RESUMEN
We report a durable (12-month) response to capecitabine monotherapy, shown clinically, by MRI, and by cerebrospinal fluid analysis, in a patient with leptomeningeal metastasis from breast cancer.
Asunto(s)
Antimetabolitos Antineoplásicos/uso terapéutico , Neoplasias Encefálicas/secundario , Neoplasias de la Mama/tratamiento farmacológico , Desoxicitidina/análogos & derivados , Desoxicitidina/uso terapéutico , Neoplasias Meníngeas/tratamiento farmacológico , Neoplasias Meníngeas/secundario , Neoplasias Orbitales/secundario , Adulto , Neoplasias Encefálicas/líquido cefalorraquídeo , Neoplasias Encefálicas/tratamiento farmacológico , Neoplasias de la Mama/líquido cefalorraquídeo , Neoplasias de la Mama/secundario , Capecitabina , Femenino , Fluorouracilo/análogos & derivados , Humanos , Neoplasias Meníngeas/líquido cefalorraquídeo , Neoplasias Orbitales/líquido cefalorraquídeo , Neoplasias Orbitales/tratamiento farmacológico , Resultado del TratamientoRESUMEN
A 3-month-old female infant with Turner's syndrome was noted to have progressive swelling of the left upper lid at the age of 1 month. A computed tomogram demonstrated a well-circumscribed, low-density, homogeneous orbital mass. Initially, the main clinical differential diagnosis included dermoid cyst, hemangioma, and encephalocele. Medial orbitotomy followed by histopathologic examination disclosed a cystic choristomatous malformation containing brain tissue. No choroid plexuses within the mass were demonstrated on microscopic examination. Aspiration of fluid from the cystic mass and subsequent biochemical studies unequivocally demonstrated that the mass was filled with cerebrospinal fluid. Despite five surgical procedures, including two frontal craniotomies, and specialized roentgenographic studies, no communication could be demonstrated between the orbital mass and the central nervous system. We postulate that the cerebrospinal fluid was produced within the orbital mass, which represented ectopic brain tissue. Problems in diagnosis and management of this unusual orbital malformation are discussed.
Asunto(s)
Encéfalo , Coristoma/patología , Neoplasias Orbitales/patología , Coristoma/líquido cefalorraquídeo , Coristoma/cirugía , Femenino , Humanos , Lactante , Órbita/patología , Órbita/cirugía , Neoplasias Orbitales/líquido cefalorraquídeo , Neoplasias Orbitales/cirugía , Síndrome de Turner/patologíaRESUMEN
The diagnosis of a case of childhood orbital granulocytic sarcoma, initially classified as a poorly-differentiated malignant tumor, was finally considered at the time of relapse following primary treatment with chemotherapy and local irradiation. At this time, systematic cerebrospinal fluid examination showed numerous blast cells with Auer rods, consistent with the diagnosis of meningeal acute myeloid leukemia of M2 type, and concomitant biopsy of the tumor indicated the diagnosis of chloroma. Reevaluation of the primary biopsy confirmed this diagnosis.