Spinal cord compression by secondary epi- and intradural metastases in childhood

Abstract

Over a 9-year period, 35 out of 614 children with malignant tumours who were treated at the Centre Léon Bérard developed spinal metastases. Of these, 18 with known malignancies before the development of spinal cord compression are reviewed. The most common tumours causing spinal metastases were Ewing's sarcoma, neuroblastoma and renal tumours. Cord compression occurred 5-88 months after the diagnosis of systemic cancer. The median interval from first symptoms to the diagnosis of compression was 17 days. There were 16 patients with neurological deficit, including 5 with paraplegia. Specific imaging procedures were performed in 16 patients. Treatment included operation in 8 patients, followed by chemotherapy (6 patients) and/or radiotherapy (4 patients); 9 of the 10 non-operated patients received radiotherapy. Only 6 patients had a significant neurological improvement. All patients but 1 died within a median time of 2 months. Early diagnosis might prevent permanent disability in these children with a short survival expectancy.

Spinal intradural extraosseous Ewing's sarcoma

“…In previously reported cases, only Bouffet et al provide sufficient follow-up data to determine whether this has been previously encountered. 6 In one of the two patients described in that report, metastasis was limited to the intrathecal space. In our patients, there has not been recurrence outside of the central nervous system.…”

Intradural extramedullary Ewing's sarcoma: A case report and review of the literature

“…The MRI usually reveals one or more inhomogeneous lesion, with solid (isointense on T1, hyperintense on T2 and irregularly enhancing after gadolinium administration) and cystic components (hyperintense on T1, with numerous septations and mural nodules) [3,11,15,18]. Systematic screening and screening of the neuraxis for synchronous lesions is justified [3,5,8,9,13,17,22]. The simultaneous existence of two intradural tumors in our patient at the L2-L3 level and the L5 level may be considered as a very unusual presentation pattern.…”

“…The symptomatology is similar with any other space-occupying lesion of the spinal cord [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18]20,22]. The MRI usually reveals one or more inhomogeneous lesion, with solid (isointense on T1, hyperintense on T2 and irregularly enhancing after gadolinium administration) and cystic components (hyperintense on T1, with numerous septations and mural nodules) [3,11,15,18]. Systematic screening and screening of the neuraxis for synchronous lesions is justified [3,5,8,9,13,17,22].…”

“…This neoplasm is more common in males [3][4][5][6][7][8][9][10][11][12][13][14] during the 4th decade of life [1,11,15,16] and usually affects the thoracic and lumbar regions [3][4][5][6][7][9][10][11][12][13][15][16][17][18][19][20]; however, there are a few reports involving cervical spine [14,[21][22][23]. The symptomatology is similar with any other space-occupying lesion of the spinal cord [3][4][5][6][7][8][9][10][11][12][13][14][15][16]…”

Spinal Compression Due to Burkitt Lymphoma in a Newly Diagnosed HIV-infected Child

“…14,15 Evidence to support this approach is also derived from studies of medullar compression due to neuroblastoma and tumoral metastases. 16,17 The reduced immunity in HIV-infected patients with lymphoma makes them more susceptible to the toxic effects of cytostatics, hence a higher risk exists of severe, lifethreatening infections during chemotherapy. Before the widespread use of HAART, in patients with Burkitt lymphoma and HIV, the chemotherapy was less aggressive than in non-HIV-infected patients, with corresponding poorer results.…”