Study design Retrospective review of spinal exostoses treated at our institution and literature review. Objectives Review of 12 cases of spinal exostoses treated at our institution compared with 165 cases of spinal exostoses reported in the literature. Summary of background data Spinal exostoses are uncommon. Most reports consist of 1 to 3 cases. The relationship between solitary exostoses and those associated with multiple hereditary exostoses (MHE), as well as the incidence of intraspinal and extraspinal location, symptoms presentation, and results of treatment are unclear. Methods The medical records, operative reports, and diagnostic imaging of 12 patients with spinal exostoses treated at our institution between 1972 and 2002 were reviewed. The literature was reviewed using MEDLINE search of English literature and bibliographies of published manuscripts. Results Solitary spinal exostoses were more common than those associated with MHE. Lesions were most common in the upper cervical spine and originated from the posterior elements. Patients with exostoses associated with MHE were significantly younger and had a higher incidence of symptoms consistent with neural structure compression than patients with solitary exostoses. Complete excision resulted in resolution of preoperative symptoms. Intralesional excision resulted in recurrence in all cases. Conclusions Spinal exostoses are more common than reported previously. Patients with MHE that present with back pain or neurological symptoms should produce a high index of suspicion. Evaluation should include both computed tomography and magnetic resonance imaging to define the origin of the exostosis and the presence of neural structure compression. Surgical excision should be preformed en bloc.

Spinal exostoses: analysis of twelve cases and review of the literature.

Object Spinal osteochondromas (OCs) are rare and can originate as solitary lesions or in the context of hereditary multiple exostoses. Concurrent spinal cord compression is a very rare entity. The purpose of this study was to evaluate the authors' 10-year experience with the imaging characteristics and surgical outcome in patients with symptomatic spinal OC. Methods Between 1997 and 2007, 8 consecutive cases of symptomatic intraspinal OC with documented spinal cord compression were treated surgically. These patients were analyzed with regard to presentation, imaging, and outcome. The relevant English literature was reviewed using MEDLINE and Google search engines. Results Three patients had cervical, 2 had thoracic, and 3 had lumbar lesions. Classic MR imaging characteristics were rarely found. Multiple hereditary exostoses were equally responsible for cervical, thoracic, and lumbar lesions (33%). The origin of the lesion was from the pedicle (25%), lamina (25%), vertebral body (25%), and superior or infe...

Neurological manifestations, imaging characteristics, and surgical outcome of intraspinal osteochondroma.

Cervical spinal cord compression due to an osteochondroma in hereditary multiple exostosis: case report and review of the literature.

A 50 year old man presented with progressive unilateral cranial nerve palsies (Garcin's syndrome) for one year. Skull radiography and computed tomography (CT) showed intracranial extension of a soft tissue tumour from the right base of the skull. Necropsy revealed a papillary cell carcinoma of the right kidney and metastases in the base of the skull.

https://jnnp.bmj.com/content/jnnp/53/7/613.full.pdf

Renal cell carcinoma presenting as Garcin's syndrome.

Study Design. Case report. Objective. To report on thoracic spinal cord compression caused by a mass in a 66-year-old female with new onset of myelopathic symptoms and a history of multiple hereditary exostoses. Summary of Background Data. To our knowledge, there have been no previous reports of spinal cord compression in a patient with multiple hereditary exostoses caused by breast adenocarcinoma metastatic to osteochondromas of the spine. Methods. Chart, pathologic, and radiographic documentation of the preoperative and postoperative clinical course of the patient was used. Results. The patient had resolution of her neurologic symptoms following wide surgical excision, decompression, and stabilization from T2 to T10. The patient’s mass was found to be breast adenocarcinoma metastatic to osteochondromas of the spine. Conclusions. When faced with a patient with a history of multiple hereditary exostoses with new onset of myelopathic symptoms and a mass compressing the spinal cord, the clinician’s differential should be broad and always initially include a metastatic lesion, osteochondroma, or chondrosarcoma.

Spinal Cord Compression in a Patient With Multiple Hereditary Exostoses Caused by Breast Adenocarcinoma Metastatic to Osteochondromas of the Spine: Case Report

A case of hereditary multiple exostoses successfully operated is reported. The patient, a 15 year-old white brazilian boy, was admitted with tetraplegia and Babinski's sign. Early diagnosis followed by prompt surgery may prevent permanent spinal cord damage.

/pdf/exostose-multipla-hereditaria-com-compressao-medular-1okuiyq214.pdf

Exostose múltipla hereditária com compressão medular

A case of giant aneurysm of the left middle cerebral artery, in a 28-year-old right-handed woman, successfuly operated is reported The aneurysm measur- ing 35 x 27 x 23 mm showed clinical manifestations as a space-occupying lesion The patient recovered completely after the total excision of the aneurysm

/pdf/aneurisma-gigante-da-arteria-cerebral-media-2r79opfuzg.pdf

Aneurisma gigante da artéria cerebral média

The cases of nine pacients with intracranial abscess operated on by aspiration are reported. Only one patient did not survive. One pacient developed postoperative seizures and, another, hemiparesis. In 5 cases it was necessary a relief of increased intracranial pressure by neurosurgical emergency.

/pdf/treatment-of-intracraneal-abscess-by-tapping-oxkgez3zkv.pdf

Luiz F. Castro

Papers

Exostose múltipla hereditária com compressão medular

Aneurisma gigante da artéria cerebral média

Treatment of intracraneal abscess by tapping