6621/7687. Long-term survival of a patient with primary sellar choriocarcinoma with pulmonary metastases: a case report. Extracranial metastasis is an unusual complication of most types of primary intracranial tumor. Approximately one-third of reported cases of primary intracranial choriocarcinoma have been associated with pulmonary tumor metastasis. The prognosis of such patients has been uniformly fatal. This report describes a probable long-term survivor of primary intracranial choriocarcinoma wit pulmonary metastasis. The patient had a complete response to combination chemotherapy with cisplatin, etoposide, and bleomycin and is surviving free of disease >3 years from diagnosis. ( info) |
6622/7687. Constitutional de novo t(1;22)(p22;q11.2) and ependymoma. There is a body of evidence suggesting the presence of a tumor suppressor gene on chromosome 22 which plays a role in the pathogenesis of ependymomas. We report a patient with a de novo constitutional t(1;22)(p22;q11.2) who developed a malignant ependymoma at age 5. The patient is otherwise phenotypically normal. By fluorescence in situ hybridization (FISH) analysis, the chromosome 22 breakpoint has been localized to the region between the DiGeorge locus and BCR. Since NF2 and EWS are both distal to BCR, the are presumable not involved in this rearrangement. This patient may offer a unique opportunity to identify the chromosome 22 ependymoma tumor suppressor gene by cloning the translocation breakpoint. ( info) |
6623/7687. Extensive pulmonary metastasis of an intracranial meningioma with repeated recurrence: radiographic and pathologic features. Recurrent intracranial meningioma with multiple pulmonary metastases is rare. In this case, the initial tumor had been diagnosed and removed 10 years earlier, and subsequent locally recurrent tumors were removed three times. Nine pulmonary metastases were discovered and resected recently. The metastatic lesion was confirmed as meningioma or arachnoidocytoma by light and electron microscopy and immunohistochemical studies. The patient survived all the operations. ( info) |
6624/7687. magnetic resonance imaging of massive intracranial invasion by an ethmoidal adenoid cystic carcinoma (cylindroma). magnetic resonance imaging showed a massive intracranial invasion by an adenoid cystic carcinoma (cylindroma) originating from an ethmoid sinus. The tumor was excised and follow-up radiation therapy was planned because of bone involvement and superficial invasion of the right olfactory tract area. ( info) |
6625/7687. Non-Hodgkin's lymphoma originating in the spermatic cord. An otherwise healthy 57-year-old man was found to have an early stage, high-grade, non-Hodgkin's lymphoma (NHL) of the spermatic cord. A plan of treatment involving surgery, radiation therapy, combination chemotherapy, and central nervous system prophylaxis was recommended. He did not complete the recommended treatment plan, and subsequently returned with recurrent tumor in his brain. This case highlights the similarity of spermatic cord NHL to primary NHL of the testicle, and the propensity of both to progress or relapse in nodal and extranodal patterns. ( info) |
6626/7687. Spinal malignant lymphoma appearing after radiation and chemotherapy of a pineal region tumor. The occurrence of malignant lymphoma in the pineal region is very rare. We experienced a case of pineal region tumor that was treated by radiation and chemotherapy. After 1 year, the tumor metastasized to the cauda equina and was operated on. The diagnosis was malignant lymphoma. Although the incidence of intracranial malignant lymphoma is known to be on the increase recently, malignant lymphoma should be considered in the differential diagnosis of pineal region tumors. ( info) |
6627/7687. Hypoglossal neurinoma extending intra- and extracranially: case report. BACKGROUND: Hypoglossal neurinoma is very rare; our case is the 46th case. CASE DESCRIPTION: We report a 59-year-old woman with hypoglossal neurinoma. Her equilibrium state was disturbed due to vestibular dysfunction and she exhibited right hypoglossal palsy with glossal hemiatrophy. Computed tomography (CT) revealed a large bony erosion of the right hypoglossal canal. Magnetic resonance imaging (MRI) revealed intra- and extracranial tumor extension. There was an intracranial mass attached to the enlarged hypoglossal vertebral and posterior inferior cerebellar artery medially. The extracranial part of the mass extended along the course of the hypoglossal nerve through the enlarged hypoglossal canal. The intracranial part of the tumor was totally removed via the transcondylar approach. The diameter of the origin of the posterior interior cerebellar artery was narrow before tumor removal; it increased after surgery due to decompression. A histological diagnosis of neurilemoma was made. Her symptoms due to vestibular dysfunction disappeared postoperatively. CONCLUSIONS: Our patient's difficulty with balance was thought to be an ischemic symptom due to circulation disturbance of the posterior inferior cerebellar artery. It disappeared after tumor removal. Surgery may be necessary later if further growth of the extracranial part of the neurinoma becomes evident. ( info) |
| BACKGROUND: The natural history of intracranial meningioma is no different in the Arabian peninsula than in other countries. The extent of the total loss of vision in one or both eyes, however, is unique to this area. methods: A retrospective study was conducted at King Faisal Specialist Hospital and research Centre, a tertiary care institution in saudi arabia, on all cases of intracranial meningioma seen over a period of 9 years. The following data were collated: clinical presentation, site and size of tumor, radiologic features, surgical methods, and preoperative and postoperative visual status. RESULTS: Seventy of 232 cases (30.1%) of intracranial meningioma presented in the suprasellar area; the majority of these were more than 5 cm in diameter. Because of the large size it was not always possible to identify the exact point of origin or to achieve complete tumor removal. Deteriorating vision was the cardinal presenting feature and the incidence of blindness in one or both eyes at presentation was high (42.2%); 12.8% were totally blind on admission. None of these patients showed improvement after surgery (complete or subtotal removal of tumor). CONCLUSION: Lack of understanding of the symptoms and cultural influences are direct contributing factors to this complication of a benign intracranial lesion. This represents a serious public health concern in the Arabian peninsula. ( info) |
| Although enlargement of pituitary adenomas during pregnancy is a well documented phenomenon, this is rarely seen with craniopharyngiomas. Discussed here is the case of a patient whose initial presentation, operation, rapid regrowth, and reoperation of a pathologically proven solid craniopharyngioma, occurred during the course of a single pregnancy. Further, the rapid regrowth of the tumor resulted in total blindness for 48 hours prior to reoperation. Repeat transsphenoidal operation resulted in a gross total removal, restoration of vision, and allowed for the cesarean section delivery of a healthy infant. ( info) |
6630/7687. meningioma in children: a report of nine cases and a review of the literature. BACKGROUND: meningioma is a common tumor of the central nervous system in adults, accounting for 10%-20% of all primary intracranial tumors. It is rare in children, with an incidence of 2.19% (0.85%-2.3%). Although there are numerous case reports in the literature, no firm conclusions can be drawn. For this report we accumulated, reviewed, and analyzed reports in the literature from 1960-93. methods: A total of 318 patients with meningioma were managed in King Faisal Specialist Hospital and research Centre from 1981-93. Nine of these patients (2.8%) were children aged 16 years or less. These cases were analyzed retrospectively with regard to age, sex, clinical presentation, radiologic finding, pathologic findings, management and outcome. RESULTS: Childhood meningioma represented 2.8% of all meningioma cases and 2.2% of all central nervous system tumors seen in children. There were six males and three females. The average age at presentation was 10.1 years (range 1-16 years). There were four cases of meningioma in the orbit an one each in the temporal region, foramen magnum, tentorial region, subfrontal base, sellar region and ethmoidal air sinus. There were two cases of multiple meningioma. Meningothelial meningioma was the type most frequently seen. CONCLUSION: meningioma is rare in children and males are affected more than females. Tumor locations that are rare in adults are more common in children. The meningothelial type is most frequently seen. prognosis is poor compared with that in adults, as the tumors tend to grow more rapidly and to a larger size, undergo malignant changes, and have a greater rate of recurrence. Whenever feasible, every effort should be made to achieve total resection of the tumor at the first attempt. If radiation therapy is used in children it should be limited to those who have recurrent tumors so as to minimize organic and psychologic complications. ( info) |