Yıl: 2023 Cilt: 65 Sayı: 5 Sayfa Aralığı: 801 - 808 Metin Dili: İngilizce DOI: 10.24953/turkjped.2023.240 İndeks Tarihi: 15-11-2023

The etiologies and management of spinal cord compression in childhood cancers: Are we aware of the emergency of cord compression?

Öz:
Background. The spinal cord compression causes irreversible long-term permanent neurological sequelae. This study aims to increase awareness of childhood cancers that cause cord compression by comparing histopathological diagnosis, treatments, and survival rates to the literature. Methods. Seventy-three patients (38 male, 35 female) with spinal cord compression, among 1085 patients diagnosed with solid tumors at Gazi University Department of Pediatric Oncology between 1991 and 2021 were retrospectively evaluated. Results. The mean time between the onset of complaints and diagnosis was 27.5± 24.9 (2-150) days. The first three most common tumors that caused cord compression; were central nervous system tumors in 22 (30%), neuroblastoma in 17 (23%), and malignant germ cell tumors in 8 (10%) cases. Of the patients, 46 (63%) had compression due to extradural masses, and 27 (37%) patients had an intradural compression. The most common symptoms were pain in 60 (82%), weakness in 57 (78%), and pins and needles in 28 (38%) patients, respectively. The clinical physical neurological examination findings were motor deficit in 62 (84%), and deep tendon reflex changes in 54 patients (73.9%). Compression findings were detected in 58 (79.5%) patients at diagnosis, and in 15 (20.5%) of them during follow-up. The most common level of compression was seen in the thoracolumbar region in 19 (26%) cases. In 65 (89%) patients with cord compression, corticosteroids were given as anti-edema treatment. Surgical excision was performed in 39 (53%) patients. Spinal radiotherapy was given to 35 patients (48%) with radiosensitive tumors. Chemotherapy protocols were started in 52 (71.2%) cases according to their diagnoses. Complete neurological recovery was achieved in 33 (45%) patients. The 5-year overall survival rates for solid tumors with extradural compression and intradural compression were 62% and 22%, respectively (p=0.002). Conclusions. Neurological sequela-free recovery is possible with early diagnosis and urgent treatment. Spinal compression must be detected by detailed systemic and neurological examination and imaging methods. Patients should be rapidly transferred to pediatric oncology units after starting anti-edema treatment.
Anahtar Kelime:

Öz:
Anahtar Kelime:

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
  • 1. Freedman JL, Rheingold SR. Fisher MJ. Oncologic emergencies. In: Pizzo PA, Poplack DG, editors. Principles and Practice of Pediatric Oncology (7th ed). Philadelphia: Wolters Kluwer; 2016: 980-982.
  • 2. De Martino L, Spennato P, Vetrella S, et al. Symptomatic malignant spinal cord compression in children: a single-center experience. Ital J Pediatr 2019; 45: 80. https://doi.org/10.1186/s13052-019-0671- 5
  • 3. Aydin GB, Kutluk MT, Buyukpamukcu M, Akyuz C, Yalcin B, Varan A. Neurological complications of neuroblastic tumors: experience of a single center. Childs Nerv Syst 2010; 26: 359-365. https://doi. org/10.1007/s00381-009-0979-3
  • 4. Chintagumpala MM, Paulino A, Panigrahy A, Hawkins C, Jae A, Parsons W. Embryonel and pineal region tumors. In: Pizzo PA, Poplack DG, editors. Principles and Practice of Pediatric Oncology (7th ed). Philadelphia: Wolters Kluwer; 2016: 671-680.
  • 5. Katzenstein HM, Kent PM, London WB, Cohn SL. Treatment and outcome of 83 children with intraspinal neuroblastoma: the Pediatric Oncology Group experience. J Clin Oncol 2001; 19: 1047-1055. https://doi.org/10.1200/JCO.2001.19.4.1047
  • 6. Demir HA, Yalçin B, Büyükpamukçu N, et al. Thoracic neuroblastic tumors in childhood. Pediatr Blood Cancer 2010; 54: 885-889. https://doi. org/10.1002/pbc.22405
  • 7. Mullen E, Whangbo J, Vrooman LM. Oncologic emergencies. In: Orkin S, Fisher D, Look TA, et al., editors. Oncology of Infancy and Childhood. Philadelphia: Saunders Elsevier; 2009: 1122-1128. https://doi.org/10.1016/B978-1-4160-3431-5.00028-5
  • 8. De Bernardi B, Pianca C, Pistamiglio P, et al. Neuroblastoma with symptomatic spinal cord compression at diagnosis: treatment and results with 76 cases. J Clin Oncol 2001; 19: 183-190. https:// doi.org/10.1200/JCO.2001.19.1.183
  • 9. Robinson CG, Prayson RA, Hahn JF, et al. Long-term survival and functional status of patients with lowgrade astrocytoma of spinal cord. Int J Radiat Oncol Biol Phys 2005; 63: 91-100. https://doi.org/10.1016/j. ijrobp.2005.01.009
  • 10. Mohme M, Mende KC, Krätzig T, et al. Impact of spinal cord compression from intradural and epidural spinal tumors on perioperative symptomsimplications for surgical decision making. Neurosurg Rev 2017; 40: 377-387. https://doi. org/10.1007/s10143-016-0790-z
  • 11. Gunes D, Uysal KM, Cetinkaya H, et al. Paravertebral malignant tumors of childhood: analysis of 28 pediatric patients. Childs Nerv Syst 2009; 25: 63-69. https://doi.org/10.1007/s00381-008-0717-2
  • 12. Kurucu N, Akyüz C, Varan A, et al. Primary paraspinal and spinal epidural non-hodgkin lymphoma in childhood. J Pediatr Hematol Oncol 2021; 43: e395-e400. https://doi.org/10.1097/ MPH.0000000000001858
  • 13. Yon DK, Ahn TK, Shin DE, Kim GI, Kim MK. Extragonadal germ cell tumor of the posterior mediastinum in a child complicated with spinal cord compression: a case report. BMC Pediatr 2018; 18: 97. https://doi.org/10.1186/s12887-018-1070-6
  • 14. Li Z, Lv Z, Yang Q, Li J. Successful treatment of a primary thoracic dumb-bell yolk sac tumor presenting with severe spinal cord compression: case report. Medicine (Baltimore) 2019; 98: e17610. https://doi.org/10.1097/MD.0000000000017610
  • 15. Kutluk T, Varan A, Kafalı C, et al. Pediatric intramedullary spinal cord tumors: a single center experience. Eur J Paediatr Neurol 2015; 19: 41-47. https://doi.org/10.1016/j.ejpn.2014.09.007
  • 16. Houten JK, Weiner HL. Pediatric intramedullary spinal cord tumors: special considerations. J Neurooncol 2000; 47: 225-230. https://doi. org/10.1023/a:1006418506213
  • 17. Cambruzzi E, Medeiros MS, Cardoso CE, Silva GAG, Schlotte K, Kus WP. Diffuse leptomeningeal glioneuronal tumor in an 8-year-old girl: case report and review of the literature. Childs Nerv Syst 2023; 39: 301-305. https://doi.org/10.1007/s00381-022- 05625-1
  • 18. Tang J, Zhang D, Xu YY, et al. Clinical characteristics and therapeutic outcomes of mediastinal neuroblastoma with intraspinal extension: a retrospective study. Transl Pediatr 2021; 10: 715-722. https://doi.org/10.21037/tp-20-268
  • 19. Chapman S, Li J, Almiski M, Moffat H, Israels SJ. Epidural spinal mass as the presenting feature of b-acute lymphoblastic leukemia in a young child. J Pediatr Hematol Oncol 2020; 42: e845-e847. https://doi.org/10.1097/MPH.0000000000001609
  • 20. Boushra M. A case report of b-cell lymphoblastic leukemia/lymphoma presenting as isolated torticollis in a 2-year-old female. Clin Pract Cases Emerg Med 2020; 4: 603-606. https://doi.org/10.5811/ cpcem.2020.8.48524
  • 21. Gao H, Wan Y, Ma H, Huang T, Song W. Neuroendocrine tumor of thoracic spine: case report and literature review. Transl Cancer Res 2021; 10: 1177-1182. https://doi.org/10.21037/tcr-20-2279
  • 22. Kpelao E, Doleagbenou AK, El Kader Moumouni A, et al. Spinal cord compression in Togo: etiologies and management. World Neurosurg 2022; 162: e542-e545. https://doi.org/10.1016/j.wneu.2022.03.063
  • 23. McGirt MJ, Chaichana KL, Atiba A, et al. Incidence of spinal deformity after resection of intramedullary spinal cord tumors in children who underwent laminectomy compared with laminoplasty. J Neurosurg Pediatr 2008; 1: 57-62. https://doi.org/10.3171/PED-08/01/057
  • 24. Pollono D, Tomarchia S, Drut R, Ibañez O, Ferreyra M, Cédola J. Spinal cord compression: a review of 70 pediatric patients. Pediatr Hematol Oncol 2003; 20: 457-466.
  • 25. Tantawy AA, Ebeid FS, Mahmoud MA, Shepl OE. Spinal cord compression in childhood pediatric malignancies: multicenter egyptian study. J Pediatr Hematol Oncol 2013; 35: 232-236. https://doi.org/10.1097/MPH.0b013e318270b210
APA Okur A, vural ö, Pinarli F (2023). The etiologies and management of spinal cord compression in childhood cancers: Are we aware of the emergency of cord compression?. , 801 - 808. 10.24953/turkjped.2023.240
Chicago Okur Arzu,vural özge,Pinarli Faruk Guclu The etiologies and management of spinal cord compression in childhood cancers: Are we aware of the emergency of cord compression?. (2023): 801 - 808. 10.24953/turkjped.2023.240
MLA Okur Arzu,vural özge,Pinarli Faruk Guclu The etiologies and management of spinal cord compression in childhood cancers: Are we aware of the emergency of cord compression?. , 2023, ss.801 - 808. 10.24953/turkjped.2023.240
AMA Okur A,vural ö,Pinarli F The etiologies and management of spinal cord compression in childhood cancers: Are we aware of the emergency of cord compression?. . 2023; 801 - 808. 10.24953/turkjped.2023.240
Vancouver Okur A,vural ö,Pinarli F The etiologies and management of spinal cord compression in childhood cancers: Are we aware of the emergency of cord compression?. . 2023; 801 - 808. 10.24953/turkjped.2023.240
IEEE Okur A,vural ö,Pinarli F "The etiologies and management of spinal cord compression in childhood cancers: Are we aware of the emergency of cord compression?." , ss.801 - 808, 2023. 10.24953/turkjped.2023.240
ISNAD Okur, Arzu vd. "The etiologies and management of spinal cord compression in childhood cancers: Are we aware of the emergency of cord compression?". (2023), 801-808. https://doi.org/10.24953/turkjped.2023.240
APA Okur A, vural ö, Pinarli F (2023). The etiologies and management of spinal cord compression in childhood cancers: Are we aware of the emergency of cord compression?. Turkish Journal of Pediatrics, 65(5), 801 - 808. 10.24953/turkjped.2023.240
Chicago Okur Arzu,vural özge,Pinarli Faruk Guclu The etiologies and management of spinal cord compression in childhood cancers: Are we aware of the emergency of cord compression?. Turkish Journal of Pediatrics 65, no.5 (2023): 801 - 808. 10.24953/turkjped.2023.240
MLA Okur Arzu,vural özge,Pinarli Faruk Guclu The etiologies and management of spinal cord compression in childhood cancers: Are we aware of the emergency of cord compression?. Turkish Journal of Pediatrics, vol.65, no.5, 2023, ss.801 - 808. 10.24953/turkjped.2023.240
AMA Okur A,vural ö,Pinarli F The etiologies and management of spinal cord compression in childhood cancers: Are we aware of the emergency of cord compression?. Turkish Journal of Pediatrics. 2023; 65(5): 801 - 808. 10.24953/turkjped.2023.240
Vancouver Okur A,vural ö,Pinarli F The etiologies and management of spinal cord compression in childhood cancers: Are we aware of the emergency of cord compression?. Turkish Journal of Pediatrics. 2023; 65(5): 801 - 808. 10.24953/turkjped.2023.240
IEEE Okur A,vural ö,Pinarli F "The etiologies and management of spinal cord compression in childhood cancers: Are we aware of the emergency of cord compression?." Turkish Journal of Pediatrics, 65, ss.801 - 808, 2023. 10.24953/turkjped.2023.240
ISNAD Okur, Arzu vd. "The etiologies and management of spinal cord compression in childhood cancers: Are we aware of the emergency of cord compression?". Turkish Journal of Pediatrics 65/5 (2023), 801-808. https://doi.org/10.24953/turkjped.2023.240