Tumori dell'atlante e dell'epistrofeo

37 anni di esperienza nella diagnosi e trattamento

Translated title of the contribution: Tumours of the atlas and axis: A 37-year experience with diagnosis and management

A. F. Mavrogenis, G. Guerra, M. Romantini, C. Romagnoli, R. Casadei, P. Ruggieri

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

PurposE. This paper presents a single institution's longterm experience regarding the incidence and management of tumours of the atlas and axis and discusses clinical and imaging findings and treatment options. Materials and methods. We searched the registry of the Istituto Ortopedico Rizzoli for patients admitted and treated for tumours of the upper cervical spinE. We identified 62 patients over 37 years, from July 1973 to October 2010. There were 39 male and 23 female patients, with a mean age of 39.5 (range 5-77) years. For each patient, we collected data on clinical presentation, imaging and treatment. Mean follow-up was 10 years. Results. Benign bone tumours were diagnosed in 24 (39%) and malignant tumours in 38 (61%) patients. The most common tumours were bone metastases, followed by osteoid osteomas and chordomas. The atlas was involved in six and the axis in 52 patients; in four patients, both the atlas and axis were involved. The most common clinical presentation was pain, torticollis, dysphagia and neurological deficits. Surgical treatment was performed in 35 patients and conservative treatment, including intralesional methylprednisolone injections and halo-vest immobilisation with or without radiation therapy, chemotherapy or embolisation, in the remaining patients. One patient with osteoblastoma of the atlas had local recurrencE. All patients with metastatic bone disease had local recurrence; four of the eight patients with plasmacytoma progressed to multiple myeloma within 1-4 years. All patients with chordomas had two to four local recurrences. Patients with osteosarcomas and chondrosarcoma died owing to local and distant disease progression. Conclusions. Bone tumours of the cervical spine are rarE. However, they should be kept in mind when examining patients with neck pain or neurological symptoms at the extremities. In most cases, only intralesional surgery can be administered. Combined radiation therapy and chemotherapy is indicated for certain tumour histologies.

Original languageItalian
Pages (from-to)616-635
Number of pages20
JournalRadiologia Medica
Volume117
Issue number4
DOIs
Publication statusPublished - Jun 2012

Fingerprint

Atlases
Neoplasms
Chordoma
Bone and Bones
Recurrence
Spine
Radiotherapy
Osteoblastoma
Intralesional Injections
Osteoid Osteoma
Drug Therapy
Torticollis
Chondrosarcoma
Plasmacytoma
Neck Pain
Bone Diseases
Methylprednisolone
Osteosarcoma
Deglutition Disorders
Multiple Myeloma

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Medicine(all)

Cite this

Mavrogenis, A. F., Guerra, G., Romantini, M., Romagnoli, C., Casadei, R., & Ruggieri, P. (2012). Tumori dell'atlante e dell'epistrofeo: 37 anni di esperienza nella diagnosi e trattamento. Radiologia Medica, 117(4), 616-635. https://doi.org/10.1007/s11547-011-0753-y

Tumori dell'atlante e dell'epistrofeo : 37 anni di esperienza nella diagnosi e trattamento. / Mavrogenis, A. F.; Guerra, G.; Romantini, M.; Romagnoli, C.; Casadei, R.; Ruggieri, P.

In: Radiologia Medica, Vol. 117, No. 4, 06.2012, p. 616-635.

Research output: Contribution to journalArticle

Mavrogenis, AF, Guerra, G, Romantini, M, Romagnoli, C, Casadei, R & Ruggieri, P 2012, 'Tumori dell'atlante e dell'epistrofeo: 37 anni di esperienza nella diagnosi e trattamento', Radiologia Medica, vol. 117, no. 4, pp. 616-635. https://doi.org/10.1007/s11547-011-0753-y
Mavrogenis AF, Guerra G, Romantini M, Romagnoli C, Casadei R, Ruggieri P. Tumori dell'atlante e dell'epistrofeo: 37 anni di esperienza nella diagnosi e trattamento. Radiologia Medica. 2012 Jun;117(4):616-635. https://doi.org/10.1007/s11547-011-0753-y
Mavrogenis, A. F. ; Guerra, G. ; Romantini, M. ; Romagnoli, C. ; Casadei, R. ; Ruggieri, P. / Tumori dell'atlante e dell'epistrofeo : 37 anni di esperienza nella diagnosi e trattamento. In: Radiologia Medica. 2012 ; Vol. 117, No. 4. pp. 616-635.
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N2 - PurposE. This paper presents a single institution's longterm experience regarding the incidence and management of tumours of the atlas and axis and discusses clinical and imaging findings and treatment options. Materials and methods. We searched the registry of the Istituto Ortopedico Rizzoli for patients admitted and treated for tumours of the upper cervical spinE. We identified 62 patients over 37 years, from July 1973 to October 2010. There were 39 male and 23 female patients, with a mean age of 39.5 (range 5-77) years. For each patient, we collected data on clinical presentation, imaging and treatment. Mean follow-up was 10 years. Results. Benign bone tumours were diagnosed in 24 (39%) and malignant tumours in 38 (61%) patients. The most common tumours were bone metastases, followed by osteoid osteomas and chordomas. The atlas was involved in six and the axis in 52 patients; in four patients, both the atlas and axis were involved. The most common clinical presentation was pain, torticollis, dysphagia and neurological deficits. Surgical treatment was performed in 35 patients and conservative treatment, including intralesional methylprednisolone injections and halo-vest immobilisation with or without radiation therapy, chemotherapy or embolisation, in the remaining patients. One patient with osteoblastoma of the atlas had local recurrencE. All patients with metastatic bone disease had local recurrence; four of the eight patients with plasmacytoma progressed to multiple myeloma within 1-4 years. All patients with chordomas had two to four local recurrences. Patients with osteosarcomas and chondrosarcoma died owing to local and distant disease progression. Conclusions. Bone tumours of the cervical spine are rarE. However, they should be kept in mind when examining patients with neck pain or neurological symptoms at the extremities. In most cases, only intralesional surgery can be administered. Combined radiation therapy and chemotherapy is indicated for certain tumour histologies.

AB - PurposE. This paper presents a single institution's longterm experience regarding the incidence and management of tumours of the atlas and axis and discusses clinical and imaging findings and treatment options. Materials and methods. We searched the registry of the Istituto Ortopedico Rizzoli for patients admitted and treated for tumours of the upper cervical spinE. We identified 62 patients over 37 years, from July 1973 to October 2010. There were 39 male and 23 female patients, with a mean age of 39.5 (range 5-77) years. For each patient, we collected data on clinical presentation, imaging and treatment. Mean follow-up was 10 years. Results. Benign bone tumours were diagnosed in 24 (39%) and malignant tumours in 38 (61%) patients. The most common tumours were bone metastases, followed by osteoid osteomas and chordomas. The atlas was involved in six and the axis in 52 patients; in four patients, both the atlas and axis were involved. The most common clinical presentation was pain, torticollis, dysphagia and neurological deficits. Surgical treatment was performed in 35 patients and conservative treatment, including intralesional methylprednisolone injections and halo-vest immobilisation with or without radiation therapy, chemotherapy or embolisation, in the remaining patients. One patient with osteoblastoma of the atlas had local recurrencE. All patients with metastatic bone disease had local recurrence; four of the eight patients with plasmacytoma progressed to multiple myeloma within 1-4 years. All patients with chordomas had two to four local recurrences. Patients with osteosarcomas and chondrosarcoma died owing to local and distant disease progression. Conclusions. Bone tumours of the cervical spine are rarE. However, they should be kept in mind when examining patients with neck pain or neurological symptoms at the extremities. In most cases, only intralesional surgery can be administered. Combined radiation therapy and chemotherapy is indicated for certain tumour histologies.

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