Lumbar discectomy is one of the most commonly performed neurosurgical procedure. Far lateral disc herniations (FLDH) make up a minor portion of the total discectomy workload for spine surgeons. Due to their lower incidence, as well as their different anatomical positioning compared to the more common para-median disc herniation, the surgical procedures involved in releasing the neural compression caused by FLDHs are often challenging and at times frustrating to most spine surgeons, resulting in suboptimal outcomes for the patient related to the higher risk of spinal instability from facet joint disruption and may even be associated with nerve root injury. We discuss here a safe and simple approach to tackle FLDH.

Subdural hematoma (SDH) is a common neurosurgical pathology, characteristically recognised on plain CT and can be treated with simple and effective surgical intervention. In contrast, dural metastatic adenocarcinoma of the prostate with SDH and malignant extension into the subdural membranes is extremely rare. We describe the case of a 62-year old Caucasian male, provide a brief review of the literature, and explore the potential role of neoangiogenesis and disseminated intravascular coagulopathy in SDH development.

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We describe a patient with persisting fevers, a progressive pulmonary infiltrate, and high levels of serum lactate dehydrogenase. No underlying cause for these changes was found prior to her death despite extensive investigations. Postmortem tissue revealed invasive pulmonary aspergillosis and subsequent brain examination revealed vascular changes in keeping with intravascular large B-cell lymphoma (IVLBCL). On review, subtle yet extensive lymphomatous infiltrates involved the vasculature of multiple other organs, including the lungs. Aspergillosis is a relatively rare presenting feature of lymphoproliferative disorders, and IVLBCL is a rare subtype of diffuse large B-cell non-Hodgkin's lymphoma with, to our knowledge, very few case reports to date. Lymphoma should be considered in patients presenting with pneumonitis with bilateral lung infiltrates on imaging, with a high serum level of lactate dehydrogenase.

Extra-skeletal Ewing sarcoma in pregnancy is rare. There is thus limited scientific evidence to guide clinicians in its complicated management, particularly within the context of early gestation. We therefore share our successful outcome in a 32-year-old pregnant patient, following a unique management strategy of complete aggressive surgical resection prior to neo-adjuvant therapy. The case involved a 2-month history of right-sided back and gluteal pain, with associated paraesthesia. Lumbosacral magnetic resonance imaging (MRI) revealed an approximate 40×50 mm indeterminate mass in the lower right paraspinal musculature.The mass extended into the first right sacral foramen and the central canal; and also impinged on the S2 exiting nerve. After considering the patients' rapid deterioration, pregnant status and other clinical factors, it was elected to proceed with complete surgical resection prior to any other therapeutic modality. Following surgery, the patient experienced immediate resolution of her pain and by 6 weeks was able to cease the use of all analgesics. At 32-weeks' gestation she underwent an uncomplicated vaginal delivery. At 9 months follow up, she remains disease free and has experienced complete resolution of her back pain and radiculopathy.

Malignant rhabdoid tumor was first thought to be a subtype of wilm’s tumor, which was later disproven by Haas et al. and was categorized as a separate entity. Malignant rhabdoid tumors are mainly present in the kidneys of children, however, cases of extra renal malignant rhabdoid tumor were reported in the literature. In this report we describe a case of extra renal malignant rhabdoid tumor in the adrenal gland. Malignant rhabdoid tumor is a highly aggressive neoplasm with very poor prognosis. Due to the rarity of the disease, no universal treatment regimen has been developed yet, where treatment options include the surgical removal of the tumor, chemotherapy, radiotherapy, or a multimodality approach of management. In this report we present a case of 21-year-old lady with MRT in the adrenal gland, who had neoadjuvant radio-chemotherapy followed by laparoscopic adrenalectomy.

Diagnosis of low-grade B cell lymphoma can be challenging especially on limited cytological and histological samples, CD180 is Toll-like receptor that was found to be of value in the diagnosis of marginal zone lymphoma using flow cytometry. In this pilot study, we examine the expression of CD180, using an immunohistochemical method, on a number of common B cell lymphoproliferative neoplasms. Immunohistochemical staining for sixty-seven cases of five B cell neoplasms, specifically, marginal zone lymphoma, mantle cell lymphoma, diffuse large B cell lymphoma, follicular lymphoma, and chronic lymphocytic leukemia/small lymphocytic lymphoma was performed on archived, paraffin-embedded, formalin-fixed tissue. CD180 expression is preserved in all cases of marginal zone lymphoma, sixteen out of 17 cases of follicular lymphoma cases, and none of the diffuse large B cell lymphoma or chronic lymphocytic leukemia/small lymphocytic lymphoma cases. One in 12 cases of mantle cell lymphoma shows weak and focal staining. Using CD180 immunohistochemical stain can be valuable and offer some help in the diagnosis of B cell neoplasms, especially on small tissue samples.

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