Abstract: Dural metastases are an unusual form of spread in treated sinonasal malignancies. An analysis is presented of 20 cases of dural metastases diagnosed during imaging follow-up in a selection of cases in which anterior craniofacial resection was performed. They included 12 undifferentiated sinonasal carcinomas, 7 olfactory neuroblastomas, and 1 adenoid cystic carcinoma case. Dural metastases appeared on an average of 7.3 years after treatment in olfactory neuroblastoma. The maximum distance from malignancy to dural metastases was 14 cm for olfactory neuroblastoma, and 4.3 cm for undifferentiated sinonasal carcinoma. Dural metastases in the Burr holes were observed in 50% of undifferentiated sinonasal carcinoma, and 29% of olfactory neuroblastomas. Dural metastases presented as a nodular (60%), multinodular (10%), cystic (15%), and plaque (15%) pattern. These are suggestive of a local venous spread mechanism related to tumour rupture during surgery of anterior cranial fossa. Long-term follow-up with cranial inclusion would be indicated, given the possible late and distant presentation of dural metastases.

Resumen: Presentamos las metástasis durales como forma inusual de diseminación de tumores nasosinusales malignos tratados; se revisan 20 casos diagnosticados durante el seguimiento imagenológico a un grupo tratado con resección craneofacial anterior. Evaluamos metástasis durales en 12 carcinomas nasosinusales indiferenciados, 7 neuroblastomas olfatorios y un carcinoma adenoquístico. En neuroblastomas olfatorios aparecieron metástasis durales en promedio 7,3 años postratamiento. La distancia máxima del tumor a la metástasis fue de 14 cm para neuroblastoma olfatorio y de 4,3 cm para carcinoma nasosinusal indiferenciado. Observamos metástasis durales en los agujeros de trepanación en el 50% de los carcinomas nasosinusales indiferenciados y en el 29% de los neuroblastomas olfatorios. Las metástasis durales presentaron patrón nodular (60%), multinodular (10%), quístico (15%) y en placa (15%). Proponemos un mecanismo venoso local de diseminación relacionado a disrupción tumoral o quirúrgica de la fosa craneal anterior. El seguimiento a largo plazo con inclusión craneal estaría indicado por la posible presentación tardía y distante de metástasis durales.

In 1989, the National Research Council (NRC) Subcommittee on Horse Nutrition defined three categories of exercise: light, moderate or intense. In the 6th revised edition of "The Nutrient Requirements of Horses" (NRC, 2007), there are four categories for exercising horses: light exercise, moderate exercise, heavy exercise and very heavy exercise. Light exercise is described as 1 to 3 hours/week of mostly walking and trotting. Many horses kept for recreational riding would be included in the light exercise category. Moderate exercise consists of 3 to 5 hours/week of mostly trotting with some walking, some cantering and possibly some jumping or other type of more difficult activity. Horses used for horse shows, ranch work and frequent recreational riding would fit into the moderate exercise category. Heavy exercise is described as 4 to 5 hours/week of trotting, cantering, galloping and some jumping, cattle work, etc. Horses engaged in three day eventing, polo, endurance racing or other competitive events would be in this category. The very heavy exercise category includes racehorses and a few other horses that compete at the elite level of endurance or three day eventing. The NRC (2007) provides recommendations for nutrient intakes by mature exercising horses and for yearlings and two year olds that are receiving regular exercise. Many of the recommendations are similar to those in the 1989 publication, but others have been increased or decreased. For example, crude protein recommendations for exercising horses are generally lower than in the last edition. However, lysine requirements are relatively similar and the publication suggests that protein quality should be emphasized more than in the past. The 2007 NRC contains more information about the factors that influence the requirements for each nutrient, making it easier for users to develop diets for individual horses.