GIANT LUMBO-SACRAL TUMORS

Objectives Despite comprising just 8% of all spinal tumors, sacral tumors present a long list of issues that should be taken in consideration when neurosurgical approach is tempted. Their unique anatomic location, close relation with neural structures and pelvic organs and high-vascularity are j...

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Main Authors: Mihai-Stelian Moreanu, Ovidiu Zamfir, Alin-Vasile Chirtes, Augustin Dima, Marian Mitrica
Format: Article
Language:English
Published: London Academic Publishing 2024-11-01
Series:Romanian Neurosurgery
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Online Access:http://journals.lapub.co.uk/index.php/roneurosurgery/article/view/2834
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author Mihai-Stelian Moreanu
Ovidiu Zamfir
Alin-Vasile Chirtes
Augustin Dima
Marian Mitrica
author_facet Mihai-Stelian Moreanu
Ovidiu Zamfir
Alin-Vasile Chirtes
Augustin Dima
Marian Mitrica
author_sort Mihai-Stelian Moreanu
collection DOAJ
description Objectives Despite comprising just 8% of all spinal tumors, sacral tumors present a long list of issues that should be taken in consideration when neurosurgical approach is tempted. Their unique anatomic location, close relation with neural structures and pelvic organs and high-vascularity are just a few nuances of these type of conditions. This paper outline the importance of a good preoperative and intraoperative management in order to facilitate the maximum recovery of the patients.   Material and Methods This paper analyses retrospectively a series of 2 cases of giant sacral tumors (>100 cm3) that were operated in our clinic in 2024 by a multidisciplinary team (neurosurgeons and general surgeons). Follow-up data were obtained from the charts and medical records. All the lesions were localised under L4 vertebra with invasion of sacrum.   Results Our first case was a 47-years old man who accused diffuse mild lumbar pain for more than 2 years, but acutely aggravated in the last months with lumbosacral radicular pain, palsy of the inferior lumbar nerves, urinary incontinence and paraesthesia. MRI showed a giant L5-S2 mass and biopsy diagnostic was myxopapillary ependymoma. Second case was of a young woman with lumbosacral radicular pain debuted a few months ago, whose clinical state worsened rapidly becoming paralytic of lower limbs. MRI showed a giant sacral mass with invasion of the pelvic musculature and surrounding the iliac vessels (intraoperative aspect: sarcoma). Both patients ameliorated postoperatively, and are currently enrolled in a recovery program. Sub-total resection and near-total resection were obtained.   Conclusions Sacral tumors exhibit a challenge in the field of spine surgery being clinical silence over a period of months and years, and then followed by gross deficit. We diagnosed sacral tumors based on clinical, radiographic and laboratory aspects. Prognostic factors were preoperative clinical status and gross-total resection.
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institution Kabale University
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language English
publishDate 2024-11-01
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series Romanian Neurosurgery
spelling doaj-art-1e18b9820b4f4c1a8cdb52446ec9934c2024-11-14T15:47:07ZengLondon Academic PublishingRomanian Neurosurgery1220-88412344-49592024-11-0138Special Issue10.33962/roneuro-2024-109GIANT LUMBO-SACRAL TUMORSMihai-Stelian MoreanuOvidiu ZamfirAlin-Vasile ChirtesAugustin DimaMarian Mitrica Objectives Despite comprising just 8% of all spinal tumors, sacral tumors present a long list of issues that should be taken in consideration when neurosurgical approach is tempted. Their unique anatomic location, close relation with neural structures and pelvic organs and high-vascularity are just a few nuances of these type of conditions. This paper outline the importance of a good preoperative and intraoperative management in order to facilitate the maximum recovery of the patients.   Material and Methods This paper analyses retrospectively a series of 2 cases of giant sacral tumors (>100 cm3) that were operated in our clinic in 2024 by a multidisciplinary team (neurosurgeons and general surgeons). Follow-up data were obtained from the charts and medical records. All the lesions were localised under L4 vertebra with invasion of sacrum.   Results Our first case was a 47-years old man who accused diffuse mild lumbar pain for more than 2 years, but acutely aggravated in the last months with lumbosacral radicular pain, palsy of the inferior lumbar nerves, urinary incontinence and paraesthesia. MRI showed a giant L5-S2 mass and biopsy diagnostic was myxopapillary ependymoma. Second case was of a young woman with lumbosacral radicular pain debuted a few months ago, whose clinical state worsened rapidly becoming paralytic of lower limbs. MRI showed a giant sacral mass with invasion of the pelvic musculature and surrounding the iliac vessels (intraoperative aspect: sarcoma). Both patients ameliorated postoperatively, and are currently enrolled in a recovery program. Sub-total resection and near-total resection were obtained.   Conclusions Sacral tumors exhibit a challenge in the field of spine surgery being clinical silence over a period of months and years, and then followed by gross deficit. We diagnosed sacral tumors based on clinical, radiographic and laboratory aspects. Prognostic factors were preoperative clinical status and gross-total resection. http://journals.lapub.co.uk/index.php/roneurosurgery/article/view/2834sacral tumoursMRIspinequality of life
spellingShingle Mihai-Stelian Moreanu
Ovidiu Zamfir
Alin-Vasile Chirtes
Augustin Dima
Marian Mitrica
GIANT LUMBO-SACRAL TUMORS
Romanian Neurosurgery
sacral tumours
MRI
spine
quality of life
title GIANT LUMBO-SACRAL TUMORS
title_full GIANT LUMBO-SACRAL TUMORS
title_fullStr GIANT LUMBO-SACRAL TUMORS
title_full_unstemmed GIANT LUMBO-SACRAL TUMORS
title_short GIANT LUMBO-SACRAL TUMORS
title_sort giant lumbo sacral tumors
topic sacral tumours
MRI
spine
quality of life
url http://journals.lapub.co.uk/index.php/roneurosurgery/article/view/2834
work_keys_str_mv AT mihaistelianmoreanu giantlumbosacraltumors
AT ovidiuzamfir giantlumbosacraltumors
AT alinvasilechirtes giantlumbosacraltumors
AT augustindima giantlumbosacraltumors
AT marianmitrica giantlumbosacraltumors