsulosin. They were killed after 1 hour, and immunohistochemical staining for SP was performed. SP immunoreactive areas were quantified in the dorsal spinal cord of the L5 to S2 segments. RESULTS: Chemical irritation of the prostate increased SP immunoreactive areas in the L6 to S2 segments. Enhancement was observed in the whole dorsal spinal cord regions. This enhancement was significantly attenuated by tamsulosin in the L6 and S1 segments. CONCLUSIONS: SP probably plays a significant role in mediating nociceptive processing from the prostate. Tamsulosin can attenuate nociception-induced SP upregulation within the spinal cord.
