A Rare Case of Brain Metastasis of Thymic Carcinoma.

BACKGROUND: Thymic carcinoma is a rare cancer that often metastasizes to the liver and kidneys but rarely to the brain. CASE REPORT: We present a rare case of an 81-year-old woman with multiple cerebellar metastases of thymic carcinoma. She was initially diagnosed with stage IVb thymic carcinoma based on biopsy examination of a lesion in the anterior mediastinum. The patient refused to undergo treatment at the time. Six months later, she presented with gait disturbance and nausea. Contrast-enhanced magnetic resonance imaging revealed multiple cerebellar metastases. She underwent craniotomy and resection of the left cerebellar metastasis. Postoperative histological examination confirmed metastasis of the original thymic carcinoma. The patient underwent additional stereotactic radiotherapy for the cavity of the cerebellar metastasis and the small cerebellar metastatic lesions. Seven months after radiotherapy, she died due to progression of the thymic carcinoma. CONCLUSION: We believe that these findings add important information to the literature on this rare entity.

[Case of hydrocephalus after cervical laminoplasty for cervical ossification of the posterior longitudinal ligament].

We report a rare complication of cervical laminoplasty in cervical ossification of the posterior longitudinal ligament (OPLL). A 69-year-old man suffered from gait disturbance and numbness of the bilateral hand for 6 months. He underwent C3-7 partial laminoplasty at the department of orthopedic surgery. After the operation, his symptoms immeadiately disappeared. However 1 month later, he presented with memory disturbance and gait disturbance. A computed tomography (CT) scan of head showed hydrocephalus, and cervical magnetic resonance imaging (MRI) showed fluid collection in the epidural and subcutaneous spaces. A ventriculoperitoneal shunt was performed, and it resolved the memory and gait disturbance. This is the second case report of hydrocephalus after laminoplasty for cervical OPLL.

Upper plexus thoracic outlet syndrome--case report.

A 47-year-old right-handed female became aware of proximal ache and muscle weakness in the right shoulder and elbow in 1997. Atrophy of the right biceps muscle was recognized and the right deltoid, triceps, supraspinatus, and infraspinatus muscles were weak. The Morley test and elevated arm stress test were positive. Neurolysis of the brachial plexus and anterior scalenectomy were performed via a right supraclavicular approach. An abnormal fibromuscular band was identified passing between the upper and middle trunks and constricting the middle trunk. Another scalene muscle anomaly was found passing between the C-5 and C-6 nerve roots and connecting the anterior and middle scalene muscles. These muscles were resected, and thorough neurolysis was performed around all nerves and the trunks. Postoperatively, all symptoms completely resolved and the patient was discharged 5 days after surgery. Thoracic outlet syndrome (TOS) manifests as symptoms of lower cervical nerve involvements with hypesthesia and paresthesia. However, upper plexus TOS manifests as symptoms due to the involvement of the C-5 to C-7 nerve roots, and is relatively rare. Transaxillary first rib resection is performed as the primary operation for TOS, but supraclavicular scalenectomy is effective for upper plexus TOS.