Primary osseous tumors of the spinal column account for approximately 1% of the total number of spinal tumors found in the pediatric patient population. The authors present a case of a C1 benign giant cell lesion that was incidentally found in a 15-year-old patient. A transoral biopsy was performed followed by treatment with denosumab, with definitive management in the form of transoral tumor resection with subsequent occiput-cervical three posterior instrumented fusion. The patient tolerated all of the procedures well, as there were no post-operative complications, discharged home neurologically intact and was eager to return to school when assessed during a follow-up visit in clinic. Osteolytic lesions affecting the cervical spine are rare in the pediatric population. It is of utmost importance to have sufficient background knowledge in order to formulate a differential diagnosis, as well as an understanding of principles underlying surgical techniques required to prevent occipital-cervical instability in this patient population. The information presented will guide surgical decision-making by identifying the patient population that would benefit from neurosurgical interventions to stabilize the atlantoaxial junction, in the context of rare osteolytic conditions affecting the cervical spine.
þ1.2mm), however there was no statistically significant difference when compared with B mode (þ2.7mm).CONCLUSIONS: The detection and sizing of stones are feasible with advanced beamforming methods with ultrasound. ADMIRE and MLSC hold promise for improving stone contrast, shadow contrast, and reducing sizing error. Future work will include imaging a broader population of human stone formers.
A 58-year-old man presented to the ED with worsening bilateral leg pain that was associated with unexplained weight loss of 40 lb (18 kg).History The patient reported no history of trauma to the legs. He said the left-sided leg pain began about 6 months ago and was gradual in onset and progression. The pain spread to involve the left hip, right hip, and right thigh in a contiguous fashion. The patient worked with outpatient physical therapy and aquatic therapy with no improvement of symptoms during those 6 months.Three months before this admission, he saw his primary care provider (PCP) about the pain and weight loss. His hemoglobin at that time was 7.8 g/dL, although it had been within the normal range of 13 to 17 g/dL at his last physical examination 1 year earlier. A complete metabolic panel showed mildly elevated alkaline phosphatase of 128 U/L (normal range, 38 to 113 U/L) and elevated amylase of 133 U/L (normal range, 30 to 104 U/L) but was otherwise normal.He visited a gastroenterologist for his unexplained weight loss and diminished appetite and had a colonoscopy with esophagogastroduodenoscopy (EGD), which was completed just 2 days before this admission. Both were unrevealing for any masses or inflammatory disease, but the colonoscopy showed nonbleeding diverticulosis.His leg pain continued, preventing him from working his job in construction and inhibiting his ability to carry out activities of daily living. This caused him to seek medical attention at the ED. On arrival, he reported some lower abdominal pain contiguous with his leg and hip pain. He reported reduced appetite with unexplained weight loss. He was not following any diets or restrictions and reported eating one meal per day, around 9 or 10 p.m. It was not clear if he had tried any protein supplements or shakes. He reported drinking three to four beers per day, and on further discussion, acknowledged drinking four 24-oz beers daily for several years. He was independent before his pain prohibited him from Christopher Heinrich practices in hospital medicine at the Cleveland (Ohio) Clinic Foundation. The author has disclosed no potential conflicts of interest, financial or otherwise.
No abstract
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.