RESUMO
Resumen Los meningiomas son los tumores primarios más frecuentes del sistema nervioso central, tienden a ser benignos y de lento crecimiento. Pueden ser asintomáticos o incluso manifestarse únicamente con síntomas psiquiátricos, incluyendo un cuadro psicótico. No existen estudios clínicos controlados randomizados que estudien la relación entre meningioma y cuadros psicóticos. La evidencia disponible se basa en series y reportes de casos. Existe una relación entre la magnitud del edema perilesional y la presencia de síntomas psicóticos. Por otra parte, el tamaño de la lesión o su localización neuroanatómica específica tendrían menor relevancia. La resección quirúrgica de la lesión, en conjunto con el manejo psiquiátrico adecuado, usualmente conduce al cese de la sintomatología psicótica. En la evaluación de pacientes con síntomas psicóticos se debe tener un elevado índice de sospecha, en particular en cuadros de reciente inicio, con manifestaciones atípicas o resistentes al tratamiento. En estos casos se recomienda un estudio con neuroimágenes. Este artículo presenta el caso de una paciente evaluada en nuestro hospital diagnosticada con un meningioma frontal izquierdo de gran tamaño, que presentó sintomatología psicótica secundaria, y se expone una revisión bibliográfica actualizada de esta asociación.
Meningiomas are the most frequent central nervous primary tumors, which tend to be benign and present a slow growth. They may be asymptomatic or present clinically just with psychiatric symptoms including a psychotic state. There are no clinical randomized controlled trials that study the relationship between meningioma and a psychotic episode. Available evidence is based on case reports and series. There is a relationship between the magnitude of perilesional edema and the presence of psychotic symptoms. On the other hand, the size of the tumor or its specific neuroanatomic location would have less relevance. Surgical resection of the tumor associated with psychiatric management usually leads to the cessation of psychotic symptoms. In the assessment of patients with psychotic symptoms, there must be a high index of suspicion, particularly in first psychotic episodes, atypical manifestations and resistance to treatment. In these cases, a neuroimaging study is recommended. This article presents the case of a patient evaluated in our hospital and diagnosed with a large left frontal meningioma with secondary psychotic symptoms, and an updated bibliographic review of this association is presented.
Assuntos
Humanos , Feminino , Adulto , Transtornos Psicóticos/etiologia , Neoplasias Meníngeas/complicações , Meningioma/complicações , Transtornos Psicóticos/tratamento farmacológico , Antipsicóticos/uso terapêutico , Haloperidol/uso terapêutico , Neoplasias Meníngeas/diagnóstico por imagem , Meningioma/diagnóstico por imagemRESUMO
Mantle cell lymphoma (MCL) is an uncommon type of gastrointestinal lymphoma. MCL is a distinct subtype of B-cell non-Hodgkin lymphomas. The major subtype of MCL is characterized by the presence of multiple lymphomatous polyposis (MLP), in which multiple polyps are observed along the gastrointestinal tract. The malignant cells express pan B-cell marker and the T-cell marker cluster of differentiation 5. The chromosomal translocation t(11;14)(q13;q32) that causes cyclin D1 overexpression is commonly observed on the cytogenetic analysis of MCL. Survival improvement has recently been achieved for patient with MCL by the successful introduction of monoclonal antibodies and dose-intensified approaches for treatment, including autologous stem cell transplantation strategies. Some reports suggest that there is an increased incidence of second malignancies in patients with MCL or lymphoma. We report a case of MCL involving the colon; the patient was a 60-year-old man who complained of low abdominal discomfort during defecation. During the workup, a meningioma was unexpectedly discovered. On analysis, the tumor was found to be a t(11;14)-negative and non-MLP-type MCL.
Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Cromossomos Humanos Par 11 , Cromossomos Humanos Par 14 , Ciclina D1/metabolismo , Linfoma de Célula do Manto/diagnóstico , Imageamento por Ressonância Magnética , Neoplasias Meníngeas/complicações , Meningioma/complicações , Tomografia por Emissão de Pósitrons , Translocação GenéticaRESUMO
Multiple endocrine neoplasia type 1 (MEN1) syndrome includes varying combinations of endocrine and non-endocrine tumors. There are also a considerable number of atypical MEN1 syndrome. In this case, a 68-yr-old woman was referred to the Department of Endocrinology for hypercalcemia. Five years ago, she had diagnosed as primary hyperaldosteronism and now newly diagnosed as parathyroid hyperplasia with laboratory and pathologic findings. Hurthle-cell thyroid cancer was also resected during the parathyroid exploration and small meningioma was found on brain MRI. Her general condition has markedly improved and her adrenal mass and meningioma are being closely observed now. We could find the loss of heterozygosity of the MEN1 locus in parathyroid glands, suggesting a MEN1-related tumor, but not a germline mutation. Considering a variety of phenotypic expression and a limitation of current molecular analysis, periodic follow up will be needed in patients with a MEN1-like phenotype.
Assuntos
Idoso , Feminino , Humanos , Sequência de Bases , Encéfalo/diagnóstico por imagem , Hiperaldosteronismo/complicações , Hiperparatireoidismo Primário/diagnóstico , Perda de Heterozigosidade , Imageamento por Ressonância Magnética , Neoplasias Meníngeas/complicações , Meningioma/complicações , Mutação , Glândulas Paratireoides/patologia , Proteínas Proto-Oncogênicas/genética , Análise de Sequência de DNA , Neoplasias da Glândula Tireoide/complicações , Tomografia Computadorizada por Raios XRESUMO
Occurrence of peritumoral brain edema (PBE) in meningiomas has been associated with several factors in recent years, although its pathophysiological mechanism has not yet been fully elucidated. The aim of this study was to analyze the correlation between the presence / degree of PBE and factors such as gender, age, size and histological subtype of tumor. We analyzed the MRI images of 74 patients operated on Hospital Beneficência Portuguesa de Porto Alegre for the presence / degree of PBE and data was statistically correlated with the parameters of the patient. PBE was present in 70.1 percent of patients. Tumors with higher volume had more PBE. Tumors of the olfactory groove showed more PBE than sphenoid wing and parassagittal tumors. Transitional subtype showed more PBE than fibroblastic and meningothelial subtypes.
A presença de edema cerebral peritumoral (ECP) em meningiomas tem sido associada a diversos fatores nos últimos anos, embora o seu mecanismo fisiopatológico ainda não tenha sido inteiramente elucidado. O objetivo desse estudo foi analisar a correlação entre a presença/grau de ECP e fatores como sexo, idade, volume e subtipo histológico do tumor. Foram analisadas imagens de RM de 74 pacientes operados no Hospital Beneficência Portuguesa de Porto Alegre quanto à presença/grau de ECP e os dados correlacionados estatisticamente com os parâmetros do paciente. ECP estava presente em 70,1 por cento dos pacientes. Tumores com maior volume apresentaram mais ECP. Tumores da goteira olfatória apresentaram mais ECP que os da asa do esfenóide e que os parassagitais. Meningiomas transicionais apresentaram mais ECP que os fibroblásticos e que os meningoteliais.
Assuntos
Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem , Edema Encefálico/patologia , Neoplasias Meníngeas/patologia , Meningioma/patologia , Fatores Etários , Edema Encefálico/etiologia , Imageamento por Ressonância Magnética , Neoplasias Meníngeas/complicações , Meningioma/complicações , Estudos Retrospectivos , Índice de Gravidade de Doença , Fatores Sexuais , Carga Tumoral , Adulto JovemAssuntos
Feminino , Humanos , Pessoa de Meia-Idade , Astrocitoma/complicações , Neoplasias Meníngeas/complicações , Meningioma/complicações , Esclerose Tuberosa/complicações , Astrocitoma/diagnóstico , Evolução Fatal , Imageamento por Ressonância Magnética , Neoplasias Meníngeas/diagnóstico , Meningioma/diagnósticoAssuntos
Adulto , Humanos , Masculino , Osso Frontal , Displasia Fibrosa Óssea/complicações , Neoplasias Meníngeas/complicações , Meningioma/complicações , Displasia Fibrosa Óssea/cirurgia , Imageamento por Ressonância Magnética , Neoplasias Meníngeas/cirurgia , Meningioma/cirurgia , Tomografia Computadorizada por Raios XRESUMO
Meningioma rarely manifests as a subarachnoid hemorrhage (SAH), and invasion directly into a major intracranial artery is extremely rare. To the best of our knowledge, meningioma presenting with an SAH associated with major intracranial arterial invasion has never been reported. We present a case of sphenoid ridge meningotheliomatous meningioma manifesting as an SAH without pathologically atypical or malignant features, due to direct tumor invasion into the middle cerebral artery.
Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias Meníngeas/complicações , Meningioma/complicações , Artéria Cerebral Média/patologia , Invasividade Neoplásica , Neoplasias Cranianas/complicações , Osso Esfenoide , Hemorragia Subaracnóidea/etiologiaRESUMO
La neuralgia del trigémino es una patología que se caracteriza por un dolor paroxístico ante estímulos inocuos, principalmente tactiles y que afecta a una de las divisiones del nervio trigémino. En este artículo se presenta un caso de neuralgia secundaria a la compresión del ganglio trigeminal, producto de un meningioma del ligamento petroclinoideo y una breve revisión de la literatura.
The trigeminal neuralgia is a pathology that is characterized by a paroxictic pain before innocuous stimuli, mainly tactile and that it affects one of the divisions of the trigeminal nerve. In this article we present a case of secondary trigeminal neuralgia, due to meningioma of the petroclinoid ligament and a brief revision of the literature.
Assuntos
Humanos , Feminino , Idoso , Meningioma/complicações , Neoplasias Meníngeas/complicações , Neuralgia do Trigêmeo/etiologia , Constrição Patológica , Dor Facial/etiologia , Nervo Trigêmeo/patologiaRESUMO
A case of falcine meningioma associated with acute subdural hemorrhage is reported. The possible mechanisms of hemorrhage in the case are discussed. We believe that an early recognition and surgery can prevent neurological deterioration.
Assuntos
Idoso , Hematoma Subdural/etiologia , Humanos , Masculino , Neoplasias Meníngeas/complicações , Meningioma/complicações , Tomografia Computadorizada por Raios XRESUMO
The co-existence of schwannoma and meningioma as a mixed intracranial tumour is uncommon and so far only eight cases have been published in the literature. Because of rarity, we report a unique case of mixed tumour having schwann cell and meningeal components, in a patient with neurofibromatosis type -2 (NF-2). The possible mechanisms for the occurrence of these mixed tumours are discussed.
Assuntos
Adulto , Neoplasias Encefálicas/complicações , Humanos , Imageamento por Ressonância Magnética , Masculino , Neoplasias Meníngeas/complicações , Meningioma/complicações , Neoplasias Complexas Mistas/complicações , Neurilemoma/complicações , Neurofibromatose 2/complicaçõesRESUMO
Two unusual cases of meningiomas associated with opposite chronic subdural haematoma are presented.
Assuntos
Idoso , Encéfalo/diagnóstico por imagem , Doença Crônica , Hematoma Subdural/etiologia , Humanos , Masculino , Neoplasias Meníngeas/complicações , Meningioma/complicações , Tomografia Computadorizada por Raios XRESUMO
Meningiomas causing intracranial hemorrhage are rare, and hemorrhage from a lateral ventricular meningioma seems to be even rarer. We report a case of trigonal meningioma in a 43-year-old woman who presented with intraventricular hemorrhage, and describe the CT, MRI and angiographic findings.
Assuntos
Adulto , Feminino , Humanos , Hemorragias Intracranianas/etiologia , Ventrículos Laterais/diagnóstico por imagem , Neoplasias Meníngeas/complicações , Meningioma/complicaçõesRESUMO
Movement disorders are uncommon presenting features of brain tumours. Early recognition of such lesions is important to arrest further deficit. We treated seven patients with movement disorders secondary to brain tumours over a period of seven years. Only two of these were intrinsic thalamic tumours (astrocytomas) while the rest were extrinsic tumours. The intrinsic tumours were accompanied by hemichorea. Among the extrinsic tumours, there was one pituitary macroadenoma with hemiballismus and four meningiomas with parkinsonism. Symptoms were unilateral in all patients except one with anterior third falcine meningioma who had bilateral rest tremors. There was relief in movement disorders observed after surgery. Imaging by computed tomography or magnetic resonance imaging is mandatory in the evaluation of movement disorders, especially if the presentation is atypical, unilateral and/or accompanied by long tract signs.
Assuntos
Adenoma/complicações , Adulto , Idoso , Astrocitoma/complicações , Neoplasias Encefálicas/complicações , Coreia/etiologia , Feminino , Humanos , Masculino , Neoplasias Meníngeas/complicações , Meningioma/complicações , Pessoa de Meia-Idade , Doença de Parkinson Secundária/etiologia , Neoplasias Hipofisárias/complicaçõesRESUMO
A 62-year-old woman was evaluated for tinnitis and headache. Magnetic resonance imaging and angiography revealed the coexistence of a tentorial tumor encroaching the junction of the right transverse-sigmoid sinuses, and dural arteriovenous fistulous malformation (AVFM) of the right transverse sinus. AVFM was not manipulated at all during the surgery. The pathology was fibroblastic meningioma. Postoperatively, the dural AVFM completely disappeared on follow-up angiography. The fistulas were occluded also after surgery, even though there was no manipulation of the AVFM. It is suggested that the right dominant transverse-sigmoid sinuses are partially occluded by tentorial meningioma, developing the dural arteriovenous fistula of the right transverse sinus. An acquired origin of the dural AVFM was suggested in this case.
Assuntos
Feminino , Humanos , Malformações Arteriovenosas/diagnóstico , Malformações Arteriovenosas/complicações , Artéria Carótida Externa/patologia , Artéria Carótida Interna/patologia , Angiografia Cerebral , Dura-Máter/patologia , Veias Jugulares/patologia , Imageamento por Ressonância Magnética , Neoplasias Meníngeas/diagnóstico , Neoplasias Meníngeas/complicações , Meningioma/diagnóstico , Meningioma/complicações , Pessoa de Meia-IdadeAssuntos
Adenoma Cromófobo/complicações , Adulto , Neoplasias Encefálicas/complicações , Hemorragia Cerebral/etiologia , Craniofaringioma/complicações , Feminino , Glioblastoma/complicações , Glioma/complicações , Humanos , Masculino , Neoplasias Meníngeas/complicações , Meningioma/complicações , Pessoa de Meia-Idade , Oligodendroglioma/complicações , Neoplasias Hipofisárias/complicaçõesRESUMO
A rare case of extracerebral dural cavernous angioma sited near the sigmoid sinus is reported. This 60 yr old male patient gave history of episodic ataxia of left sided limbs experienced twice on same day and occasional giddiness. Examination did not reveal any findings. A mass was diagnosed on CT Scan following which angiography was carried out. The features matched with those of a meningioma. Retro-sigmoid craniectomy was performed. Occipital artery was coagulated. Tumor was dissected out. Post-operative course of the patient was uneventful. Histopathology revealed that the mass was a cavernous haemangioma.