Unusual spinal metastases from an adenoid cystic carcinoma of the maxillary sinus.

Adenoid cystic carcinoma (ACC), the second most common cancer occurring in the sinonasal tract, is an aggressive malignancy with a poor five-year survival rate. Spinal metastases to the vertebral column related to this cancer are rare. This report presents a patient with maxillary sinus carcinoma with vertebral metastases at the thoracic level and compression of the spinal cord seven years after surgical resection of the primary tumor. Eleven years after detection of the primary tumor the patient is still able to walk. The role of decompression and/or fusion in spinal metastases with neurologic deficits is still under debate, although recent studies have confirmed the beneficial role of surgical intervention in selected patients. This report represents an example of modern individual treatment of an aggressive tumor in a palliative situation. The epidemiology, clinical findings, treatment and outcome of this atypical distant metastasis in long-term survivors are presented.

[Atypical dislocated dens fracture type II with rotational atlantoaxial luxation after a riding accident]. / Atypische dislozierte Densfraktur Typ II mit rotatorischer atlantoaxialer Luxation nach Reitunfall.

We present a rare case of a combined dislocated odontoid dens fracture type II (Anderson/D'Alonzo) and rotational atlantoaxial luxation in a 15-year-old girl who was involved in a riding accident.She fell off her horse after it had stopped suddenly, losing consciousness for a few minutes. At presentation in the hospital, she had no complaints other than limited, painful neck movement. Radiologically, a posterior dislocation of an odontoid type II fracture (Anderson/D'Alonzo) was found. Computed tomography reconstruction demonstrated a rotational, hooklike fixed luxation of the left atlantoaxial facet joint. Manual repositioning after application of a cervical collar failed. Therefore, operative treatment was indicated for this highly unstable fracture. Posterior transarticular atlantoaxial screw fixation according to Magerl was performed; an iliac corticocancellous bone graft was harvested and shaped to conform to the posterior processes of C1 and C2. Additionally a hook-claw atlas fixation of C1 was done.To our knowledge, this is the first case of adolescent atlantoaxial cervical spine trauma in combination with an odontoid fracture and fixed rotational luxation reported in literature.

Analysis of volatile radiolysis products in gamma-irradiated LDPE and polypropylene films by thermal desorption-gas chromatography-mass spectrometry.

Low-molecular-weight ('volatile') radiolysis products of low-density polyethylene (LDPE) and polypropylene (PP) films were investigated by thermal desorption-(TDS)-GC-MS after absorbed doses of up to 25 kGy. The films produce fingerprint chromatograms with highly characteristic patterns of groups of radiation-induced peaks; these are mainly hydrocarbons, aldehydes, ketones, and carboxylic acids with concentrations (after 25 kGy) ca one order of magnitude below that of the residual hydrocarbons (oligomers). PP additionally produces very substantial amounts of three degradation products of phenol-type antioxidants. The low molecular-weight (MW) radiolysis products are retained for considerable times in LDPE films and they are retained in PP films much longer than had been expected. Besides product identification, the following topics are addressed: Effects of the absorbed dose and the desorption temperature; comparison of several commercial (proprietary) films; high-temperature thermal desorption; the question whether TDS analyzes radiation-induced artifacts rather than genuine products; the possible existence of cyclic radiolysis products; the possibility of identifying an LDPE film as irradiated after a dose of only 1 kGy; and atypical trace fragments of antioxidants. Finally, the geometry and efficiency of the thermal desorption system is briefly discussed, and the implications of our findings for irradiation detection and for the safety of irradiated materials are considered.