The literature on spinal neurinomas (N) and meningiomas (M) in children is reviewed, and five personal cases of N are added (one in the context of Recklinghausen's disease). The cases of N totalled 151, and of M 69, accounting respectively for 10.9% and 4.3% of childhood spinal tumours and 2.6% and 1.3% of spinal N and M of all ages. Sixty-one cases of N (16 in the context of Recklinghausen's disease) and 26 cases of M (5 in the context of Recklinghausen's disease) are analyzed in detail. N occurs chiefly between ages 9 and 15 years, the sex ratio is 3 : 2, all levels of the spinal canal are equally affected, and extradural N or conditions with an extradural component (48%) are more frequent than in adults (26.9%). M occurs chiefly between 12 and 15 years, the sex ratio is 3 : 2, the prevalence of the thoracic segment (47.8%) is less marked than in adults (81%), and the frequency of the extradural site (10.6%) is close to the sum of the extradural and dumb-bell lesions in adults (11.1%). In children vertebral signs, i.e., spinal rigidity and tenderness, and spasm of paravertebral muscles, are more intense, earlier, and more frequent than in adults, and the clinical history is shorter. The chances of recovery from neurological deficits are greater, as are those of malignant degeneration.
✓ Two cases of intramedullary neurinoma are presented in patients with no signs of von Recklinghausen's disease. Only 16 similar cases have been published so far. The relevant literature is reviewed.
SummaryThis paper reports two cases of spinal osteochondroma, in whi& preoperative diagnosis was greatly facilitated by CT scan examination. Moreover, by giving a precise indication of turnout extent, as well as of its relationships with the adjacent structures, CT was of great value also with regard to surgical treatment.Personal experience with the present cases, as well as a review of pertinent literature, suggests that the following CT scan findings may be considered as typical of spinal osteochondroma: a) roundish, sharply-outlined mass; b) bone-like density, with scattered calcifications; c) paraspinal, dumb-bell, or eccentric intraspinal location; d) osteosclerotic &anges in neighbouring bone; e) lack of contrast enhancement.The value of CT scan examination in the diagnosis of vertebral tumours is stressed.
Six cases of giant cell tumor of the spine are reported. Based on cases reported in the literature and on their personal experience, the authors stress the difficulty of making a proper differential diagnosis between giant cell tumor and other giant cell variants (i.e., aneurysmal bone cyst and benign osteoblastoma) on the basis of the clinicoradiological findings alone. It is pointed out that the disappointing recurrence rate of about 50% for giant cell tumors in ordinary locations (such as the long bones) and in the sacrum is remarkably decreased when these tumors involve the movable part of the vertebral column; giant cell tumors above the level of the sacrum have a better prognosis. (Neurosurgery, 6: 29--34, 1980)]
This paper reports two cases of spinal osteochondroma, in which preoperative diagnosis was greatly facilitated by CT scan examination. Moreover, by giving a precise indication of tumour extent, as well as of its relationships with the adjacent structures, CT was of great value also with regard to surgical treatment. Personal experience with the present cases, as well as a review of pertinent literature, suggests that the following CT scan findings may be considered as typical of spinal osteochondroma: a) roundish, sharply-outlined mass; b) bone-like density, with scattered calcifications; c) paraspinal, dump-bell, or eccentric intra-spinal location; d) osteosclerotic changes in neighbouring bone; e) lack of contrast enhancement. The value of CT scan examination in the diagnosis of vertebral tumours is stressed.
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