Surgical consideration of the intraspinal component in extradural dumbbell tumors

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

Background: The dumbbell tumor is considered a distinct group of tumors of the spinal nerve sheath owing to its intriguing clinical and radiological characteristics. More than half of dumbbell tumors are completely restricted to the extradural space, although preoperative MRI in some cases suggests the presence of intradural/extradural tumors. The aim of this retrospective investigation is to elucidate the clinical features and to suggest the surgical strategy to reduce the operating time and prevent additional complications in extradural type. Methods: The medical records and radiological studies of 7 consecutive cases (4 male, 3 female, mean age 40.4 years) who underwent removal of the intraspinal component of their extradural dumbbell tumors between January 1996 and December 2005 were analyzed. Diagnosis and preoperative evaluation were performed with MRI and myelogram/CTs. Results: The relationship of the tumor mass to dural sac in preoperative MRIs was so indistinct as to suggest an intradural mass in 5 cases. We found that extradural portion was covered with an attenuated dura and that the dural ring was invaginated into the intradural portion in these cases. Therefore, the author began with the epidural removal of the intraspinal and extraspinal component, followed by carefully extracting the intradural-like mass. Conclusions: In conclusion, we suggest that invagination of the dural ring is the anatomical feature that may be confused with an intradural/extradural tumor during operations for extradural dumbbell tumors. Initial epidural mass removal, extraction of intradural/extradural tumors subsequent to dural opening, and affirmation of presence of intradural tumor remnant could save time during dumbbell tumor surgery.

Original languageEnglish
Pages (from-to)98-103
Number of pages6
JournalSurgical Neurology
Volume70
Issue number1
DOIs
Publication statusPublished - 2008 Jul 1

Fingerprint

Neoplasms
Nerve Sheath Neoplasms
Spinal Nerves
Medical Records

Keywords

  • Dumbbell tumor
  • Dural ring
  • Extradural tumor
  • Nerve sheath

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

Cite this

Surgical consideration of the intraspinal component in extradural dumbbell tumors. / Kim, Joo-Han; Han, Suk; Kim, Jong Hyun; Kwon, Taek-Hyun; Chung, Hung Seob; Park, Youn-Kwan.

In: Surgical Neurology, Vol. 70, No. 1, 01.07.2008, p. 98-103.

Research output: Contribution to journalArticle

@article{fca2d94b365245c39105ca01edf8627e,
title = "Surgical consideration of the intraspinal component in extradural dumbbell tumors",
abstract = "Background: The dumbbell tumor is considered a distinct group of tumors of the spinal nerve sheath owing to its intriguing clinical and radiological characteristics. More than half of dumbbell tumors are completely restricted to the extradural space, although preoperative MRI in some cases suggests the presence of intradural/extradural tumors. The aim of this retrospective investigation is to elucidate the clinical features and to suggest the surgical strategy to reduce the operating time and prevent additional complications in extradural type. Methods: The medical records and radiological studies of 7 consecutive cases (4 male, 3 female, mean age 40.4 years) who underwent removal of the intraspinal component of their extradural dumbbell tumors between January 1996 and December 2005 were analyzed. Diagnosis and preoperative evaluation were performed with MRI and myelogram/CTs. Results: The relationship of the tumor mass to dural sac in preoperative MRIs was so indistinct as to suggest an intradural mass in 5 cases. We found that extradural portion was covered with an attenuated dura and that the dural ring was invaginated into the intradural portion in these cases. Therefore, the author began with the epidural removal of the intraspinal and extraspinal component, followed by carefully extracting the intradural-like mass. Conclusions: In conclusion, we suggest that invagination of the dural ring is the anatomical feature that may be confused with an intradural/extradural tumor during operations for extradural dumbbell tumors. Initial epidural mass removal, extraction of intradural/extradural tumors subsequent to dural opening, and affirmation of presence of intradural tumor remnant could save time during dumbbell tumor surgery.",
keywords = "Dumbbell tumor, Dural ring, Extradural tumor, Nerve sheath",
author = "Joo-Han Kim and Suk Han and Kim, {Jong Hyun} and Taek-Hyun Kwon and Chung, {Hung Seob} and Youn-Kwan Park",
year = "2008",
month = "7",
day = "1",
doi = "10.1016/j.surneu.2007.05.028",
language = "English",
volume = "70",
pages = "98--103",
journal = "World Neurosurgery",
issn = "1878-8750",
publisher = "Elsevier Inc.",
number = "1",

}

TY - JOUR

T1 - Surgical consideration of the intraspinal component in extradural dumbbell tumors

AU - Kim, Joo-Han

AU - Han, Suk

AU - Kim, Jong Hyun

AU - Kwon, Taek-Hyun

AU - Chung, Hung Seob

AU - Park, Youn-Kwan

PY - 2008/7/1

Y1 - 2008/7/1

N2 - Background: The dumbbell tumor is considered a distinct group of tumors of the spinal nerve sheath owing to its intriguing clinical and radiological characteristics. More than half of dumbbell tumors are completely restricted to the extradural space, although preoperative MRI in some cases suggests the presence of intradural/extradural tumors. The aim of this retrospective investigation is to elucidate the clinical features and to suggest the surgical strategy to reduce the operating time and prevent additional complications in extradural type. Methods: The medical records and radiological studies of 7 consecutive cases (4 male, 3 female, mean age 40.4 years) who underwent removal of the intraspinal component of their extradural dumbbell tumors between January 1996 and December 2005 were analyzed. Diagnosis and preoperative evaluation were performed with MRI and myelogram/CTs. Results: The relationship of the tumor mass to dural sac in preoperative MRIs was so indistinct as to suggest an intradural mass in 5 cases. We found that extradural portion was covered with an attenuated dura and that the dural ring was invaginated into the intradural portion in these cases. Therefore, the author began with the epidural removal of the intraspinal and extraspinal component, followed by carefully extracting the intradural-like mass. Conclusions: In conclusion, we suggest that invagination of the dural ring is the anatomical feature that may be confused with an intradural/extradural tumor during operations for extradural dumbbell tumors. Initial epidural mass removal, extraction of intradural/extradural tumors subsequent to dural opening, and affirmation of presence of intradural tumor remnant could save time during dumbbell tumor surgery.

AB - Background: The dumbbell tumor is considered a distinct group of tumors of the spinal nerve sheath owing to its intriguing clinical and radiological characteristics. More than half of dumbbell tumors are completely restricted to the extradural space, although preoperative MRI in some cases suggests the presence of intradural/extradural tumors. The aim of this retrospective investigation is to elucidate the clinical features and to suggest the surgical strategy to reduce the operating time and prevent additional complications in extradural type. Methods: The medical records and radiological studies of 7 consecutive cases (4 male, 3 female, mean age 40.4 years) who underwent removal of the intraspinal component of their extradural dumbbell tumors between January 1996 and December 2005 were analyzed. Diagnosis and preoperative evaluation were performed with MRI and myelogram/CTs. Results: The relationship of the tumor mass to dural sac in preoperative MRIs was so indistinct as to suggest an intradural mass in 5 cases. We found that extradural portion was covered with an attenuated dura and that the dural ring was invaginated into the intradural portion in these cases. Therefore, the author began with the epidural removal of the intraspinal and extraspinal component, followed by carefully extracting the intradural-like mass. Conclusions: In conclusion, we suggest that invagination of the dural ring is the anatomical feature that may be confused with an intradural/extradural tumor during operations for extradural dumbbell tumors. Initial epidural mass removal, extraction of intradural/extradural tumors subsequent to dural opening, and affirmation of presence of intradural tumor remnant could save time during dumbbell tumor surgery.

KW - Dumbbell tumor

KW - Dural ring

KW - Extradural tumor

KW - Nerve sheath

UR - http://www.scopus.com/inward/record.url?scp=45549103951&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=45549103951&partnerID=8YFLogxK

U2 - 10.1016/j.surneu.2007.05.028

DO - 10.1016/j.surneu.2007.05.028

M3 - Article

VL - 70

SP - 98

EP - 103

JO - World Neurosurgery

JF - World Neurosurgery

SN - 1878-8750

IS - 1

ER -