Profile of High Grade Gliomas - A Single Center Experience.

INTRODUCTION: The term high grade glioma (HGG), is usually used to describe WHO grade III and IV tumours. There has been a recent increase in incidence of HGGs in the Western world, particularly in the elderly population. This probably reflects the easy availability of vastly improved diagnostic imaging. A five year retroprospective study was planned to study demography, clinical presentation, imaging, surgical intervention, histopathological examination of specimens and postoperative outcome of patients of high grade gliomas. OBJECTIVES: To determine the demographic, clinical, histopathogical and radiological profile of patients of High Grade Gliomas (HGG) and to ascertain post-operative mortality at 24 hours and 7 days Material and Methods: The present study of 226 cases from our institute for the last 5 years (retrospective 3 years and prospective 2 years) extending from August 2010 to July 2015 is based on study about demography, clinical presentation, imaging, surgical intervention, histopathological examination of specimens and postoperative outcome. The clinic-pathological vis-a-vis imaging was also studied. The analyzed data from the results and observations of this study were compared with the previous studies. RESULTS: The study was retrospective as well as prospective. Total of 226 patients were registered. Out of these, 225 patients were operated (except one patient). The provisional diagnosis was based on the radio-imaging basis and the final diagnosis confirmed by histopathological examination. Majority of patients operated for HGG, irrespective of the procedure or extent of resection had good surgical outcome after the procedure. CONCLUSION: The overall survival is multifactorial in HGGs. The surgical intervention particularly in patients with features of raised ICP due to mass lesion provides symptomatic relief and improves quality of life in majority of patients and are discharged reasonably in better state of health.

Pneumomediastinum, pneumorachis, subcutaneous emphysema: An unusual complication of leukemia in a child.

Pneumorrhachis (PR), or epidural emphysema, denotes the presence of air in the spinal epidural space. It can be associated with a variety of etiologies, including trauma; recent iatrogenic manipulations during surgical, anesthesiological and diagnostic interventions; malignancy and its associated therapy. It usually represents an asymptomatic epiphenomenon but also can be symptomatic by itself, as well as by its underlying pathology, and rarely can be fatal. The pathogenesis and etiology of PR are varied and can sometimes be a diagnostic challenge. As such, there are no standard guidelines for the management of symptomatic PR and its treatment is often individualized. Here, we present a case of a 14-year-old boy treated for leukemia who developed this complication and whether chemotherapy related or not, it proved to be fatal for him. To our knowledge, this is the first case in the literature of this complication with acute lymphoblastic leukemia.