ABSTRACT
Introduction Cerebral metastases are the most common cancer of the central nervous system (CNS). Meningeal infiltration by neoplasms that did not originate in the CNS is a rare fact that is present in 0.02% of the autopsies. Epidemiologically, the radiological presentation mimicking a subdural hematoma is even more uncommon. We report a case of meningeal carcinomatosis by an adenocarcinoma of the prostate mimicking a chronic subdural hematoma. Case Report A 60-year-old male patient was diagnosed with prostate cancer in 2011. He underwent radical resection of the prostate, as well as adjuvant hormonal therapy and chemotherapy. Five years later, the patient presented peripheral facial paralysis that evolved with vomiting and mental confusion. Tomography and magnetic resonance imaging scans confirmed the subdural collection. At surgery, the dura was infiltrated by friable material of difficult hemostasis. The anatomicopathological examination showed atypical epithelial cells. The immunohistochemistry was positive for prostate-specific antigen (PSA) and other keymarkers, and it was conclusive for meningeal carcinomatosis by a prostate adenocarcinoma.
Subject(s)
Humans , Male , Middle Aged , Prostatic Neoplasms/complications , Adenocarcinoma/therapy , Hematoma, Subdural, Chronic/therapy , Neoplasm Metastasis/therapy , Prostate/surgery , Prostate/pathology , Adenocarcinoma/complications , Adenocarcinoma/diagnostic imaging , Prostate-Specific Antigen , Hematoma, Subdural, Chronic/complicationsABSTRACT
Tumores hipofisários secretores de prolactina representam ate 64 por cento do total de adenomas secretores. A proporção superior de macroprolactinomas em homens ainda não tem sua causa estabelecida, apesar de estudos moleculares iniciais apontarem para um provável crescimento tumoral acelerado no sexo masculino; uma outra causa seria a apresentação clínica diferente entre os sexos. O tratamento farmacológico apresenta-se como escolha inicial na maioria dos casos, com altas taxas de controle tumoral mediante o uso de agonistas dopaminérgicos. A cirurgia é indicada principalmente a pacientes que não toleram ou não obtém bons resultados com as medicações, em tumores de grande conteúdo cístico e em casos de apoplexia hipofisária. A indicação da radioterapia ainda não está bem definida, porém os melhores resultados obtidos atualmente com o uso de radiocirurgia indicam o possível papel dessa modalidade no tratamento de adenomas que não responderam adequadamente à cirurgia nem ao tratamento clínico...
Subject(s)
Humans , Male , Female , Dopamine Agonists/therapeutic use , Pituitary Neoplasms/surgery , Pituitary Neoplasms/diagnosis , Pituitary Neoplasms/radiotherapy , Pituitary Neoplasms/therapy , Prolactinoma/surgery , Prolactinoma/diagnosis , Prolactinoma/radiotherapy , Prolactinoma/therapyABSTRACT
Objetivo: Revisão da literatura sobre os cistos aracnóides intracranianos formação e evolução, dados epidemiológicos e clínicos, aspectos de neuroimagem e tratamento. Método: Realizamos pesquisa bibliográfica utilizando como base de dados o MEDLINE (National Library of Medicine), abrangendo operíodo de 1980 a 2006. As palavras-chave utilizadas foram arachnoid cysts e intracranial cysts. Também realizamos pesquisa manual em jornais e revistas médicas. Artigos com dados clínicos incompletos não foram incluídos no trabalho. Conclusões: Embora haja um consenso sobre a intervenção cirúrgica para os casos sintomáticos, a abordagem ideal ainda é controversa.
Objective: To review the current literature on intracranial arachnoid cysts related to its formation,evolution, the epidemiological, clinical and neuro imaging aspects and also its treatment. Method:Bibliographic review was done using Medline data base from 1980 to 2006. The key words used were arachnoid cysts and intracranial cysts. Manual research on pertinent medical publications was also done.Articles with incomplete clinical data were not included. Conclusions: Although there is a consensus that surgery should be performed only in the symptomatic cases, there is no general agreement whichis the best surgical approach to deal with arachnoid cysts.