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Chirurgia 2018 August;31(4):158-62

DOI: 10.23736/S0394-9508.17.04772-6

Copyright © 2017 EDIZIONI MINERVA MEDICA

lingua: Inglese

Spinal leiomyoma: description of a very rare localization in the spine and literature review

Paolo QUAGLIETTA

Unit of Neurosurgery, Department of Neurosciences, Hospital of Cosenza, Cosenza, Italy


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Leiomyomas are benign tumors composed of smooth muscle, vascular and collagen tissue which are predominantly found in the uterus and gastrointestinal tracts (>2% of soft tissue tumors with an incidence of 8 per million subjects). Involvement of the spine is extremely rare. This paper presents the case of a young woman with a localization to the transverse process of the T12 level in the absence of symptoms. A 36-year-old woman treated in November 2015 for a Hodgkin’s lymphoma and in remission presented with an CT that showed a mass of the 1 cm at the left transverse process of T12. On magnetic resonance imaging (MRI), the tumor was well-circumscribed, isointense on T1-weighted image. Following gadolinium administration, the tumor showed no contrast enhancement. In the presumption of a malignant localization and express wish of the patient, posterior approach was performed in June of 2016. Due to the well-demarcated dissection plane and mild adhesion to the left transverse process, the tumor was completely removed. Histopathological examination showed a compact gray nodule of 1.3 cm g, vascularized and bordered of striated muscle tissue composed of spindle-shaped elements arranged in a collated pattern without significant cellular pleomorphism or mitotic activity. Immunohistochemical examination revealed that the tumor cell were positive for smooth muscle actin ML; negative for 34 CD and S 100-. The Ki67 and MIBI index was 5%. Taken together all of these findings were consistent with a diagnosis of leiomyoma vascular. The postoperative period was normal, and the patient was discharged in good clinical condition with no neurological deficits. Although the spinal leiomyomas are extremely rare, in the literature have been published to our knowledge only 8 cases, they should be considered in the differential diagnosis of rare spinal lesions in females. Of course, the total removal of the lesion is key in the treatment of such tumors. In our case the size and the localization they have facilitated the excision thus giving a definitive answer to the anxieties of a patient already treated for Hodgkin’s lymphoma in the presumption that this localization could be in relation with the underlying disease.


KEY WORDS: Leiomyoma - Spinal neoplasms - Epidural neoplasms

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