Cases reported "Meningeal Neoplasms"

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1/90. Primary melanocytoma arising from the thoracic leptomeninges case.

    Primary melanocytoma arising from the leptomeninges of the spinal cord is very rare. A surgical specimen of a thoracic meningeal tumor was resected from a 75-year-old woman complaining of gait disturbance was investigated. magnetic resonance imaging and myelography showed a dumb-bell-type tumor in the subdural space at the 1st to 2nd thoracic vertebrae. The tumor was subtotally resected because of adhesion to the lamina and thoracic medulla. The localized, gelatinous black tumor showed a well-defined margin without dissemination or infiltration. The tumor had a thin capsule and was composed of solid proliferation of neoplastic melanocytes. Neither whorl formation nor foci of palisaded nuclei were observed. The neoplastic cells were of two major types: an epithelioid- or polygonal-shaped type and a spindle-shaped type, and had a large nucleus, a prominent nucleolus, coarse chromatin, and melanin-pigments in their cytoplasm. Only a few mitotic figures were observed. They were positive for HMB-45 and S-100 protein. This case was considered to be primary melanocytoma arising from the thoracic leptomeninges.
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ranking = 1
keywords = subdural
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2/90. Acute subdural hematoma and pachymeningitis carcinomatosa: case report.

    Subdural hematomas may affect 0.4-5 p. 100 of patients with cancer, because of predisposing risk factors or because of the cancer itself. The most likely association is with hematological cancer with coagulative disorders. An association with pachymeningitis carcinomatosa is less likely. In this instance the subdural hematoma is due to a neoplastic obstruction of dural vein with subdural engorgement and hemorrhage or subdural effusion. We report a case in which an acute neurological deterioration due to a subdural hematoma disclosed a dural metastasis from a breast cancer operated four years earlier and present a literature review.
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ranking = 8
keywords = subdural
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3/90. Falx meningioma presenting as acute subdural hematoma: case report.

    BACKGROUND: Acute subdural hematomas caused by meningiomas have been rarely encountered. Pathophysiologic mechanisms and clinical considerations in these patients have not been sufficiently explored. We addressed the possible mechanism of spontaneous hemorrhage in our case and briefly discuss the optimal treatment. CASE DESCRIPTION: This case of falx meningioma presenting as an acute subdural hematoma in a 78-year-old woman is described. On initial computed tomography (CT), an enhancing tumor of the falx appeared to be the cause of hemorrhage. Only faint contrast staining in the periphery of the tumor was seen on right external carotid arteriograms, with no evidence of other vascular supply. Extravasation of contrast material during the procedure occurred suddenly and was successfully treated by endovascular embolization using a microcatheter. The hematoma was emergently evacuated with gross total removal of the tumor. Pathologic examination confirmed a transitional meningioma with abundant hyalinized structures. Disruption of a thin-walled vessel adjacent to the tumor capsule was assumed to be the site of hemorrhage. CONCLUSIONS: The longstanding ischemia of the tumor was considered to have produced the deposition of hyalin in the tissue, which changed the hemodynamics within the tumor, producing vascular stress leading to rupture. The prognosis of patients with meningiomas complicated by acute subdural hematoma is generally poor, with mortality reported in approximately one-half of such patients. Surgical exploration is the most effective treatment and should be conducted before irreversible brain damage has occurred.
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ranking = 7
keywords = subdural
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4/90. meningioma recurrence at a different site masquerading as a subdural hematoma. Case report.

    It is unusual for a meningioma to recur at a distant site. It is more unusual for a meningioma to present as a subdural hematoma. The authors report a unique case in which both of these events occurred in the same patient during a 4-year period. The authors discuss the pathogenesis of these rare events with regard to meningiomas.
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ranking = 5
keywords = subdural
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5/90. Spontaneous epidural haematoma associated with radiation-induced malignant fibrous histiocytoma.

    We report a case of spontaneous epidural haemorrhage associated with metastatic radiation-induced malignant fibrous histiocytoma of the dural meninges in a patient who had been previously treated for nasopharyngeal carcinoma with radiotherapy.
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ranking = 0.32225993381428
keywords = haematoma, haemorrhage
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6/90. MRI appearances mimicking the dural tail sign: a report of two cases.

    We report two cases in which the MRI appearances mimicked the dural tail sign; a glioma extending into the subarachnoid space, and a meningioma extending to the subdural space. They indicate that tumour invasion into the subarachnoid or subdural space, should be considered when prominent linear enhancement is observed along the dura mater adjacent to tumours.
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ranking = 2
keywords = subdural
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7/90. meningioma presented as subarachnoid haemorrhage: case report.

    A case of parasagittal meningioma causing subarachnoidal haemorrhage (SAH) is reported. Computed tomography (CT) was found negative in the patient with acute severe headache and haemorrhage was observed on cerebrospinal fluid (CSF) examination. Digital subtraction angiography (DSA) showed an avascular space over the convexity and magnetic resonance imaging (MRI) revealed the tumour. The importance of MRI for the detection of underlying pathology in SAH with unknown aetiology is emphasised.
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ranking = 0.065321483715286
keywords = haemorrhage
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8/90. Leptomeningeal myelomatosis mimicking a subdural haematoma.

    We report a rare appearance at presentation of meningeal myelomatosis without bone involvement, in the form of an extraaxial mass of mixed density, resembling a chronic subdural haematoma.
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ranking = 8.859378452916
keywords = subdural, subdural haematoma, haematoma
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9/90. Spinal leptomeningeal metastases of giant cell glioblastoma associated with subarachnoid haemorrhage: case report.

    A case of subarachnoid haemorrhage (SAH) due to spinal leptomeningeal metastases of a giant cell glioblastoma is described. A 51 year old male presented with a four week history of headache. Neurological examination was normal except for a slight left hemiparesis. Computed tomography (CT) revealed a large cyst with a mural nodule in the right temporal lobe. The tumour was removed followed by 60 Gy of radiation therapy. Thirty-two months later he developed headache and shoulder pain with symptoms of normal pressure hydrocephalus. Head CT showed ventriculomegaly and SAH. magnetic resonance imaging showed spinal leptomeningeal metastases at the C4-5, T12, and L2 levels, but no local recurrence or tumour dissemination in the brain. He died 34 months after surgery. autopsy revealed diffuse SAH over the whole brain and spinal cord, associated with spinal leptomeningeal metastases, but no cerebral aneurysms. Spinal radiotherapy and ventriculoperitoneal shunting could possibly have extended survival in this patient.
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ranking = 0.054434569762739
keywords = haemorrhage
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10/90. Metastatic prostate adenocarcinoma of the dura mater.

    A 70-year-old man with known metastatic prostate carcinoma to the long bones of the lower extremities, presented with a several day history of lethargy and confusion. CT was interpreted as showing bilateral acute and chronic subdural hematomas (SDH). Upon opening the dura, a yellowish, firm tumor was layered over the frontal convexity. No hematoma was found. Histological examination revealed prostate carcinoma.
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ranking = 1
keywords = subdural
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