Congenital maturing immature intraventricular teratoma.

We report a case of a maturing immature intraventricular teratoma in a neonate. The computed tomography and magnetic resonance imaging and pathologic findings are described. The relevant literature is reviewed and management is discussed.

Congenital subependymal giant cell astrocytoma: clinical considerations and expression of radial glial cell markers in giant cells.

OBJECTS: Congenital Subependymal giant cell astrocytoma (SEGA), diagnosed in fetal and neonatal period, is extremely rare. Previous studies have reported poor surgical outcomes of this small group of patients. We encountered a patient diagnosed as congenital SEGA and report the surgical outcome along with interesting immuno-phenotypes of giant tumor cells. CASE: Ventriculomegaly and a hypoechoic mass near the foramen of Monro were detected in a fetus on prenatal ultrasonography in the 35th week of gestation. Surgery was scheduled 2 months later to reduce the risk of operative complications. At postnatal 2 months, gross total resection of the tumor was achieved without complications. The patient had been followed up for 1 year without tumor recurrence. In double immunofluorescence, the prototype cells of SEGA expressed a variety of neural stem cell (nestin and Sox2) and radial glial cell markers (vimentin and brain lipid-binding protein), in addition to glutamate/aspartate transporter and glial fibrillary acidic protein. CONCLUSIONS: Congenital SEGA can be successfully treated with judicious use of observation period and careful evaluation of general conditions. Pathological findings support the concept that SEGA may originate from aberrant radial glial cells in the developing brain.

Massive congenital intracranial immature teratoma of the lateral ventricle with retro-orbital extension: a case report and review of the literature.

Germ cell tumors comprise 0.4-3.1% of all intracranial tumors, and teratoma constitutes 9-30% of them. Congenital intracranial tumors are very rare and only account for 0.5-1.5% of all childhood brain tumors. The most common type of these tumors present at birth is teratomas, which represent 0.5% of all intracranial tumors. Most teratomas are midline tumors located predominantly in the sellar and pineal regions. In this study, we report a neonatal intracranial immature teratoma at the lateral ventricle because of its rare location. A 5-day-old female neonate presented with a history of irritability and left eye protrusion since birth. A head computed tomographic (CT) scan and magnetic resonance imaging (MRI) disclosed a large tumor filling the left lateral ventricle and extending into the ipsilateral retro-orbital space. With left frontotemporoparietal craniotomy, a large grayish-white lobulated vascular mass was encountered, and total removal of tumor was performed. Histological examination revealed the diagnosis of immature teratoma. The prognosis of congenital intracranial immature teratoma is usually poor because the lesions are extensive when they are identified. Prenatal ultrasonography is necessary for the prenatal diagnosis. Fetal MRI should be made for the evaluation of intracranial tumor. If the tumor is detected before the 24th week of gestation, termination of the pregnancy should be considered.

Congenital intracranial immature teratoma of the lateral ventricle: a case report and review of the literature.

OBJECTIVE: Congenital intracranial tumors are very rare and only account for 0.5-1.5% of all childhood brain tumors. The most common type of these tumors present at birth is teratomas, which represent 0.5% of all intracranial tumors. Most teratomas are midline tumors located predominantly in the sellar and pineal regions. In this study, we report a neonatal intracranial immature teratoma at the lateral ventricle because of its rare location. CASE REPORT: A 3-day-old female neonate presented with a history of irritability, vomiting, and recurrent generalized clonic seizures since birth. A head computed tomographic scan and magnetic resonance imaging disclosed a large tumor filling the right lateral ventricle and extending into the ipsilateral posterior fossa. With right parieto-occipital craniotomy, large grayish-white lobulated vascular mass was encountered and total removal of tumor was performed. Histological examination revealed the diagnosis of immature teratoma. CONCLUSION: The prognosis of congenital intracranial immature teratoma is usually poor because the lesions are extensive when they are identified. Prenatal ultrasonography is necessary for the prenatal diagnosis. Fetal magnetic resonance imaging should be made for the evaluation of intracranial tumor. If the tumor is detected before the 24 week of gestation, termination of the pregnancy should be considered.

Congenital intracranial teratoma of the lateral ventricle.

A case of lateral ventricular teratoma in neonate, where near total excision of tumour was done, is being reported with the review of literature.

Midline posterior fossa teratoma--case report.

A 20-day-old female neonate presented with an immature teratoma in the midline posterior fossa. The tumor was totally removed but the patient died of pneumonia. Teratoma is a rare tumor, but very difficult to treat as the patients tend to be young, and the outcome is very poor.

Choroid plexus papillomas of the III ventricle in infants. Report of three cases.

The III ventricle is an uncommon location for choroid plexus papilloma at any age. We describe three new cases of choroid plexus papillomas of the III ventricle (CPPs). All children were boys under 4 months of age and all presented with increased intracranial pressure, hydrocephalus and macrocephaly. The three were examined by preoperative computed tomography (CT) and ultrasonography. Two of them were investigated with magnetic resonance imaging (MRI). The first case was treated with a right corticofrontal transventricular approach and subtotal resection, so that he required a second operation through a transcallosal approach. In the other two cases a transcallosal approach was used. Two children needed permanent ventriculo-peritoneal shunts. The average follow-up of 4.3 years has revealed no neurological deficits in any case. The timing of and the need for shunting are major considerations. Clinical and imaging follow-up (CT and/or ultrasonography) are very helpful in controlling postoperative hydrocephalus and subdural effusion, avoiding unnecessary shunting in many cases. The operative approaches, transcortical and transcallosal, are discussed.

Fetal cavernous angioma--case report.

A neonate male who developed cavernous angioma was born with a severe intraventricular hemorrhage and intraparenchymal hemorrhage in the basal ganglia. magnetic resonance imaging revealed a large, non-enhanced hematoma that packed the lateral ventricle. Surgery on the 2nd day of life verified a cavernous angioma associated with minimal hemosiderin and gliosis. Fetal cavernous angiomas, unlike such malformations in other age groups, can present with a devastating hemorrhage because of the lack of gliosis in the surrounding brain.

Multiple intradural spinal lipomata with intracranial extension.

An intradural, intramedullary lipoma originating within the upper cervical cord with significant extension into the posterior fossa is reported in an infant. Two additional lipomas were found in the lumbar region. This constellation of findings represents the first description of multiple intradural, intramedullary spinal lipomas with extensive intracranial involvement.

Agenesis of corpus callosum and intraventricular lipomas.

Intracranial lipomas are rare and usually do not have clinical expression. They are located most commonly in the interhemispheric fissure and may also be found in the quadrigeminal, ambient, chiasmatic, interpeduncular, sylvian, and perimesencephalic cisterns. Interhemispheric lipomas may be associated with choroid plexus lipomas. The ultrasonography, computed tomography, and magnetic resonance imaging findings are reported in a neonate with lateral ventricular choroid plexus lipomas and interhemispheric lipoma associated with agenesis of the corpus callosum.

Congenital choroid plexus papilloma of the fourth ventricle.

A newborn infant with marked hydrocephalus had a large papilloma of the choroid plexus originating in the fourth ventricle and infiltrating the brain stem. The computed tomographic (CT) scan appearance was distinctive, showing vascularity and marked enhancement with contrast medium. Histological confirmation was made from several surgical sites. Total removal of the tumor was not possible. Review of congenital choroid plexus brain tumors reveals the location of this child's tumor in the fourth ventricle to be uncommon.

Choroid plexus papilloma in early infants.

Four infants with choroid plexus papillomas which were successfully treated with surgery are described. All patients showed the clinical signs of increased intracranial pressure and hydrocephalus within 8 weeks after birth. The tumors were in the lateral ventricles and histologically three of them were benign papillomas and other one was a malignant papilloma. Computerized tomography scan was useful for the diagnosis of both of the tumor and the hydrocephalus that was caused by the overproduction of cerebrospinal fluid and/or the obstruction of it's pathway. The tumor stain on the angiograms was noticed in two patients. Three patients have grown normally in both physical and mental functions after the surgical treatment, whereas one showed psychomotor retardation because of poorly controlled hydrocephalus.

[Computerized tomography of a prenatal astrocytoma in a 5-month-old infant]. / Computertomogramm eines pränatalen Astrozytoms bei einem 5 Monate alten Säugling.

The authors report on a patient of 5 months of age in whom the computer tomogram revealed a space-occupying growth without any sign of a compressive intracranial process. Histological diagnosis yielded the rare occurrence of a fibrillary astrocytoma of grade 2.

[Sonographic detection of brain tumors in infancy]. / Sonographischer Nachweis von Hirntumoren im Säuglingsalter.

Using the open fontanelle as an acoustic window brain tumours were diagnosed by gray scale ultrasonography in 3 infants aged 1 day to 5 months. The tumours were characterized by their echo dense structure and their good delimination from the surrounding brain. In 2 children the tumour was localized infratentorially (medulloblastoma and unclassified neuroectodermal tumour) and had caused an occlusive hydrocephalus. Both children died aged 3 and 5 months in central nervous dysregulation. One child suffered from plexus papilloma which had caused a hypersecretory hydrocephalus. After resection of the tumour the hydrocephalus decreased without any further treatment. Comparison with axial computed tomography and autopsy findings showed, that gray scale ultrasonography is equally efficient in diagnosing brain tumours and associated hydrocephalus.