RESUMO
5-Aminolevulinic acid (ALA) has been successfully used to confirm the target tumor tissues obtained during stereotactic biopsy. The authors report their experience with 2 patients who underwent stereotactic biopsies of thalamic malignant lymphoma and pontine glioma utilizing 5-ALA. Intraoperatively, the tumor specimens fluoresced, allowing for confirmation that the obtained target specimen contained tumor tissues. No serious side effects or complications occurred.
Assuntos
Ácido Aminolevulínico , Astrocitoma/diagnóstico , Neoplasias Encefálicas/diagnóstico , Linfoma Difuso de Grandes Células B/diagnóstico , Técnicas Estereotáxicas , Idoso , Astrocitoma/patologia , Biópsia/métodos , Neoplasias Encefálicas/patologia , Criança , Feminino , Humanos , Linfoma Difuso de Grandes Células B/patologia , Masculino , Ponte/patologia , Tálamo/patologiaRESUMO
A 69-year-old woman was admitted to our hospital because of disturbed consciousness. She awoke to a solid mass in her left breast, but it had been present for about 20 years. On arrival to our hospital, she was comatose, and Babinski's reflexes were present bilaterally. She had no paresis or neck stiffness. Her left breast contained a 10 cm x 12 cm node with multiple ulcers. Blood analysis showed she was in a hypercoagulative state. Computed tomography of the brain demonstrated bilateral hypodensities in the thalamus and hyperdensities at the vein of Galen and at the straight sinus. Angiography showed an absence of flow in the inferior sagittal sinus, in the vein of Galen, and in the straight sinus. Thus, she was diagnosed as having a deep cerebral venous thrombosis. She was treated by continuous heparin infusion, and her consciousness improved gradually. The biopsy of her left breast confirmed the presence of a mucinous carcinoma. The hypercoagulative state associated with the carcinoma was considered to be the cause of her deep cerebral venous thrombosis. It is very rare to diagnose deep cerebral venous thrombosis in a cancer patient while the patient is still alive. In this case, computed tomography of the brain was useful for the diagnosis.
Assuntos
Adenocarcinoma Mucinoso/complicações , Neoplasias da Mama/complicações , Veias Cerebrais , Trombose Venosa/etiologia , Idoso , Veias Cerebrais/diagnóstico por imagem , Feminino , Heparina/administração & dosagem , Humanos , Infusões Intravenosas , Trombofilia/tratamento farmacológico , Trombofilia/etiologia , Tomografia Computadorizada por Raios X , Resultado do Tratamento , Trombose Venosa/diagnóstico por imagem , Trombose Venosa/tratamento farmacológicoRESUMO
We report a case of Wegener's granulomatosis (WG) with central nervous system (CNS) involvement in a woman who complained of bilateral visual disturbance. The intracranial necrotizing granulomatous lesion was confirmed by MR imaging and brain biopsy. After high-dose oral corticosteroid treatment, not only clinical manifestations but also laboratory tests improved. Moreover, the CNS lesion completely regressed. This suggests that high-dose corticosteroid alone might be effective in treating WG with CNS involvement.