Thigh Numbness Research Articles

ULTRASTRUCTURE OF CHORDOMA

A 50-year-old male developed a sacro-coccygeal chordoma. Prior to the surgery, he had experienced back-pain, numbness of the right thigh and difficulty in voiding and defecation. Total excision of the mass was done and all symptoms were relieved. The light microscopic examination revealed a chordoma. The ultrastructural study was performed with particular interest in physaliferous cells. The fine structure disclosed the prominent associations of mitochondria and rough endoplasmic reticulum. The mitochondria showed irregularities in sizes and shapes but did not attenuate as much as previously reported. The vacuoles that were observed by light microscopy in physaliferous cells were both extra-cellular and intra-cellular and contained finely granular material of acid mucopolysaccharides probably of chondroitin type. The presence of both subplasmalemmal linear densities (SLD) and pinocytic vesicles was consistent with the histogenetic conviction that the tumor arose from mesodermal derivatives.

Meralgia Paraesthetica

THE SYNDROME of burning, tingling, and numbness of the anterolateral thigh was described by Bernhardt 1 in 1895. It was named meralgia paraesthetica the same year. Many causes for this syndrome involving the distribution of the lateral femoral cutaneous nerve of the thigh have been suggested. It has been implied that it can be caused by intrapelvic disease, herpes zoster, and a congenitally tight foramen where the nerve passes through the inguinal ligament just medial to the anterior superior iliac portion of the spine. It has also been associated with osteoarthritis of the lumbar spine and herniated disk on the opposite side, the symptom secondary to muscle spasm. Most often, it is caused from various kinds of trauma secondary to mechanical causes. Mechanical causes were suggested by Stookey 2 in 1928. He was impressed by the accentuation of the symptoms when patients stood or walked and the relief of symptoms

Para-articular ossification, a complication of anterior poliomyelitis; a case report.

The development of para-articular ossifications associated with anterior poliomyelitis is considered an unusual complication, although para-articular calcification and ossification are not infrequent sequelae of traumatic paraplegias or cord lesions with accompanying sensory deficits. Drehmann (1) in 1927 reported a case of para-articular calcification following acute anterior poliomyelitis in a boy two and a half years old. Three cases of myositis ossificans, all in adults, were published in 1951 by Costello and Brown (2). In 1952 Freiberg (3) reported an unusually extensive case of calcification and ossification of hips, shoulders, and metacarpophalangeal joints, and cited 2 other cases, in adults, with extensive calcifications in the hip regions. The authors recently observed an extensive ossification of the left hip in a patient in the convalescent stage of acute anterior poliomyelitis. This complication seems not to have been reported previously in the roentgen literature, except as noted by Caffey (4). B. R., a 12-year-old white girl, was admitted to South View Isolation Hospital on Sept. 10, 1955, with poliomyelitis, confirmed by laboratory findings. The immediate hospital course was one of progressive weakness of all extremities, most pronounced in the right arm and left leg. After an initial ten-day isolation period, the patient was transferred to St. Luke's Hospitals, where, in addition to the above findings, numbness of the left anterior thigh was noted. The prescribed post-polio treatments were given during the succeeding three months, but the response was not as anticipated, in that posture became progressively poorer as a result of contractures of the left hip. A careful review of the family and personal history revealed no evidence of local injury or disease of the left hip, or of previous significant illness. Preparatory to surgery for correction of contractures of the hip, roentgen studies were done on Jan. 6, 1956. These revealed an extensive para-articular ossification (Fig. 1). Laminagraphy of the involved area failed to reveal any evidence of fracture or intrinsic disease in the femur. Complete skeletal surveys showed no similar involvement elsewhere. Relevant laboratory findings were: serum total protein, 7.3 gm. per cent; serum phosphorus, 4.6 mg. per cent; serum calcium, 10.4 mg. per cent; alkaline phosphatase, 7.4 Bodansky units. Follow-up x-ray studies during the succeeding six months revealed findings consistent with bone of increasing maturity (Fig. 2). Surgical extirpation was considered advisable because of the extreme flexion contractures and fixation of the hip. Operation was performed on June 29, 1956, ten months after onset of the disease. The major muscle groups were identified and found not to be replaced by ossifying tissue.

TUMOR OF THE PINEAL GLAND (PINEALOCYTOMA) WITH MENINGEAL AND NEURAL METASTASES

The case we are reporting is unusual and in some respects seems to be unique. The problem it presented to the clinician and the pathologist was finally solved by microscopic study of the tissues obtained post mortem. REPORT OF A CASE History. —The patient, a hatter, aged 33, on admission to the hospital on Jan. 20, 1933, complained chiefly of pains in the back, numbness of the hands and progressive weakness and numbness of the right thigh. The family history was irrelevant. In 1929 the patient had suffered from polyuria, polydipsia, blurring of vision and loss of sexual power. He was observed at the Mount Sinai Hospital, where a diagnosis of tumor of the pituitary gland was made (a flattened sella turcica was found) and roentgen therapy was instituted. At that time the basal metabolic rate was —29. The blurring of vision improved sufficiently to permit him to return to