Introduction: Calcified thoracic disc herniations are rare and their approach represents a surgical challenge when they are giant and symptomatic Surgery is indicated in cases of intractable back pain with medical management persistent intercostal neuralgia or progressive neurological deficit with the transthoracic extrapleural approach being the one of choice because it has advantages regarding the best view of the operative field We present the case of a patient with a giant calcified thoracic hernia who was successfully operated on in our hospital using an extrapleural transthoracic approach. Clinical case: A 53-year-old male with dorsal pain in the medial region radiating to the inframammary region and progressive difficulty walking moderate proximal paraparesis T8 sensory level and urinary retention CT and MRI images showed a large calcified T6-7 disc herniation causing severe compression of the spinal cord The patient underwent a T6-7 extrapleural transthoracic discectomy plus a T6 partial corpectomy without fusion The patient tolerated the procedure well with no complications and the postoperative images one month after surgery demonstrated spinal cord decompression At follow-up irradiated back pain sensory level paraparesis and urinary retention improved. Conclusion: Extrapleural transthoracic discectomy can be considered a safe approach in the case of giant calcified thoracic hernias since it allows resection of the calcified disc fragment and decompression of the spinal cord. Keywords: Intervertebral Disc Displacement, Diskectomy, Spinal Cord, Decompression (Source: MeSH NLM)

Introducción: Las hernias del disco torácico calcificadas son poco frecuentes y su abordaje representa u n desafío quirúrgico cuando son gigantes y sintomáticas. La discectomía transtorácica extrapleural puede considerarse un abordaje seguro para resecar el fragmento de disco calcificado y descomprimir la médula espinal. Caso clínico: Hombre de 53 años con dorsalgia media irradiada a región inframamaria y dificultad progresiva para deambular, paraparesia proximal moderada, nivel sensitivo T8 y retención urinaria. Las imágenes demostraron una gran hernia de disco T6-7 calcificada que causaba una compresión severa de la médula espinal. El paciente se sometió a discectomía transtorácica extrapleural T6-7 más corpectomía parcial T6 sin fusión. El paciente toleró bien el procedimiento sin complicaciones y las imágenes postoperatorias al mes de la cirugia demostraron la descompresión de la médula espinal. En el seguimiento, la dorsalgia irradiada, el nivel sensitivo, la paraparesia y la retención urinaria mejoraron.

Introduction: Solitary intracranial plasmacytoma is a rare plasma cell tumor that affects the skull, meninges, and brain. Unlike multiple myeloma, it does not have systemic manifestations. Its symptoms are characterized by a progressively growing tumor that generates local pain. It does not have a pathognomonic image and can be confused with other lesions, being its diagnosis histological. The prognosis is good and the main treatment modalities are surgery and/or radiation therapy. Clinical Case: 64-year-old female patient with a clinical picture characterized by loss of strength in lower limbs and thermal rise. On examination: Patient awake, Glasgow 15 points, paraparesis 4/5, photoreactive and isochoric pupils. Imaging examinations show an extensive contrast-enhancing lesion involving cerebral meninges at the frontoparietal level bilaterally, with a moderate mass effect. A subtotal resection of the lesion is performed, with the patient presenting a good clinical evolution. The histological result was a plasma cell tumor. In the 6-month follow-up, no residual lesion was observed, maintaining outpatient control by an outpatient clinic. This case shows a rare pathology that is sometimes confused with a meningioma. Conclusion: Solitary intracranial plasmacytoma is a rare tumor that can easily be confused with other more common lesions. Its diagnosis is only made with a histological study. It has a good prognosis and can be treated by surgical resection and/or radiotherapy. Keywords: Plasmacytoma, Brain, Meninges, Neoplasms, Plasma Cell (Source: MeSH NLM)