1/17. Multifocal cerebral hemangio-endothelioma. Case report and review of the literature.BACKGROUND: Intracranial hemangio-endotheliomas (HE) are rare vascular tumours that present histological features and biological behaviour of an intermediate malignancy. We report the first case of primary HE presenting as multiple intracranial masses. CASE DESCRIPTION: The patient is a 20-year-old female who presented with paresis of the left arm. magnetic resonance imaging (MRI) showed multiple lesions in both frontal lobes. Total surgical excision of the tumours was obtained; a histological diagnosis of hemangio-endothelioma was made. Five months later, MRI scan showed new intradiploic skull lesions whereas a scintigraphic study revealed multicentric extracranial bone involvement. Treatment based on interferon-alpha (IFN-alpha) administration was undertaken; this produced partial regression of the lesions. Approximately three years after the first operation, the patient is in good clinical condition. CONCLUSIONS: Surgery continues to play the leading role in the treatment of intracranial HE. However, adjuvant therapy with IFN represents a new and well-tolerated therapeutic method for residual intracranial lesions as well as multicentric extracranial disease.- - - - - - - - - - ranking = 1keywords = administration (Clic here for more details about this article) |
2/17. Neuroradiological features of intraosseous cavernous hemangioma--case report.A 40-year-old man presented to our hospital because of a painless lump on his right forehead. radiography showed a radiolucent defect in the frontal bone. Bone window computed tomography demonstrated a lucent mass which expanded externally from the diploe destroying and passing through the outer plate. T1-weighted magnetic resonance imaging revealed the lesion as non-homogeneously isointense, and T2-weighted imaging as non-homogeneously hyperintense. The lesion was enhanced non-homogeneously after contrast administration. The lesion was subtotally removed. Histological examination suggested cavernous hemangioma. Preoperative examinations could not provide a definitive diagnosis, which was established by the operative finding. Because of the difficulty of diagnosis in the early stage, surgical treatment in the early stage is recommended for total removal and definitive diagnosis of intraosseous tumor.- - - - - - - - - - ranking = 1keywords = administration (Clic here for more details about this article) |
3/17. Severe colitis after administration of UFT chemotherapy for temporal bone carcinoma.UFT (Uftoral), a blend of uracil and tegafur, is an antitumour agent for oral administration that is presumed to maintain the concentration of 5-fluorouracil (5-FU) in tumour tissue. As a result of increased use of high-dose 5-FU-based chemotherapy for various solid tumours, complicated drug-induced colitis is more frequently observed. Dihydropyrimidine dehydrogenase (DPD) is the rate-limiting enzyme in the catabolism of 5-FU and its deficiency is responsible for the severe toxicities encountered in cancer patients receiving 5-FU. The authors present the case of a patient with locally advanced temporal bone carcinoma who developed haematochezia during a course of chemotherapy with UFT. colonoscopy of the patient showed bleeding petechia-like lesions and superficial inflammatory exudate, whilst histology revealed non-specific inflammatory changes of the colon mucosa. As the haematochezia improved with supportive treatment, neutropenia complicated the clinical picture. This patient developed life-threatening UFT toxicity without an exon-14 DPD gene mutation.- - - - - - - - - - ranking = 5keywords = administration (Clic here for more details about this article) |
4/17. Primary angiosarcoma of the cranial vault: a case report and review of the literature.BACKGROUND: Angiosarcoma is a rare neoplasm. It is most likely to affect the scalp in elderly people and involvement of the cranium is uncommon. We report a case of primary malignant angiosarcoma of the cranial vault. CASE DESCRIPTION: An 82-year-old man presented with right hemiparesis, deformity of the cranium and mildly swollen scalp. Further studies disclosed bilateral parietal lesions, with destruction of the dura matter and infiltration of the brain parenchyma. thrombocytopenia was found. Faint enhancement of the lesions was seen on magnetic resonance imaging (MRI) after i.v. administration of contrast medium with gadolinium. The tumor was excised including the affected portion of the skull and dura matter. Histologic examination revealed typical pictures of angiosarcoma with immunohistochemical evidence of factor viii-related antigen. Postoperative radiotherapy was employed. The patient remained well at 10 months postoperative follow up. CONCLUSION: Primary angiosarcoma of the cranium is sometimes difficult to differentiate from trauma on clinical examination. We review the literature pertaining to the pathogenesis, clinical course and treatment of this condition. Determination of platelet count may be helpful in monitoring the progression of the disease. The tumor may show faint enhancement on MRI.- - - - - - - - - - ranking = 1keywords = administration (Clic here for more details about this article) |
5/17. Unusual metastatic spread of follicular thyroid carcinoma: report of a case.Concurrent skull and liver metastases from follicular thyroid carcinoma is a very rare event. We herein present the case of a 72-year-old woman who initially presented with a swelling in the right supraorbital region that proved to be metastasis from a well-differentiated follicular thyroid carcinoma of clear-cell type. The metastatic workup disclosed a huge liver metastasis and an additional metastasis in the left iliac fossa. The treatment of this patient included a total thyroidectomy, an excision of the skull lesion, and the administration of radioiodine therapy, as well as thyroid-stimulating hormone (TSH) suppression therapy. However, the course of her disease was relentless. Although well-differentiated thyroid carcinoma tends to show an excellent course, the presence of metastatic disease leads to a very dismal prognosis.- - - - - - - - - - ranking = 1keywords = administration (Clic here for more details about this article) |
6/17. skull metastasis in primary vulvar adenocarcinoma of the Bartholin's gland: a case report.BACKGROUND: Metastatic bone involvement in vulvar squamous carcinoma is very rare. Here, we present a case of primary adenocarcinoma of the Bartholin's gland giving rise to isolated skull metastasis. CASE: A 74-year-old woman was referred with a diagnosis of primary vulvar adenocarcinoma of the right labium minus. A right hemivulvectomy was performed with ipsilateral inguinofemoral lymphadenectomy, revealing a primary adenocarcinoma of the Bartholin's gland and metastatic involvement in 6 out of 13 lymphnodes. During chemotherapy administration, the patient started complaining of a worsening of right hypoacousis. CT scan and MRI of the brain showed the presence of a metastatic lesion on the right side of the skullbone. The diagnosis was metastatic poorly differentiated adenocarcinoma. CONCLUSION: In adenocarcinoma of the Bartholin's gland at an advanced stage of disease, a bone scan or survey in the preoperative as well as follow up staging procedures could be useful.- - - - - - - - - - ranking = 1keywords = administration (Clic here for more details about this article) |
7/17. Intraosseous hemangioma of the skull with dural tail sign: radiologic features with pathologic correlation.Osseous hemangiomas of the calvaria account for about 0.2% of bone neoplasms. We report a case of an extensive intraosseous cavernous hemangioma in a 46-year-old woman. MR imaging showed a mass in the right frontal bone with intra- and extracranial extension and a dural tail sign after gadopentetate dimeglumine administration, mimicking a meningioma in which the dural tail sign was due to a direct noninvasive superficial growth of the lesion.- - - - - - - - - - ranking = 1keywords = administration (Clic here for more details about this article) |
8/17. Intracranial aggressive fibromatosis presenting as panhypopituitarism and diabetes insipidus.Aggressive fibromatosis (AF) is a rare, locally aggressive, proliferative fibroblastic lesion affecting musculoaponeurotic structures, most often, of the limbs and trunk. Intracranial AF is extremely rare and requires aggressive treatment to prevent recurrence. We present a case of a 34 year-old male with AF involving intracranial structures causing panhypopituitarism and diabetes insipidus. Patient was admitted to hospital because of polyuria, polydipsia, and loss of libido, impotence, hearing loss, and gait disturbance. On cranial magnetic resonance imaging, the lesion extended through the sphenoid sinus into the both pterygoid recesses, destroying the left lateral wall of the sphenoid sinus and invading the retroorbital area. There was also a distinct lesion in the hypothalamic area. The tumor was markedly isointense on both T2- and T1-weighted images relative to gray matter, and enhanced strongly after administration of gadolinium. The patient underwent partial resection of the lesion via a transcranial approach. The pathological examination of the mass was reported as AF. No other sites were found to be involved by thorax and abdominal tomography. Hormonal assessment of hypothalamic-pituitary dysfunction revealed panhypopituitarism with central diabetes insipidus. Replacement therapy was instituted. In this case, standard treatment of wide-field surgical resection was impossible. On the basis of reports that radiotherapy is an effective treatment for this kind of tumor, we administered radiation to the affected area, since chemotherapy and hormonal treatment of non-resectable tumors are not satisfactory. To our knowledge, this is the first reported case of AF presenting as panhypopituitarism with central diabetes insipidus.- - - - - - - - - - ranking = 1keywords = administration (Clic here for more details about this article) |
9/17. thyrotoxicosis caused by functioning metastatic thyroid carcinoma. A rare and elusive cause of hyperthyroidism with low radioactive iodine uptake.A patient with progressively worsening thyrotoxicosis, refractory to medical therapy, is described. Repeated measurements of thyroidal RAI uptake over a 13 month period were low consistently and could not be explained by iodine ingestion, thyroiditis, or administration of exogenous thyroid hormone. An I-131 scan ultimately revealed striking activity at the base of the skull, reflecting ectopic excessive production of thyroid hormone by a solitary functioning metastatic thyroid carcinoma. The thyrotoxic state resolved after large doses of therapeutic I-131. Typical features of this rare cause of hyperthyroidism are discussed.- - - - - - - - - - ranking = 1keywords = administration (Clic here for more details about this article) |
10/17. Computed tomographic evaluation of subdural and epidural metastases.Head computed tomography scans of eight patients with calvarial metastases revealed extension of the tumors into the epidural and subdural spaces; Epidural and subdural extensions enhanced after contrast medium administration and were either crescentic or biconcave. In six patients, these tumors produced sufficient mass effect to displace intraparenchymal structures. The subdural and epidural tumor extensions appeared similar to subdural and epidural hematomas, but could be diagnosed correctly because the former enhanced uniformly and were associated with destructive calvarial changes.- - - - - - - - - - ranking = 1keywords = administration (Clic here for more details about this article) |
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