MALIGNI TUMORJI TORAKOLUMBALNE HRBTENICEZ OBSEŽNIM ŠIRJENJEM IZVEN SPINALNEGA KANALA: PRIKAZTREH PRIMEROV

Abstract

BACKGROUND Tumors of the spine where spinal part of the tumor spreads trough the intervertebralforamen are so-called hourglass or dumbbell tumors. Malignant tumors of this kind arerare and most frequently neurogenic in origin. The extraspinal part of the tumor could beextremely large; however, the symptoms and signs are most commonly attributable to thespinal part. METHODS Three patients with malignant dumbbell tumors with an extensive exstraspinal part arepresented. Two patients had malignant peripheral nerve sheet tumor and one patient hadsynovial sarcoma. RESULTS In two patients operation was performed in several steps and the spinal part of the tumorwas operated first. The third patient was first operated for the extraspinal part butdied after the operation due to the general postoperative complications. Corpectomy andadequate stabilization was performed in one patient. Two patients received adjuvantoncological treatment. The longest survival was achieved in a patient who had the mostradical surgery. CONCLUSIONS Patients with rare tumors are presented where surgical and postoperative treatment ischallenging, experiences with the treatment are few, individual and multidisciplinaryapproach is mandatory, postoperative course is demanding and the prognosis is lessfavorable