1/12. Pediatric angiosarcoma of the heart: a unique presentation and metastatic pattern.We report the seventh case of angiosarcoma of the heart in a child. The patient was a 23-month-old female who presented for lower extremity limping and underwent open surgical biopsy of the femur. Immediately postoperatively, she developed pericardial tamponade, and a bulky intracardiac mass was discovered as the underlying cause. The mass was composed of highly pleomorphic tumor cells reactive for the endothelial markers CD31, CD34, and factor viii-related antigen (FVIII-RA). Staging evaluation revealed widespread metastases involving the brain, ovaries, and bone marrow. She died of complications of metastatic disease 8 months following initial presentation. Unusual features of this case include the young age of the patient, left-sided nature of the cardiac tumor, presentation secondary to metastatic disease, and the pattern of metastases. The literature on cardiac angiosarcoma, which is limited to six case reports in the pediatric population, is also reviewed.- - - - - - - - - - ranking = 1keywords = brain (Clic here for more details about this article) |
2/12. Limitations of the immunocytochemical detection of isolated tumor cells in frozen samples of bone marrow obtained from melanoma patients.We report on a case of a 70-year-old woman with an ocular melanoma, which was diagnosed and treated 14 years ago. The patient was referred to the hospital with a suspected lymphoma. Cytological examination of bone marrow proved a marked infiltration with melanoma cells. Because detection of isolated tumor cells in the bone marrow of patients with various types of tumors was shown to be of prognostic significance and since current tumor-staging techniques are unable to detect single disseminated tumor cells or small aggregates of tumor cells, which might be the seed for subsequent metastatic relapse, we therefore evaluated the feasibility of immunocytochemical screening of bone marrow aspirates of 36 melanoma patients in different clinical stages using three monoclonal antibodies against melanoma-associated antigens in comparison with 43 non-melanoma control patients. Two of these antibodies (HMB45 and NKI-beteb) are directed against the melanoma antigen gp100/pmel17, whereas the third one (TA99) recognizes gp75/Tyrosinase-related protein 1 (TRP-1). None of the patients demonstrated a macroscopic bone marrow infiltration as was present in our patient with metastatic ocular melanoma. Seven (20.6%) of the 34 eligible melanoma patients presented with cells in the bone marrow positive for one or more of the above-mentioned melanosomal markers. Four of the positive patients were clinically free of tumors by the time of puncture, whereas the remaining 3 patients showed overt metastases in the subcutaneous fat (2 patients) and the brain (1 patient). On the other hand, 20 (66%) of the 29 patients with negative bone marrow findings also presented with clinical advanced disease with overt metastasis in the skin, lymph node, spleen, liver, lung, bone and brain. In conclusion, immunocytochemical screening of bone marrow samples is a feasible procedure that allows the detection of micrometastatic tumor cells in a subset of melanoma patients. Massive invasion of bone marrow with melanoma cells is a rare event even in far-advanced metastatic stages and no clear correlation between tumor load and bone marrow infiltration could be established.- - - - - - - - - - ranking = 2keywords = brain (Clic here for more details about this article) |
3/12. bone marrow metastasis in anaplastic oligodendroglioma.oligodendroglioma is a rare primary brain tumour. These tumours rarely metastasis extraneurally because of the absence of a lymphatic system, the presence of the blood-brain barrier and the patient's poor overall survival. oligodendroglioma may spread via the cerebrospinal fluid or after surgical intervention. Metastasis to bone marrow is extremely rare. oligodendroglioma is now considered a chemosensitive disease. If chemotherapy leads to prolonged survival, we may see more extraneural metastases in future.- - - - - - - - - - ranking = 2keywords = brain (Clic here for more details about this article) |
4/12. Double leukemias simultaneously showing lymphoblastic leukemia of the bone marrow and monocytic leukemia of the central nervous system.A rare case of different leukemias simultaneously occurring in the bone marrow (BM) and the central nervous system (CNS) was encountered. A 4-year-old girl was diagnosed with acute lymphoblastic leukemia and achieved a complete remission with chemotherapy. Two years after diagnosis, she was found to have acute monocytic leukemia at first relapse in the BM. One month after the second course of induction therapy, lymphoblastic leukemia in the BM and monocytic leukemia in the CNS were found simultaneously. Chromosomal analysis of leukemia cells in the BM and CNS showed distinct results. The mechanism of double leukemias occurring was obscure, although a lineage switch, therapy-related, or de novo leukemia could be considered as possibilities. Double leukemias should be kept in mind when leukemias relapse in several sites.- - - - - - - - - - ranking = 381.28207862885keywords = central nervous system, nervous system (Clic here for more details about this article) |
5/12. Clonal stability of initial leukemia in a child with central nervous system relapse 7.4 years after bone marrow relapse of common acute lymphoblastic leukemic.Second central nervous system (CNS) relapses represent about 7.3% of subsequent recurrences of childhood acute lymphoblastic leukemia (ALL). In most children these subsequent CNS relapses occur during the first 18 months after diagnosis of the first relapse (mean 1.42 /- 0.73 years). We present a patient who suffered a second ALL relapse in the CNS more than seven years after diagnosis of his first relapse. The leukemic clone was completely stable over more than ten years as shown by minimal residual disease techniques. Possible reasons for the recurrence of the leukemic clone after this very long period of dormancy (e.g. role of the disease site, immune system dysfunction) are discussed.- - - - - - - - - - ranking = 381.28207862885keywords = central nervous system, nervous system (Clic here for more details about this article) |
6/12. Intracranial spread of Merkel cell carcinoma through intact skull.We report an unusual case of Merkel cell carcinoma presenting as a frontal scalp mass with apparent invasion into underlying brain parenchyma through grossly intact calvaria. Despite wide local excision, craniectomy, intracranial tumor resection, and postoperative adjuvant irradiation, widespread systemic metastases resistant to chemotherapy developed, and the patient died 9 months after surgery. This case report confirms that Merkel cell carcinoma of the head and neck, already known to be an aggressive tumor, has the capacity for rapid intracranial extension. We propose that in this case, the mechanism of intracranial metastasis was via communicating veins rather than through bone destruction or systemic metastasis. Appropriate preoperative imaging should be carried out to define the extent of this tumor when it is adjacent to the skull. We found contrast-enhanced magnetic resonance imaging to be superior to computed tomography for defining soft tissue extent and marrow space involvement within underlying bone.- - - - - - - - - - ranking = 1keywords = brain (Clic here for more details about this article) |
7/12. 1p/19q chromosome deletions in metastatic oligodendroglioma.Extracranial metastasis of primary brain tumors is a rare phenomenon. Of the few cases reported of metastatic oligodendroglioma, only two have evaluated genetic alterations, specifically deletions of chromosomes 1p and 19q. Herein, we report two additional patients with metastatic anaplastic oligodendroglioma to bone, both followed until death. All available pathology specimens were reviewed and genetic analysis was performed in one of the cases. Although the bone metastasis was non-informative, the primary intracranial tumor revealed codeletions of the 1p and 19q chromosomal arms, commonly recognized as the genetically favorable profile of oligodendrogliomas. Both patients died of complications related to their systemic disease and did not have any radiologic evidence of intracranial progression at the time of their last MRI studies. Along with the reported literature, our data suggest that despite their generally favorable behavioral profiles, oligodendroglial tumors with 1p/19q deletions may be more prone to metastasis as they progress. Genetic analysis serves a valuable ancillary role in the diagnostic workup of such cases.- - - - - - - - - - ranking = 1keywords = brain (Clic here for more details about this article) |
8/12. Non-pyothorax-associated primary pleural lymphoma with complex karyotypic abnormalities.We describe a case of non-pyothorax-associated primary pleural lymphoma with bone marrow and central nervous system involvement, and complex karyotypic abnormalities involving nullisomy chromosome 17 and multiple breakpoints that are commonly associated with acute leukemia and myeloproliferative diseases.- - - - - - - - - - ranking = 76.25641572577keywords = central nervous system, nervous system (Clic here for more details about this article) |
9/12. Bilateral non-Hodgkin's lymphoma of the breast mimicking mastitis.We recently encountered a case of recurrent non-Hodgkin's lymphoma manifested after a long period of quiescence as bilateral involvement of the breasts. This 37-year-old woman had stage IVA nodular poorly differentiated lymphocytic lymphoma diagnosed 9 years previously and was followed up without treatment. She was lost to follow-up after 4 years but had been in good health until seen with malaise and fever and pain, swelling, and erythema involving both breasts. Biopsies of lymph node and bone marrow showed a high-grade non-Hodgkin's lymphoma (lymphoblastic lymphoma) of B cell origin with central nervous system involvement. Combination chemotherapy produced a dramatic remission, but the patient died of pseudomonas septicemia.- - - - - - - - - - ranking = 76.25641572577keywords = central nervous system, nervous system (Clic here for more details about this article) |
10/12. Pancytopaenia from a disseminated anaplastic oligodendroglioma.The rarity of extraneural metastases from a central nervous system (CNS) tumour may mean that the manifestations of a metastatic lesion are confused with a second pathology. This report concerns a patient who developed a fatal and clinically unexplained, pancytopaenia 3 months after removal of an anaplastic oligodendroglioma. Postmortem revealed widespread bone marrow dissemination of the CNS primary and a solitary liver metastasis. A brief review of the literature and some possible reasons for the rarity of extracranial metastases are discussed.- - - - - - - - - - ranking = 76.25641572577keywords = central nervous system, nervous system (Clic here for more details about this article) |
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