The surgical records at the National Institute of Mental Health and Neurosciences, Bangalore, revealed 75 cases of spinal epidural malignant tumours operated on in a period of 8 years (1972-1980). Of these, 21 cases (30.4%) were labelled as "primary" spinal lymphomas, with no evidence of any systemic lymphomatous deposit anywhere in the body at the time of surgery. An analysis of their clinical behaviour, treatment, histological classification, and prognosis showed that a (majority of the patients had lower limb weakness and localized pain at the site of lesion as the presenting clinical symptom, b) laminectomy with decompression of the tumour followed by radiotherapy was the treatment of choice, c) histologically mixed histiocytic lymphocytic variety of lymphoma was commonest, and d) six survivors had a histiocytic lymphocytic lymphoma, suggesting a better prognosis associated with this type.
A case of subdural effusion caused by carcinomatous metastatic dural deposits is presented. An attempt is made to explain the possible underlying pathophysiological mechanism of malignant subdural haemorrhagic effusion. Whenever malignant subdural effusion is suspected, biopsy of the membrane and cytological examination of the fluid is imperative for a definite diagnosis.
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