2 research outputs found
Recurrence and Prognostic Value of Asymptomatic Spinal Cord Lesions in Multiple Sclerosis
Spinal magnetic resonance imaging (MRI) is currently not recommended for the routine monitoring of clinically stable multiple sclerosis (MS) patients. We aimed to investigate the occurrence of asymptomatic spinal lesions (a-SL) in clinically stable MS patients, and their association with clinical and radiological outcomes, including the recurrence of spinal lesions. The hospital MS registry was searched for clinically stable MS patients (no relapses, no disability progression) with spinal MRIs performed at T1 (baseline) and T2 (9-36 months after T1). Information on relapses, disability and new brain/spinal MRI lesions at T3 ( 656 months after T2) was collected and analyzed. Out of 300 MS patients, 45 showed a-SL between T1 and T2. The presence of a-SL was not associated with the subsequent occurrence of relapses or disability progression at T3, but did correlate with the risk of new brain (rate ratio (RR) = 1.63, 95% CI = 1.16-2.25, p = 0.003) and recurrent spinal lesions (RR = 7.28, 95% CI = 4.02-13.22, p < 0.0001). Accounting for asymptomatic brain lesions (a-BL), the presence of either a-BL or a-SL was associated with subsequent risk for new brain (OR = 1.81, 95% CI = 1.25-2.60, p = 0.001) or spinal (RR = 2.63, 95% CI = 1.27-5.45, p = 0.009) lesions. Asymptomatic spinal demyelinating lesions occurred in 15% of clinically stable MS patients within a median period of 14 months and conferred an increased risk of future radiological activity at the brain and spinal level
A rare case of life-threatening giant plexiform schwannoma
A 28-year-old woman with idiopathic scoliosis presented
with a cervical mass and progressive gait disturbance over the
course of 2 years. Examination demonstrated mild spastic
paraplegia, hypoesthesia with upper level at T5 and severe
respiratory failure requiring assisted ventilation. Magnetic
resonance imaging showed multiple thoracic masses compressing
left lung, trachea, and spinal cord (Figure). Surgical
resection was performed. Through C5\u2013T1 laminectomy, the
intradural part of the neoplasia was completely removed, and
the extradural part was enucleated as much as possible. After
surgery, the respiratory function improved. Histologic pattern
and S100 protein diffuse reactivity were consistent with
plexiform schwannoma, a rare benign cutaneous variation of
schwannoma [1]. Although deep-seated plexiform schwannomas
involving spinal cord are occasionally described [2],
this case is undoubtedly impressive because of the lifethreatening
tumor size (Figure)