Intraspinal Inclusion Tumor After Myelomeningocele Repair: A Long-Term Single-Center Experience.

Author:Fiaschi P, Piatelli G, Cama A, Capra V, Consales A, Ravegnani M, Pavanello M
Published on:World Neurosurg. 2018 Nov 15


In questa serie di pazienti dell’Istituto Gaslini di Genova gli autori descrivono il follow-up a lungo termine  e le diverse opzioni di trattamento dei tumori iatrogenic intraspinali nei pazienti già sottoposti a riparazione di mielomeningocele.


OBJECTIVE: Given the lack of significant responses to many queries regarding behavior, treatment options, and possible prevention of iatrogenic intraspinal inclusion tumors (IITs), we think that further clinical, radiologic, and follow-up data are mandatory to better characterize this entity. We retrospectively reviewed a series of 14 consecutive patients with IIT occurring after myelomeningocele repair. The long follow-up is a mainstay of this series and may help a better understanding of the history of this slow-growing disease. To date, this is the largest series of IITs after myelomeningocele repair reported in the literature.

METHODS: A retrospective chart review was performed to identify all cases of surgically repaired myelomeningocele at the Department of Neurosurgery of G. Gaslini Children's Hospital in Genoa, from January 1993 to January 2018. Among them, data regarding patients in whom an IIT developed were recovered. The medical records of these patients and their clinical history, neurologic examination, and diagnostic workup were reviewed.

RESULTS: From January 1993 to January 2018, 160 cases of myelomeningocele were surgically treated. Among them, 14 cases of IIT developed. The mean time between myelomeningocele repair and IIT diagnosis was 94.7 months. The mean follow-up time was 60.1 months.

CONCLUSIONS: It is well established that IITs may be discovered in patients who have previously undergone myelomeningocele repair. In our series, with a long follow-up time, we describe the possible range of behavior of such lesions and the utility of surgical treatment of primary therapy. Our series confirms that residual IITs showed marked stability during our long follow-up.

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