RESUMEN
We report a 44-year-old with progressive quadriparesis due to a dumbbell malignant peripheral nerve sheath tumour (MPNST) of the second cervical nerve, 17 years after whole brain radiotherapy for a pineal germinoma. To our knowledge this is the first case of radiation induced high cervical MPNST arising from a benign neurofibroma.
Asunto(s)
Plexo Cervical/efectos de la radiación , Irradiación Craneana/efectos adversos , Neoplasias de la Vaina del Nervio/diagnóstico , Neoplasias de la Vaina del Nervio/etiología , Neurofibroma/complicaciones , Cuadriplejía/etiología , Neoplasias de la Médula Espinal/complicaciones , Adulto , Germinoma/radioterapia , Humanos , Imagen por Resonancia Magnética/métodos , Masculino , Neoplasias de la Vaina del Nervio/complicaciones , Neoplasias de la Vaina del Nervio/patología , Neoplasias de la Vaina del Nervio/cirugía , Neurofibroma/etiología , Pinealoma/radioterapia , Neoplasias de la Médula Espinal/etiologíaRESUMEN
We report a 30-year-old male who had undergone a renal transplant and suffered with secondary hyperparathyroidism. He presented with back pain and minimal neurological deterioration, caused by a thoracic brown tumour. The imaging findings, surgical treatment of the spinal lesion and outcome are discussed. We also discuss primary medical therapy and suggest a rational approach to further imaging of patients in whom brown tumour is suspected.
Asunto(s)
Trasplante de Riñón , Neoplasias de la Columna Vertebral/complicaciones , Adulto , Marcha/fisiología , Humanos , Hiperparatiroidismo Secundario/complicaciones , Fallo Renal Crónico/complicaciones , Fallo Renal Crónico/cirugía , Imagen por Resonancia Magnética , Masculino , Compresión de la Médula Espinal/etiología , Compresión de la Médula Espinal/cirugía , Neoplasias de la Columna Vertebral/patología , Neoplasias de la Columna Vertebral/cirugíaRESUMEN
In 1998, one of us (MJM) published an article discussing several patients with Osler-Weber-Rendu Syndrome or hereditary haemorrhagic telangiectasia with secondary cerebral complications. These were intracerebral haemorrhage, ischaemic infarct and intracerebral abscess. We outlined the background of the syndrome as well as its genotype and predicted an increasingly important role for genetic testing. Our aim in this paper is to examine the progress of one of the patients as well as recommending follow-up guidelines for patients with pulmonary arteriovenous fistulae that have been treated.