Indolent enhancing spinal lesions mimicking spinal metastasis in pediatric patients with malignant primary brain tumors
| Autor: | Feng Chi Chang, Yi-Yen Lee, Chih Chun Wu, Shih-Chieh Lin, Yi-Wei Chen, Ting-Rong Hsu, Hsin Hung Chen, Shu-Ting Chen, Ching-Lan Wu, Hsin-Wei Wu, Chia-Hung Wu, Kang-Lung Lee |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Adult
Male Pathology medicine.medical_specialty Adolescent Science Biopsy Article Malignant Primary Brain Tumors Metastasis Diagnosis Differential Young Adult Predictive Value of Tests medicine Humans Child Bone Marrow Diseases Retrospective Studies Multidisciplinary Spinal Neoplasms business.industry Brain Neoplasms Magnetic Resonance Imaging Spine CNS cancer Child Preschool Medicine Spinal metastasis Female Cancer imaging business |
| Zdroj: | Scientific Reports Scientific Reports, Vol 12, Iss 1, Pp 1-10 (2022) |
| ISSN: | 2045-2322 |
| Popis: | Spinal metastasis from malignant primary brain tumors (MPBTs) in pediatric patients is rare and often appears as enhancing lesions on MRI. However, some indolent enhancing spinal lesions (IESLs) resulting from previous treatment mimic metastasis on MRI, leading to unnecessary investigation and treatment. In 2005–2020, we retrospectively enrolled 12 pediatric/young patients with clinical impression of spinal metastasis and pathological diagnosis of their spinal lesions. Three patients had MPBT with IESL, and 9 patients had malignant tumors with metastases. The histopathologic diagnosis of IESL was unremarkable marrow change. We evaluated their MRI, CT, and bone scan findings. The following imaging findings of IESL vs. spinal metastasis were noted: (1) IESLs appeared round/ovoid (3/3, 100%), whereas spinal metastasis appeared irregular (9/9, 100%) (P = 0.005); (2) target-shaped enhancement was noted in (3/3, 100%) vs. (0/9, 0%) of cases, respectively (P = 0.005); (3) pathologic fracture of the vertebral body was noted in (1/3, 33.3%) vs. (9/9, 100%) of cases, respectively (P = 0.045); (4) expansile vertebral shape was noted in (0/3, 0%) vs. (9/9, 100%) of cases, respectively (P = 0.005); (5) obliteration of the basivertebral vein was noted in (0/3, 0%) vs. (9/9, 100%) of cases, respectively (P = 0.005); and (6) osteoblastic change on CT was noted in (3/3, 100%) vs. (2/9, 22.2%) of cases, respectively (P = 0.034). IESL in pediatric patients with MPBT can be differentiated from metastasis based on their imaging characteristics. We suggest close follow-up rather than aggressive investigation and treatment for IESL. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full text from SpringerLink