1.
Management of brown tumor of spine with primary hyperparathyroidism: A case report and literature review.
Hu, J, He, S, Yang, J, Ye, C, Yang, X, Xiao, J
Medicine. 2019;(14):e15007
-
-
Free full text
-
Abstract
RATIONALE Brown tumor (BT) is a rare benign lesion in skeletal system. It is especially rare secondary to primary hyperparathyroidism (HPT). The differential diagnosis can be misleading due to its diversified clinical characteristics. Final diagnosis mainly relies on excessive elevated parathyroid hormone and biopsy. Treatments include surgical interventions and drugs. Only 19 articles (total 22 cases) reported BT of spine caused by primary HPT. PATIENT CONCERNS A 50-year-old woman was admitted to our hospital complaining left elbow and thoracodorsal pain with the lower limbs weakness. DIAGNOSES Multifocal BT. INTERVENTIONS The patient received intramuscular injection of Miacalcic and incense of Calcitonin (Salmon) Nasal Spray to decrease serum calcium level. Surgery was performed later to excise the ectopia parathyroidoma. OUTCOMES At 1-year follow-up, the patient was able to lead an independent life in her full capacity, even though she occasionally complained mild weakness of lower limbs. LESSONS BT of spine with HPT is rarely seen in the clinical practice. Treating the primary parathyroid diseases can be effective. For patients with vertebral fractures and neural deficits, immediately surgical intervention will be necessary to prevent the worse of neurological function.
2.
Solitary juvenile xanthogranuloma in the spine pretreated with neoadjuvant denosumab therapy followed by surgical resection in a 5-year-old child: case report and literature review.
Irmola, T, Laitinen, MK, Parkkinen, J, Engellau, J, Neva, MH
European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society. 2018;(Suppl 3):555-560
Abstract
PURPOSE We present a case report that describes neoadjuvant denosumab therapy initiated in a child with a solitary giant cell-rich juvenile xanthogranuloma tumor involving the spine, and review the current literature. METHODS A giant cell-rich histiocytic lesion involving the 11th thoracic vertebral body was identified in a healthy 5-year-old girl with persistent back and pelvic pain for several months. Imaging examinations and an open biopsy were performed to obtain a definite pathologic diagnosis. As the tumor appeared to be aggressive in nature, we administered adjuvant therapy with denosumab preoperatively and then performed a total spondylectomy. RESULTS Histopathology confirmed that the tumor was juvenile xanthogranuloma. No tumor metastases or recurrence were detected at the 3-year follow-up, and the patient was asymptomatic. CONCLUSIONS In giant cell-rich tumors, denosumab is occasionally used as neoadjuvant or adjuvant therapy, especially for tumors in difficult locations or with substantial soft tissue extensions. Rare adverse events in children include skin infections and disruption of calcium homeostasis. Surgical treatment is aimed at removing the tumor and relieving the symptomatic spinal cord compression. Use of denosumab as neoadjuvant therapy for juvenile xanthogranuloma involving the spine has not been reported previously.
3.
Congential scoliosis in Wilson's disease: case report and review of the literature.
Li, Z, Yu, X, Shen, J, Liang, J
BMC surgery. 2014;:71
Abstract
BACKGROUND Wilson's disease (WD) is an autosomal recessive disorder of copper metabolism, which leads to the accumulation of this metal in liver, brain, cornea and kidney. Little is reported about spinal deformity associated with this syndrome. This study is to present a case of thoracic kyphosis occurring in the setting of Wilson'disease and explore the possible association between the two diseases. CASE PRESENTATION Case report and literature review. A previously unreported thoracic kyphosis in Wislon's disease is decribed. The patient was a 7-year-old Chinese female that underwent a posterior correction, using the Moss-SI spinal system performed at Thoracic 9-Lumbar 1 (T9-L1) levels. At 16-month follow-up, the patient was clinically pain free and well balanced. Plain radiographs showed solid spine fusion with no loss of deformity correction. After evaluating 211 WD patients referred to Peking Union Medical College Hospital from February 1991 to February 2012, the prevalence of congential scoliosis among patients with WD was 5.21% (11/211), much higher than that among general population (1/1000). CONCLUSIONS To the best of our knowledge, this is the first report of WD with thoracic kyphosis. During sugery, surgeons and anesthesiologists must pay particular attention to the abnormal liver and brain function associated with WD. The prevalence of scoliosis is much higher among patients with WD, indicating a potential association between congential scoliosis and WD. However, the exact mechanism how copper-chelating agents induce scoliosis is unclear.