Asunto(s)
Adenocarcinoma/patología , Fosa Craneal Anterior/patología , Neoplasias de los Senos Paranasales/patología , Adenocarcinoma/metabolismo , Adenocarcinoma/cirugía , Biomarcadores de Tumor/metabolismo , Niño , Fosa Craneal Anterior/metabolismo , Fosa Craneal Anterior/cirugía , Humanos , Masculino , Neoplasias de los Senos Paranasales/metabolismo , Neoplasias de los Senos Paranasales/cirugía , PronósticoRESUMEN
Neurenteric cysts are rare developmental lesions typically found outside the central nervous system but when they do, we most likely find them in a spinal (cervical or dorsal) intradural extramedular location, often associated with dysraphism. The more unusual intracranial cases have been published because of its rarity, occurring mostly as a posterior fossa extra-axial cyst, in adults. Supratentorial cases are distinctly infrequent, especially in children, resulting in few case reports and even fewer case reviews. We describe a case of a child with a supratentorial neurenteric cyst and present a brief review of the literature about these cysts in children, a noticeable gap in the literature.
Asunto(s)
Lóbulo Frontal/cirugía , Defectos del Tubo Neural/cirugía , Adolescente , Imagen de Difusión por Resonancia Magnética , Lóbulo Frontal/anomalías , Lóbulo Frontal/diagnóstico por imagen , Humanos , Masculino , Defectos del Tubo Neural/complicaciones , Defectos del Tubo Neural/diagnóstico por imagen , Procedimientos Neuroquirúrgicos/métodos , Convulsiones/etiologíaRESUMEN
Choroid plexus tumors (CPT) can present in the baseline magnetic resonance imaging (MRI) with lesions compatible with leptomeningeal dissemination. Therapeutic strategy in this condition is controversial. We present a case of an infant with CPP and significant diffuse leptomeningeal contrast enhancement at diagnosis, which spontaneously resolved after removal of the primary tumor. In these challenging cases, several aspects, such as histopathological/molecular diagnosis and close radiological follow-up, should be taken into account to avoid unnecessary treatments.
Asunto(s)
Neoplasias Meníngeas/diagnóstico por imagen , Papiloma del Plexo Coroideo/diagnóstico por imagen , Plexo Coroideo/diagnóstico por imagen , Plexo Coroideo/patología , Diagnóstico Diferencial , Femenino , Humanos , Lactante , Imagen por Resonancia Magnética , Meninges/diagnóstico por imagen , Meninges/patología , Papiloma del Plexo Coroideo/patología , Papiloma del Plexo Coroideo/cirugíaAsunto(s)
Espina Bífida Oculta/diagnóstico , Preescolar , Diagnóstico Tardío , Humanos , Región Lumbosacra , MasculinoRESUMEN
OBJECTIVEDiffuse intrinsic pontine glioma (DIPG) is a highly aggressive and lethal brainstem tumor in children. In the 1980s, routine biopsy at presentation was abandoned since it was claimed "unnecessary" for diagnosis. In the last decade, however, several groups have reincorporated this procedure as standard of care or in the context of clinical trials. Expert neurosurgical teams report no mortality and acceptable morbidity, and no relevant complications have been previously described. The aim of this study was to review needle tract dissemination as a potential complication in DIPG.METHODSThe authors retrospectively analyzed the incidence of dissemination through surgical tracts in DIPG patients who underwent biopsy procedures at diagnosis in 3 dedicated centers. Clinical records and images as well as radiation dosimetry from diagnosis to relapse were reviewed.RESULTSFour patients (2 boys and 2 girls, age range 6-12 years) had surgical tract dissemination: in 3 cases in the needle tract and in 1 case in the Ommaya catheter tract. The median time from biopsy to identification of dissemination was 5 months (range 4-6 months). The median overall survival was 11 months (range 7-12 months). Disseminated lesions were in the marginal radiotherapy field (n = 2), out of the field (n = 1), and in the radiotherapy field (n = 1).CONCLUSIONSAlthough surgical tract dissemination in DIPG is a rare complication (associated with 2.4% of procedures in this study), it should be mentioned to patients and family when procedures involving a surgical tract are proposed. The inclusion of the needle tract in the radiotherapy field may have only limited benefit. Future studies are warranted to explore the benefit of larger radiotherapy fields in patients with DIPG.
Asunto(s)
Biopsia/efectos adversos , Neoplasias del Tronco Encefálico/patología , Glioma/patología , Invasividad Neoplásica/patología , Puente/patología , Niño , Femenino , Humanos , MasculinoRESUMEN
Diffuse intrinsic pontine glioma (DIPG) is an aggressive infiltrative glioma for which no curative therapy is available. Radiation therapy (RT) is the only potentially effective intervention in delaying tumor progression, but only transiently. At progression, re-irradiation is gaining popularity as an effective palliative therapy. However, at second progression, exclusive symptomatic treatment is usually offered. Here we report two patients with DIPG at second progression who were treated with a second re-irradiation course with good response. Importantly, treatment was well tolerated with no irradiation associated acute toxicity identified.
Asunto(s)
Neoplasias del Tronco Encefálico/radioterapia , Progresión de la Enfermedad , Glioma/radioterapia , Reirradiación/métodos , Neoplasias del Tronco Encefálico/diagnóstico por imagen , Niño , Preescolar , Femenino , Glioma/diagnóstico por imagen , Humanos , MasculinoRESUMEN
Sclerosing epithelioid fibrosarcoma (SEF) is a rare variant of low-grade fibrosarcoma, with specific histological and immunohistochemical features and a poor prognosis. We report a case of SEF of the paravertebral column in a 49-year old male who presented a paraspinal mass with extension into the L4-L5 neural foramen and invasion of the L5 nerve root. Histology of the tumourectomy specimen and its immunohistochemical study led to the diagnosis of SEF. This case was particularly unusual due to its paravertebral column location and, despite its low grade, illustrates the malignant potential of SEF.