Assuntos
Adenocarcinoma/patologia , Fossa Craniana Anterior/patologia , Neoplasias dos Seios Paranasais/patologia , Adenocarcinoma/metabolismo , Adenocarcinoma/cirurgia , Biomarcadores Tumorais/metabolismo , Criança , Fossa Craniana Anterior/metabolismo , Fossa Craniana Anterior/cirurgia , Humanos , Masculino , Neoplasias dos Seios Paranasais/metabolismo , Neoplasias dos Seios Paranasais/cirurgia , PrognósticoRESUMO
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.
Assuntos
Lobo Frontal/cirurgia , Defeitos do Tubo Neural/cirurgia , Adolescente , Imagem de Difusão por Ressonância Magnética , Lobo Frontal/anormalidades , Lobo Frontal/diagnóstico por imagem , Humanos , Masculino , Defeitos do Tubo Neural/complicações , Defeitos do Tubo Neural/diagnóstico por imagem , Procedimentos Neurocirúrgicos/métodos , Convulsões/etiologiaRESUMO
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.
Assuntos
Neoplasias Meníngeas/diagnóstico por imagem , Papiloma do Plexo Corióideo/diagnóstico por imagem , Plexo Corióideo/diagnóstico por imagem , Plexo Corióideo/patologia , Diagnóstico Diferencial , Feminino , Humanos , Lactente , Imageamento por Ressonância Magnética , Meninges/diagnóstico por imagem , Meninges/patologia , Papiloma do Plexo Corióideo/patologia , Papiloma do Plexo Corióideo/cirurgiaRESUMO
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.
Assuntos
Neoplasias do Tronco Encefálico/radioterapia , Progressão da Doença , Glioma/radioterapia , Reirradiação/métodos , Neoplasias do Tronco Encefálico/diagnóstico por imagem , Criança , Pré-Escolar , Feminino , Glioma/diagnóstico por imagem , Humanos , MasculinoRESUMO
INTRODUCTION: Tumours of the choroid plexus are uncommon, with a peak incidence in the early years of life. Clinically they usually produce intracranial hypertension. Histologically, they can be divided into papillomas and carcinomas. Metastasis rarely occurs in the case of papillomas. CASE REPORT: An 11-year-old female with an intracranial lesion in the 4th ventricle and a sacral intradural lesion. A sub-occipital craniotomy with total resection of the ventricular lesion was performed and this was followed later by partial exeresis of the spinal lesion. The histological study provides the diagnosis of typical choroid plexus papilloma in the intracranial lesion and choroid plexus papilloma metastasis in the spinal lesion. A review of the literature showed that choroid plexus papillomas with metastatic lesions are very rarely found at the paediatric age. There is no general agreement on the treatment of plexus papilloma metastasis at the paediatric age, expectant management being adopted in two cases and surgical treatment involving a laminectomy in the other. CONCLUSIONS: Choroid plexus papillomas are rare, benign lesions with a good prognosis. Metastasis seldom exists. Preferred treatment is total resection of the lesion. For the treatment of metastases, there is no evidence as to which is the best approach and different alternatives have been suggested.