CASE REPORT BY DR. MODAR MONTHER SPINAL CORD TUMORS.

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Presentation transcript:

CASE REPORT BY DR. MODAR MONTHER SPINAL CORD TUMORS

SPINE AND SPINAL CORD TUMORS Dr. Modar Monther; Neurosurgeon, Dr. Abanamy Hospital 15% of primary CNS tumors. Most primary CNS spinal tumors are benign. Most present by compression rather than invasion.

CLASSIFICATION Dr. Modar Monther; Neurosurgeon, Dr. Abanamy Hospital Extradural (ED) 55% Intradural extramedullary (ID-EM) 40% Intramedullary spinal cord tumors (IMSCT) 5%

Extradural Spinal Tumors Dr. Modar Monther; Neurosurgeon, Dr. Abanamy Hospital Metastatic  Majority of ED tumors  Lymphoma  Lung  Breast  Prostate  Most osteolytic, some osteoblastic. Primary

Primary Skeletal Neoplasms Dr. Modar Monther; Neurosurgeon, Dr. Abanamy Hospital CELL OF ORIGINBENIGNMALIGNANT OsseousOsteoid Osteoma Osteoblastoma Osteosarcoma CartilaginousOsteochondroma Enchondroma Chondroblastoma Chondromyxoid-fibroma Chondrosarcoma FibrousFibromaFibrosarcoma Malignant fibrous histocytoma

Primary Skeletal Neoplasms Dr. Modar Monther; Neurosurgeon, Dr. Abanamy Hospital Marrow  Ewing’s sarcoma  Multiple myeloma  Lymphoma  Metastasis others  Giant cell tumor  Hemangioma  Related lesions  Eosinophilic-Granuloma  Aneurysmal-Bone cyst

Intradural Extramedullary Dr. Modar Monther; Neurosurgeon, Dr. Abanamy Hospital Meningioma lymphoma

Intramedullary Spinal Cord Tumors Dr. Modar Monther; Neurosurgeon, Dr. Abanamy Hospital Astrocytoma 30% Ependymoma 30% miscellaneous

CASE REPORT Dr. Modar Monther; Neurosurgeon, Dr. Abanamy Hospital MRN : year-old male Complaint of pain and parasthesia of the right thigh No urinary incontinence

Neurological Exam Dr. Modar Monther; Neurosurgeon, Dr. Abanamy Hospital Parasthesia of the right thigh down to the antero- lateral aspect of the right leg Weak tendon reflex of the right knee Other tendon reflexes normal Motor power and tone normal

RADIOLOGY TIWI MRI: low intensity well defined mass Dr. Modar Monther; Neurosurgeon, Dr. Abanamy Hospital

RASIOLOGY T2WI MRI: The same lesion, hyperintense on T2WI with encroachment of the spinal cord at the T12 level Dr. Modar Monther; Neurosurgeon, Dr. Abanamy Hospital

RADIOLOGY TIWI MRI with gadolinium: The lesion shows inhancement Dr. Modar Monther; Neurosurgeon, Dr. Abanamy Hospital

RADIOLOGY The hyperintense lesion showing significant encroachment on the spinal cord Dr. Modar Monther; Neurosurgeon, Dr. Abanamy Hospital

MANAGEMENT Dr. Modar Monther; Neurosurgeon, Dr. Abanamy Hospital Microscopic excision of the tumor

SURGERY Dr. Modar Monther; Neurosurgeon, Dr. Abanamy Hospital TUMOR DURA OPENED AND RETRACTED SPINOUS PROCESSES OF T11, L1 AFTER T12 LAMINECTO MY

SURGERY Dr. Modar Monther; Neurosurgeon, Dr. Abanamy Hospital Spinal cord compressed anterior to the tumor

SURGERY Dr. Modar Monther; Neurosurgeon, Dr. Abanamy Hospital SPINAL CORD AFTER RESECTION OF THE TUMOR

SURGERY Dr. Modar Monther; Neurosurgeon, Dr. Abanamy Hospital Water-tight dural closure

PATHOLOGY Dr. Modar Monther; Neurosurgeon, Dr. Abanamy Hospital Benign Schwannoma

POST - OP Dr. Modar Monther; Neurosurgeon, Dr. Abanamy Hospital The patient was discharged from hospital after 5 days without any neurological deficit

Dr. Modar Monther; Neurosurgeon, Dr. Abanamy Hospital Thanks Dr. Maan Kurdi Anesthesia Department/OT staff OPD department Surgery department LAB department