PROBLEMI DI DIAGNOSI DIFFERENZIALE NELLE METASTASI SOLITARIE DEL RACHIDE CERVICALE

Translated title of the contribution: Problems of differential diagnosis in single metastases of the cervical spine

M. Marchi, M. C. Malaguti, C. Monti

Research output: Contribution to journalArticle

Abstract

Detection of a tumoral lesion in the cervical spine poses the problem of differential diagnosis between a benign or malignant primary tumour and a metastasis to determine appropriate treatment decisions. Differential diagnosis should be based on careful clinical assessment (age, history-taking, symptoms) and radiological findings and is often arduous, especially when a single lesion is detected in patients with no known primary malignancy. We reviewed the records of the Rizzoli orthopedic hospital from 1990 to 1993 comprising a series of 42 patients aged between 50 and 80 with radiographic findings of a single osteolytic lesion in the cervical spine. After bone scintigraphy, the lesion was confirmed as isolated in 18 patients. Analysis of the lesions on conventional X-ray and CT and MR images sometimes revealed diagnostic clues, especially to distinguish between metastases and chordoma. A typical finding in ten patients with metastases was collapse of the vertebral body with destruction of the cortical bone and the presence of parenchymatous tissue with strong contrast uptake invading the peri- and paravertebral tissues and canal, sparing the intervertebral disk. Four patients with chordoma had C2 involvement with a large mass expanding into the retropharyngeal space and an inhomogenous tumour aspect due to areas of necrosis and gelatinous tissue which reflect to histological features of this type of tumour. The other cases, 2 myelomas, 1 lymphoma and 1 hemangiopericytoma did not present characteristic features. CT and MR determined the loco-regional staging of the lesion, but recourse to CT-guided biopsy was the only means of achieving an unequivocal diagnosis, essential for the purposes of appropriate treatment.

Translated title of the contributionProblems of differential diagnosis in single metastases of the cervical spine
Original languageItalian
Pages (from-to)207-214
Number of pages8
JournalRivista di Neuroradiologia
Volume8
Issue number2
Publication statusPublished - 1995

ASJC Scopus subject areas

  • Clinical Neurology
  • Radiology Nuclear Medicine and imaging
  • Radiological and Ultrasound Technology

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