Spinal metastasis

In most cases of the thoracolumbar infarction, the swollen cord shows peripheral enhancement of the central gray matter. The concomitant enhancement of the cauda equina was reported first by Friedman and Flanders in 1992 (Fig. 17.8). This phenomenon is a characteristic finding in the course of spinal cord ischemia which might involve the cord itself and the ventral cauda equina as well, which is composed of motor fibre bundles (Amano et al. 1998). It indicates disruption of the blood-cord barrier as well as reactive hyperemia (Friedman and Flanders 1992 Amano et al. 1998). The differential diagnosis of contrast enhancement of the cauda equina includes transverse myelitis, bacterial or viral meningitis, and spinal metastasis. 

Then the soft tissue sample was taken with an 18-G (13 cm) Tru-Cut biopsy needle under CTF guidance (b). Histopathol-ogy revealed a spinal metastasis of prostate carcinoma... 

Alvarez L, Alcaraz M, Perez-Higueras A, Granizo JJ, de Miguel I, Rossi RE et al Percutaneous vertebroplasty functional improvement in patients with osteoporotic compression fractures. Spine 2006 31 1113-8.Chataigner H, Onimus M Surgery in spinal metastasis without spinal cord compression indications and strategy related to the risk of recurrence. Eur Spine J 2000 9 523-7... 

G7. Gokaslan, L., Chintala, S. K., York, J. E., et al.. Expression and localization of urokinase-type plasminogen activator in human spinal column tumors. Clin. Exp. Metastasis. 16, 713-719 (1998). 

A few rare cases have been known to degenerate into a spinal cellular carcinoma with metastasis to the lungs... 

Fig. lO.la-e. Painful thoracic metastasis with rupture of the posterior wall. Percutaneous vertebroplasty under dual guidance of computed tomography (CT) and fluoroscopy, a Plani-flcation of the needle intercostovertebral pathway on CT. b A 22-gauge spinal needle is used for local anesthesia. This needle is used as a pilot (tandem technique) for the vertebroplasty needle, c The 10-gauge needle positioned in the anterior part of the tumor. Injection of methylmethacrylate under strict lateral fluoroscopy, d, e Good vertebral Ailing with excellent pain relief... 

Weill A, Chiras J, Simon JM et al (1996) Spinal metastases indications for and results of percutaneous injection of acrylic surgical cement. Radiology 199(l) 241-247 Wenger M (2003) Vertebroplasty for metastasis. Med Oncol... 

Lomax AJ, Yannakou CK, Rosenthal MA. Spinal cord metastasis in a patient treated with bevacizumab for glioblastoma. Target Oncol... 

Fig. 24.12. Clear cell sarcoma of the kidney in a 9-year-old boypresenting with hematuria. Contrast-enhanced CT (coronal reconstruction) shows a left upper pole renal mass and a spinal bone metastasis (arrow) (courtesy Dr. J.-L. Ferrand, Clinique Saint-Jean, Montpellier, France)...

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