Spinal Tumors （Soft tissue tumors）原发性脊柱肿瘤（软组织肿瘤）课件.ppt

Female hemorrhage rate affected by hormones. * Re Hemorrhage rates are rare. * The case of an intramedullary intradural thoracic spinal cord lipoma in the absence of dysraphism is an extraordinary finding. Caram et al. published a study of 51 intradural lipomas [2] of which only 7 were identified as truly intramedullary lesions [3], and most of the intramedullary lipomas that have been reported in adults were found to be located in the conus medullaris or cauda equina in association with dysraphism [4]. Non-dysraphic lipomas appear to be true neoplasms as compared to hamartomatous dysraphic lipomas. The former undergo a progressive increase in tumor size due to adipocyte hyperplasia whereas the latter only grow via hypertrophy [5]. The clinical presentation of intramedullary lipomas is similar to that of other intramedullary masses that cause cord compression, namely progressive myelopathy, axial pain, gait difficulties, weakness, and sensory disturbance. Symptoms vary depending on the exact tumor location. MR imaging is the most sensitive modality for diagnosing these tumors preoperatively. Hyperintense lesions on T1-weighted images that lose signal intensity on fat saturation sequences are the hallmark of these tumors. Spinal lipomas are indolent tumors thought to be congenital in origin, and as such, they may replace normal neural tube tissue during development, leading to a relatively vulnerable cord with compromised function. * Figure 2. (a) Mature adipocytes surrounding a segment of peripheral nerve . (b) Mature adipocytes with eccentrically placed nuclei and no evidence of malignancy or dedifferentiation. This slide excludes the possibility of liposarcoma. * Primary Spinal Tumors(Soft tissue tumors) H. Louis Harkey Department of Neurosurgery University of Mississippi Jackson, MS Anatomical Classification of Spinal Cord Tumors Extradural : Benign and malignant verteberal tumors, tumors near the spinal cord. Intradural tumors Extramedullary: n