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Clinical Neuroscience

MAY 30, 2012

[Prognostic factors of primary spinal tumors]

LAZÁRY Áron, BORS István Béla, SZÖVÉRFI Zsolt, RÓNAI Márton, VARGA Péter Pál

[Aims - Primary spinal tumors are rare diseases and there are less objective data in the international literature. We analyzed the epidemiology and clinical consequences of primary spinal tumors based on the clinical experience of the National Center for Spinal Disorders. Methods - Demographic and clinical data of 300 patients treated in our institute between 1995 and 2007 was collected retrospectively and analysed. Results - Beyond the relatively more frequent pathologies (chordoma, myeloma multiplex) we treated in our hospital some of the very rare types of tumors (spinal leiomyosarcoma, synovial sarcoma). Primary spinal tumors are most often located in the lumbosacral region causing most frequently (73%) local or radiating pain. Modern therapy of these patologies is based on the surgical intervention. Mean operation time was 130 minutes, mean blood loss was 650 ml in our pratice during these often technically challenging surgeries. We found a significant association among the operation time, the blood loss and the extension of the tumor (p<0.01). Histology (p<0.0001), severity of symptomes (p<0.05) and blood loss (p<0.05) were significantly related to mortality. Local recurrence was more than 5-fold in case of patients previously operated in another institute (p<0.0001). Conclusions - We successfully determined some significant prognostic factor on clinical behavior of primary spinal tumors performing a large scale retrospective study. Long time follow up of the patients and completion of our database with prospective data are planned for the future.]

Clinical Neuroscience

FEBRUARY 20, 2003

[Surgical treament of sacro-coccygeal chordoma]

VARGA Péter Pál

[Chordoma is an uncommon malignant tumor with unusual characteristics developing in the remnants of the notochord and usually manifesting itself in patients in their forties and fifties. It is usually located in the body's symmetrical axis or attached to it. The pathological structure is rather characteristic to benign tumors. Although not painful, it is a mercilessly aggressive local tumor, in some cases resulting metastatic progression and might alter its histological picture in longlived patients. It is found most prevalently (about 60 percent) in the sacrococcygeal region and at the clivus and manifesting itself spinally (over the sacrum) most likely in the lumbar region. Between 1992 and 2002, the authors have treated surgically 37 patients with sacrococcygeal chordoma. They applied wide resection following which only seven patients required re-operation. They show detailed data regarding this patient group and discuss the technical aspects of the wide tumorresection.]

Hungarian Radiology

DECEMBER 20, 2004

[Melorheostosis Uncommon appearances]

KUTKOWSKA-KAZMIERCZAK Anna, OBERSZTYN Ewa, KOZLOWSKI Kazimierz

[INTRODUCTION - Melorheostosis is a rare but well publicised disease. About 320 cases were reported up to 1994. The incidence is estimated 0.9 cases per million. CASE REPORT - We report a 40 year-old man diagnosed with severe melorheostosis and unusual radiographic appearances. No dripping candle wax cortical thickening was present. All the long bones of the upper extremities showed extensive periosteal and endosteal hyperostosis with extension of the changes into the hands and shoulder girdle. Osteosclerosis was present at both sides of the right sacro-iliac joint. There was also hypoplasia of the scapulae, distal ulnae, carpal bones and the left thumb. Distinctive features of the clinical history were that the disease was of prenatal origin. The lower extremities were normal and in spite of extensive bone and soft tissue changes in the upper extremities this patient never experienced pain - a prominent feature of adult melorheostosis. CONCLUSION - Melorheostosis is a rare disorder, diagnosis of which can be made from clinical presentation and radiographs. In case of atypical melorheostosis, the lower extremities may be found to be normal on radiographs. The presentation may be painless.]