Occult intraspinal abnormalities and congenital scoliosis

Background: Congenital scoliosis occurs because of either the failure of formation or the failure of segmentation or both. Evaluation of the incidence and the types of occult intraspinal abnormalities in congenital scoliosis is the subject of this study. Methods: During a period of 29 years, 103 patients with congenital scoliosis were studied. MRI was used in 46 patients, myelography or CT myelography was used in 64 patients and both MRI and myelography or CT myelography were used in 7 patients for intraspinal abnormalities. Results: In the MRI group, among the 46 patients, 19 patients (41.3) had intraspinal abnormalities consisting syringomyelia in 9 (19.5) diastematomyelia in 8 (17.4), tethered cord syndrome in 6 (13), low conus in 5 (10.8) and diplomyelia in 3 (6.5) of the patients. In the myelography group, among the 64 patients, 17 (26.5) had intraspinal abnormalities and diastematomyelia was the most common one found in 14 (21.8) patients. Conclusions: Intraspinal abnormalities are frequent in congenital scoliosis. Syringomyelia may be associated with congenital scoliosis. In congenital scoliosis, rib fusion may be an indicator of intraspinal abnormalities in MRI. A significant difference between clinical findings and intraspinal anomalies (P<0.05) was noted. Moreover, we believe that total spinal MRI with coronal, sagittal and axial views is a valuable tool in determining the intraspinal abnormalities in congenital scoliosis. This method is highly recommended for detection and neurosurgical intervention before corrective surgeries

Humeral metastasis from a sacrococcygeal chordoma: a case report

<p>Abstract</p> <p>Introduction</p> <p>Chordomas are rare tumors of the skeletal system that arise from an intra-osseous benign precursor of notochordal cells. They are mainly locally aggressive. However, metastases to other sites, including the humeri, resulting in pathological fractures have been reported. We report the case of a patient with a metastatic chordoma that produced a pathologic fracture of the humerus.</p> <p>Case presentation</p> <p>We report the case of a 60-year-old Iranian woman who presented with a fracture of her right humerus following a minor trauma. She had a history of a sacrococcygeal chordoma. Histological and immunohistochemical studies of the fracture site suggested the diagnosis of a chordoma.</p> <p>Conclusions</p> <p>Chordoma is a rare tumor and rarely metastasizes, but it should be considered in the differential diagnosis of epithelioid bone tumors. The only current effective treatment for this type of tumor is carbon ion therapy. There is currently no effective medical therapy available for advanced chordoma, and this type of tumor is not very responsive to radiotherapy.</p