Feeling Of Numbness Research Articles

Online Sales of Unscheduled Pharmaceutical Agents: A Case Report of Tianeptine Use in the United States

: Tianeptine is a tricyclic antidepressant that stimulates mu-opioid receptors at high doses. It is marketed and used across Europe and Latin America as an antidepressant, but is not approved by the Food and Drug Administration for use in the United States. In the United States, tianeptine is sold through online health stores as a cognition enhancer, dietary supplement, or as research chemical. We report the case of a 36-year-old man with a history of major depressive disorder, responsive to sertraline, who turned to the unmonitored use of tianeptine purchased online to treat residual feelings of apathy and boredom. His use of tianeptine was marked by rapidly escalating doses and a significant withdrawal syndrome that made discontinuation of this substance difficult. This case serves as a reminder that unscheduled pharmaceutical agents are available for misuse by the general population and have the potential to cause significant harm. Therefore, medical providers must be aware of and screen for the use of such products amongst their patients.

NON-HODGKIN'S LYMPHOMA EXTRANODAL: CASE REPORT

This paper proposes to present a female patient case, 55 years old, feoderma, complaining of acute, diffuse and continuous pain in the left hemi-mandible, feeling of numbness and burning sensation in the ipsilateral lower lip. The extraoral examination revealed trigger points in left masseter and Sternocleidomastoids and at intraoral examination evidenced increased alveolar volume in ipsilateral edentulous molars region. In radiographic examination was observed in the region, radiopaque thin lines in hypodense area, confirming great bone destruction on CT. Performed the biopsy, there were spongy consistency of tissue and bone intense destruction in the inferior alveolar nerve adjacencies. Histopathology revealed a diffuse proliferation of lymphoid cells, with the diagnosis of high-grade lymphoma. The patient was referred for cancer treatment and presents control of disease after 7 years of the diagnosis.

The use of International Classification for Nursing Practice (ICNP) in Postoperative Care of a Patient Diagnosed with a Spinal Cord Tumor

Introduction. Spinal canal tumors are divided into intradural or extradural. Depending on the location, their symptoms differ and the prognosis depends on many variables. The magnetic resonance imaging (MRI) is used as a diagnostic tool facilitating diagnosis of proliferative lesions of the spinal canal, and the surgical treatment is most commonly used treatment for tumors located in the spinal canal.Case Report. A 58 year-old patient diagnosed with Intradural extramedullary schwannoma located on the left side of the spinal canal at the L3 level was admitted to the Neurosurgery Clinic based on a referral for surgical treatment. Before surgery, the patient complained about pain in the lumbar region radiating to the lower limbs, feeling of numbness and tingling of the lower left limb for about 2 months and recurring constipation.Discussion. Patient care after surgery on the spinal cord must be comprehensive. Nursing and therapeutic care should be adopted to the individual needs of the patient following the recommendations.Conclusions. The case of the patient after surgical removal of the spinal canal tumor indicated the difficulties the patient struggled with. Main nursing care activities provided the patient with assistance in meeting his physiological needs, performing daily activities and helping to return to good physical condition. The acquired knowledge contributed to improving the daily functioning and coping with difficult situations. All the actions taken in this field brought the intended effect. (JNNN 2017;6(3):120–125)

Opieka pielęgniarska nad pacjentką z ostrym zespołem wieńcowym po przezskórnej interwencji wieńcowej

Introduction: Acute coronary syndrome (ACS) is due to acute ischaemia of the cardiac muscle, which results from a sudden obstruction of the blood flow in the coronary circulation. A life-threatening condition, it is one of the most common causes of illness and death. Objectives: To present the ACS patient's health condition, nursing diagnoses and actions, and the results of nursing care of the patient following percutaneous coronary intervention (PCI) during hospitalization. Material and methods: The study involved a female patient with acute coronary syndrome following primary PCI. The individual case study method was used. Results and conclusions: Having analyzed the patient's health condition, a number of nursing diagnoses were made. These included the patient's weakness, pain in the upper limb, the feeling of numbness, cooling, hand oedema as a result of applying a pressure dressing; difficulty breathing due to obstruction in the pulmonary circulation; urine retention resulting in pain; impaired carbohydrate metabolism; restricted physical activity and self-care deficiency; the patient's insufficient knowledge concerning necessary changes in the lifestyle following acute coronary syndrome. Potential nursing diagnoses included the risk of occurrence of ventricular arrhythmia, bleeding complications and renal dysfunction. Then the aims of nursing care were established, the performed nursing actions were presented and their results assessed. The patient's condition was stable; there were no complications and the patient was prepared to live following acute coronary syndrome.

El aburrimiento como competencia: educación para un mundo sobrestimulado

Boredom as a feeling of apathy and indifference is normally lived as a negative experience. On fact, from an educational point of view, the necessity of eradicating it has been traditionally considered. However, this is not the only way of understanding it. A deeper analysis can lead us to find some positive aspects on it. From a philosophical-educational perspective, and thus by means of critical analysis of texts, this paper will analyze in detail these aspects. We will show that boredom is nothing but time for oneself, which it is essential for the authentic subjectivity deve­lopment. The knowledge society demands autonomous and responsible individuals, but it is always paradoxically occupying our time. So in order to solve this paradox, we conclude that boredom must be currently considered as a basic and fundamental competence.

La funzione della parodia nelle riscritture di Carmelo Bene

Parody is a fundamental tool in Carmelo Bene’s rewritings. This paper investigates the forms of parody used by the author in order to understand their functions. It focuses particularly on the discrepancies between Bene’s love for tragedy and the cruel aggression that he inflicts on this genre. The main tools of my analysis consist in a close study of Bene’s works, with a constant eye on the (sometimes contradictory) purposes of the author’s artistic philosophy, and with specific attention to both the theoretical sources known by Bene and some cornerstones in literary genres studies. The analysis reveals two main functions of parody. First, Bene uses parody in order to neutralize the received ways of enjoyment of a well-known text. In Bene’s intentions, this allows the public who watches the show to establish anew an emotional involvement, which would otherwise be jeopardized due to the audience’s familiarity with the text. Secondly, through the use of parody a new sense of tragedy emerges. Although absent in the original works, this novel tragic condition envisioned by Bene better fits the essence of contemporary man: an individual paralyzed by a feeling of apathy who believes (s)he lives in a senseless world while waiting for an end that never comes.

Long-acting family planning method switching among revisit clients of public health facilities in Dire Dawa, Ethiopia.

Background“Contraceptive switching” from one method to another is a common phenomenon. Switching from a more effective long-acting method to a less effective method exposes women for unplanned pregnancy. The aim of this study was to assess the level and factors associated with long-acting family planning method switching to other methods.MethodA facility-based cross-sectional study was conducted from January to March 2013 on 634 women attending public health facilities in Dire Dawa City Administration, Ethiopia. Participants of the study were revisit clients of family planning service and were interviewed as they appear in the clinics. Data were analyzed using crude and adjusted logistic regression, and results were reported using OR and corresponding 95 % CI.ResultsLong-acting family planning method switching among revisit clients was 40.4 %; switching from implant was 29.8 % and from IUCD, it was 10.6 %. The main reasons for methods switching were side effects of the methods such as bleeding, weight loss, and feeling of arm numbness. The tendency of switching was less among married women (AOR = 2.41, 95 % CI: 1.01, 5.74), women who had 2–4 and 5 and more children (AOR 3.00, 95 % CI: 1.59, 5.67) and (AOR 2.07, 95 % CI: 1.17, 3.66), respectively. It was also less among women who want to stop birth (AOR 5.11, 95 % CI: 1.15, 24.8), among those who mentioned health care providers as source of information for family planning (AOR 1.88, 95 % CI: 1.18, 3.01), and among women whose husbands were aware of their use of the methods (AOR 3.05, 95 % CI: 1.88, 4.94).ConclusionsMethod switching from long-acting contraceptives to less effective methods is high. Method switching was significant among unmarried women, who had one child, plan to postpone fertility, and whose husbands were not aware of their wive’s use of the method. In the provision of family planning service, the health care providers should give adequate information about each method and risks of method switching. Appropriate family planning Information Education and Communication (IEC) and Behavioral Change Communication (BCC) strategies should be emphasized.

Finding an Answer: Comments on a Randomized Trial of Epidural Glucocorticoid Injections for Lumbar Spinal Stenosis.

Recently, Friedly et al. published a study on the effectiveness of epidural injections of steroids (ESIs) for lumbar spinal stenosis (LSS) [1]. Because of its apparent implications for clinical practice, this study attracted comments both in the professional [2] and lay press [3]. However, the study prompts reflection on a number of issues that extend beyond the conventional appraisal of a study. Those issues pertain to how physicians think about a condition, how it should be treated, and how to best assess the effectiveness of that treatment. The following article addresses those issues in the interest of informing physicians about how contemporary practices are confounded by lack of diagnostic discipline, and how this makes the conduct of controlled trials complicated and, therefore, makes the results difficult to assess. The cardinal issues are the symptoms of LSS; the diagnosis of LSS; the rationale for treatment; the consequent appropriate selection of patients; the outcomes assessment, either in practice or in a study including the reporting of those outcomes; and the need for rigorous control of the technical performance of the therapeutic intervention. Each of these issues has a critical bearing on appraising not only the literature on LSS, but also on how physicians treat this condition in conventional practice. The literature is profuse with heterogeneity in symptomology related to LSS. While there is no consensus in the current literature on acceptable LSS symptoms, the most commonly quoted symptoms are neurogenic claudication, radicular pain, and low back pain (LBP). Additional symptoms commonly mentioned in literature were fatigue and loss of power in the legs, anesthesia, and a feeling of numbness in the sacral dermatomes. In an attempt to achieve consensus, Katz et al. in 1995 published symptoms most strongly associated with the diagnosis of LSS (likelihood ratio ≥ 2), …

Comparison of Ropivacaine 0.75% and Lignocaine 2% with 1:200,000 Adrenaline in Dental Extractions: Single Blind Clinical Trial.

The aim of this study was to evaluate the efficacy, safety and clinical acceptability of the local anaesthetic agent ropivacaine 0.75% in comparison with lignocaine 2% with adrenaline 1:200,000 in minor oral surgical procedures. Forty-seven patients, who required bilateral extractions in a single arch, were included in this study. One hundred and sixty-six extractions were performed and all the patients were administered nerve blocks/infiltration. Pre and postoperative pulse, blood pressure, random blood sugar, electrocardiogram and partial oxygen pressure were recorded at specified time intervals. Pain score by visual analogue scale, onset of action and depth of anesthesia were also observed. Duration of anaesthesia was assessed by feeling of numbness and first sign of pain. Statistical analysis revealed insignificant difference between both the groups in terms of pulse, blood pressure, random blood sugar, and partial oxygen pressure. The depth of anesthesia was evaluated by pain, comfort during the procedure with visual analog scale and showed no significant difference between the two groups. The onset of action for maxillary infiltration was 33.29±9.2 (ropivacaine), 32.12±6.8s (2% lignocaine with adrenaline 1:200,000) and for pterygomandibular nerve block was 181.0±87.5 (ropivacaine), 32.12±6.8s (2% lignocaine with adrenaline 1:200,000). Duration of anesthesia when compared was 411.7±66.11min (ropivacaine) and 107.87±16.54 (2% lignocaine with adrenaline 1:200,000). On maxillary buccal vestibule infiltration it was also observed that in ropivacaine group there was no requirement of palatal infiltration suggestive of good diffusion property. Ropivacaine is a safe, clinically acceptable long acting local anaesthetic agent with added advantage of effective diffusion property. SDC/MISC/2013/239.

ID 128 – Effect on seizure frequency with vagus nerve stimulation therapy after titration of duty cycle

Objective To assess the effect of duty cycle (DC) increments on seizure frequency (SF) in patients undergoing Vagus Nerve Stimulation (VNS) and exhibiting suboptimal responses. To our knowledge, altering only the DC has not been reported. Methods Thirteen patients undergoing VNS for a period between 3.5 and 12.25 years and have exhibited poor or insignificant responses or continued to have few seizures of which suppression was desirable, had their DCs titrated and responses monitored. Initial DCs ranged from 5% to 16% and were increased 9% on average within the range of 10–44%. Mean SF was assessed on a four month average previous to alteration and after an average of 3 months (range 1–4). Three patients were excluded from the analysis due to concomitant drug manipulations. Results A mean of 61% (range 0–100%) in SF was seen. Seven patients had >50% reduction in SF. One patient had a reduction in SF of 45%. For the two patients where no change was seen, one had a feeling of hand numbness which continued after increasing the duty cycle and the other’s SF remained unchanged. Conclusion Increasing of DC only without altering other parameters has a positive effect on the reduction of SF. Poor and non-responders can become responders.

Early Emergency Medical Service Calls for Stroke: Was the Long-Term Education Program Based on the Experience of West Pomerania Successful?

Our objectives are to investigate whether the percentage of early emergency calls for stroke had increased and to assess current factors determining the time of deciding to seek medical help in the event of early stroke symptoms. We analyzed data concerning the decision to call for medical help in relation to observed stroke symptoms. Group I comprised 287 people who made the decision to call emergency medical service (EMS) in the first 10 minutes after observing stroke symptoms. Group II included 275 people who called EMS after that time. Data from the current database (2013-2014) were compared with relevant data from the period 2003-2005. In 2013-2014, awareness of stroke signs was 2.5 times greater than in 2003-2005. Among the groups of early and delayed EMS calls during 2003-2005 and 2013-2014, there were no significant differences in the number of people who suspected stroke. Advanced patient age, young caller age, hemiparesis, facial weakness, and the severity of neurological deficit were independent factors that correlated strongly with an early EMS call, whereas feelings of numbness and dizziness correlated significantly with delayed EMS calls. In the West Pomeranian community, general knowledge of stroke is not a significant factor when making appropriate decisions at the onset of stroke symptoms. The education campaign regarding the initial symptoms of stroke and the possible fatal consequences appears to have been ineffective.

A painful swelling of the mandible

CLINICAL PRESENTATION A 54-year-old female patient presented to the Department of Oral and Maxillofacial Surgery with a chief complaint of lower jaw pain and a feeling of numbness in the lower lip, both on the right side. The patient reported that her symptoms started 3 months ago as numbness and feeling of swelling of the lower lip accompanied by ear pain on the right side; no treatment was administered. Fifteen days earlier, the patient had presented to a General Hospital complaining of gingival pyorrhea and swelling of the right mandible. Antibiotic treatment (amoxicillin 1 g two times daily and metronidazole 500 mg three times daily) was administered with limited improvement. At this point, the patient was referred to our Department for additional evaluation and management. Her medical history was significant for breast cancer diagnosed 5 years ago. Her initial treatment included chemotherapy with docetaxel, four cycles of cyclophosphamide, epirubicin, and 5-fluorouracil and radiotherapy, which resulted in full remission. For the last 4 years, the patient was receiving the aromataseinhibitor anastrazole for hormone manipulation. No use of bisphosphonates was reported. She was a light smoker (of approximately one to two cigarettes per day for several years) and a nondrinker. Intraoral clinical examination did not reveal significant findings, except for a palpable swelling of the buccal cortical plate in the right posterior mandible toward the angle. Extraoral examination revealed facial asymmetry due to swelling of the body of the right mandible extending to the angle (Figure 1). Review of a

Parents' and caregivers' perspectives on the Manitoba Dental Association's Free First Visit program.

The Free First Visit (FFV) program was implemented in 2010 to promote early preventive dental visits for children <36 months of age in Manitoba, Canada. The purpose was to understand parents' and caregivers' perspectives on the program. Three focus groups with 21 participants were conducted in Winnipeg, Canada using an interview guide in this qualitative study. Most participants were aware of the FFV program and the appropriate age for a child's first visit. Almost all agreed with the recommendation to see a dentist by one year of age. Some reported that general dentists advised them to bring their child after three years of age. Participants appreciated that the program was free, and some noted that the program made them aware of the appropriate age for a first visit. About half of the participants had taken their child for a FFV. Reasons for not taking their child for a FFV included: nothing wrong with their child's teeth, they believed there was still time as their child was not three years old, they had government insurance, child's temperament, and feelings of apathy. There were mixed opinions regarding whether the program was helping those who needed it the most. The majority of participants liked the FFV program and believed that it should continue. Parents would benefit from further education and encouragement to seek oral care for their child by age one. Some general dentists may need further training and skills to meet the recommendations for first dental visits.

A Unique Case of Addiction to Trifluoperazine in a Non-psychotic Patient

Introduction Trifluoperazine, a typical antipsychotic, has been frequently used in psychotic disorders for many years. Sudden discontinuation of trifluoperazine is known to cause relapse of psychotic symptoms in patients suffering from major psychosis. The Case History Mr P, a 34 years old male, professor of physics, was admitted on August 12, 2014, his fourth admission in the last one year, with chief complaints of extreme restlessness, tremors of the hands and blurring of vision for two days prior admission. The patient had been taking 12-16 tablets of a combination of trifluoperazine 5mg and trihexyphenidyl 2mg for about one week prior to his hospitalization. The patient described experiencing a feeling of numbness once he took the aforementioned tablets which 'insulated' him from problems at home. He reported experiencing severe restlessness and anxiety if he did not take the tablets. The patient was diagnosed as suffering from Obsessive Compulsive Disorder one year back when he had presented with chief complaints of recurrent disturbing thoughts as to whether he had kept his car keys in a particular pocket and whether he had locked his car or not. To relieve the extreme anxiety provoked by these thoughts, he would be compelled to carry out checking compulsions. He was started at that time on Paroxetine and a combination of trifluoperazine and trihexyphenidyl. The recurrent thoughts and compulsive acts were relieved in about a month. He stopped taking paroxetine of his own but continued taking the combination of trifluoperazine and trihexyphenidyl following which he was hospitalized with us. Discussion There have been sporadic reports of addiction to antipsychotic drugs, including trihexyphenydyl, risperidone and quetiapine. Most of them are associated with a typical withdrawal syndrome on sudden stoppage of antipsychotic drug in question which is the prime reason behind the patient taking to the antipsychotic drug again. Most of the patients were known cases of schizophrenia or another long term psychotic illness. The case presented here is unique in the sense that the patient does not suffer from any psychotic illness. Conclusion Obviously, the problem of addiction is complex. This case points to the need for a fresh research into the mechanisms leading to dependence to a particular drug.

Combination effect of physical and gustatory taste masking for propiverine hydrochloride orally disintegrating tablets on palatability.

Orally disintegrating tablets (ODTs) containing propiverine hydrochloride (which is extremely bitter and leaves a feeling of numbness in the mouth) were prepared with a combined use of physical and organoleptic taste masking. Propiverine-loaded masking particles (PLMPs) were prepared with different amounts of gastric-soluble coatings as physical masking. ODTs without organoleptic masking were prepared by mixing each group of PLMPs with Ludiflash®, crospovidone, and magnesium stearate. ODTs with organoleptic masking were also prepared by addition of L-menthol, aspartame, thaumatin, and cinnamon. Fifteen-minute dissolution of propiverine in solutions with pH 1.2 was ≥ 85% for all ODTs, whereas that in pH 6.8 solutions was ≤ 85% and increased with physical masking. A single blind randomized crossover trial was conducted. Ten healthy volunteers were asked to quantify the bitterness, numbness, and overall palatability using a 100-mm visual analog scale (VAS) at the period of disintegration as well as 1 and 5 min later. VAS scores of bitterness, numbness, and overall palatability improved along with increasing amounts of physical masking, and the effects persisted for 5 min. VAS scores for numbness increased over time regardless of the amount of physical masking. Bitterness, numbness, and overall palatability were significantly improved by organoleptic masking if the amount of physical masking was small. Combined use of physical and organoleptic masking is useful for improving palatability of ODTs containing propiverine.

The ABCs of caring for sexual assault patients

The ABCs of caring for sexual assault patients

The modern treatment of the restless legs syndrome: Diagnostic and therapeutic options

Introduction : Restless legs syndrome (RLS) is a chronic neurological disorder clinically defined by the presence of irresistible need to get your feet moving, with or without a feeling of numbness. Four necessary and sufficient clinical symptoms defined as subjective symptoms affected individuals, and they are the essential diagnostic criteria: an irresistible urge (urge) to get your feet moving, usually accompanied by unpleasant sensations (dysesthesia), motor 'discomfort', the emergence or worsening of symptoms at rest (vacation) and the emergence or worsening of symptoms during the night. Start discomfort is the most common in the fifth and sixth decades of life, with a prevalence of about 10% in the general Caucasian population of Europe and North America. The women suffer often than men, and in a ratio of 2: 1st A case report : Patients aged 53 years, hypertonic, addressed to a neurologist because of problems in the form of a sense of 'numbness, tingling and burning' in the legs, which are present 2-3 years. Neurological examination was within physiological, not pathological focal manifestations. After the tests prescribed therapy pramipexole, which caused a significant reduction in symptoms. Conclusion: RLS is associated with significant impairment of quality of life, comparable to that seen in chronic diseases such as diabetes and depression. Significant lack of recognition and inadequate treatment of RLS suggests that we need better education about the disorder.

Estrogen therapy in gynecological cancer survivors

Treatment of gynecological cancer has significant impact on a woman's quality of life because it commonly includes removal of the uterus and ovaries, both being the core of a woman's femininity, whilst irradiation and chemotherapy, be they as primary therapy or when indicated as postoperative adjuvant therapy, will lead to ablation of ovarian function if the ovaries had not been removed. This will lead to an acute onset of menopausal symptoms, which may be more debilitating than those occurring as a result of natural aging, and of which hot flushes, night sweats, insomnia, mood swings, vaginal dryness, decreased libido, malaise and a general feeling of apathy are the most common. About 25% of gynecological cancers will occur in pre- and perimenopausal women, a large percentage of whom will become menopausal as a result of their treatment. There are also the gynecological cancer survivors who are not rendered menopausal as a result of the treatment strategy but who will become menopausal because of natural aging. Concern among the medical attendants of these women is whether use of estrogen therapy or estrogen and progestogens for their menopausal symptoms will reactivate tumor deposits and therefore increase the rate of recurrence and, as a result, decrease overall survival among these women. Yet the data that are available do not support this concern.There are eight retrospective studies and only one randomized study that have analyzed outcome in endometrial cancer survivors who used hormone therapy after their surgery, whilst, among ovarian cancer survivors, there are four retrospective studies and one randomized study. The studies do suffer from small numbers and, although the studies pertaining to endometrial cancer analyze mostly women with early-stage disease, a number of the studies in both the endometrial and ovarian cancer survivors do have a sizeable follow-up. These studies seem to support that estrogen therapy after the treatment for gynecological cancer does not impact negatively on outcome in endometrial and ovarian cancer survivors and that estrogen therapy can be considered as a plausible therapeutic option in survivors who are debilitated by their menopausal symptoms. It is prudent not to offer estrogen therapy to survivors of endometrial stromal sarcoma and women with granulosa cell tumors of the ovaries. Vulval, vaginal and cervical cancers are not considered hormone-dependent and therefore estrogen therapy can be given.

¿Puede la acupuntura ser utilizada como tratamiento de parálisis facial periférica? Informe de caso clínico

Peripheral facial paralysis is a sensorineural disorder caused by facial nerve injury, manifested by a feeling of numbness and lack of strength to make a movement. Acupuncture is recognized by the World Health Organization as a millenary Chinese therapy, with proven effects by a mechanism that stimulates the central nervous system, to treat pain, inflammatory processes and neurological diseases. This paper describes positive evolution of treatment with acupuncture of a clinical case with facial paralysis.

A Dumbbell-shaped Meningioma in the Thoracic Spine: A Case Report

Background Context: Thoracic involvements of meningiomas are rarely seen and only a couple of dumbbellshaped meningiomas are reported in the literature. Spinal meningiomas (SM) consist of 25% of all spinal masses. Most of the SMs are intradural. Less than 10% have extradural extension. Purpose: Pure spinal extradural meningiomas (SEM) are seen so rare. We are reporting the 7th case of meningioma with dumbbell-appearance located in the cervicothoracal region. Methods: 48 years old female patient who has no known disease before she has referred to our clinic with complaints of pain, feeling of numbness at the right arm, shoulder and the back that she has been suffering for 6 months. In the neurological examination of the patient, hypoesthesia has seen under the level of Th1. Deep tendon reflexes of the lower extremities (DTR) were observed to be suspicious bilaterally in respect to hyperactivity. In the spinal magnetic resonance imaging (MRI) of the patient), after Gadolinium infusion of the mass involving the epidural area in the spinal channel of the bone between C7 vertebra and T2 vertebrae, resulting in dumbbell appearance, a lesion with homogenous contrast enhancement was observed. Results: T1 total laminectomy was applied to the patient. The mass found in the extradural region and extending to the apex of the right lung was totally removed with micro chirurgical method. Pathology of the mass was reported as psammomatous meningioma. The patient was discharged at the post-operative 3rd day without an additional neurologic deficit. Conclusion: Though extradural spinal meningiomas are rarely seen, since they imitate spinal metastatic masses, should be kept in mind in the differential diagnosis. Surgery should be the first treatment of choice.