Intracranial chondrosarcoma: a case report and review of the literature.

INTRODUCTION: Chondrosarcoma is a rare malignant tumor originating from cartilagenous tissue. It tends to localize in the epiphysis of long bones and pelvic bones. Only 7% of the all chondrosarcomas originate in the craniocervical region. CASE REPORT: A 25-year-old man was admitted to our hospital with headache and dizziness. Physical examination and neurological examination were normal. Skull radiography revealed a radioopaque lesion in the right parieto-occipital region. Cranial computed tomography and magnetic resonance imaging showed a mass lesion including calcification areas and homogenous contrast enhancement in the right parieto-occipital region. The tumor was removed totally by a microsurgical technique. A classical type chondrosarcoma was confirmed histopathologically. The patient was discharged with no neurological deficit. DISCUSSION: Intracranial chondrosarcoma has been first reported by Mott in 1899. Primary intracranial chondrosarcomas, constitute only less than 0.16% of all brain tumors. Most of them are located at the skull base. The choroid plexus, dura mater and brain parenchyma are extremely rarely invaded. Meningiomas, solitary fibrous tumor, chordoma, hemangiopericytoma, metastasis and vascular malformations should be considered as differential diagnoses. Radical surgical removal of the tumor is the preferred management procedure. Chemotherapy and radiotherapy may by added as adjuvant therapy. We present the case of a patient with an intracranial chondrosarcoma, who has treated successfully with surgical removal.

Cervical segment nervus vagus neurofibroma with associated neurofibromatosis type 1: a case report.

INTRODUCTION: Neurofibroma occurs as an isolated or multiple lesions frequently associated with neurofibromatosis type 1 (NF-1). Neurofibroma is a benign peripheral nerve sheath tumor composed of a variable mixture of Schwann, perineurial-like, and fibroblastic cells, as well as ones with features intermediate between these various cells, immersed in a collagenous or myxoid matrix. CASE REPORT: A 10-year-old boy visited the outpatient clinic with complaints of swelling and pain on the left side of his neck, which has been present for a year. A mass was discovered adjacent to the left internal carotid artery (ICA) and was removed by a microsurgical technique. No postoperative neurological deficit was identified and the pathological diagnosis was once more reported as neurofibroma. DISCUSSION: Nerve sheath tumors may be observed in patients with von Recklinghausen's disease, although vagal neurofibromas are noted more frequently than schwannomas among these patients. For unknown reasons, neoplasms associated with von Recklinghausen's disease occur more frequently on the right side. Cervical vagal neurofibromas most often present as asymptomatic, slowly enlarging, lateral neck masses. When symptoms are observed, hoarseness is the most common. Dysphonia, dyspnea, dysphagia, cough, syncopal episodes, tongue weakness and atrophy, and Horner's syndrome have also been reported as presenting complaints.

Multiple aneurysms of the distal posterior inferior cerebellar artery: two case reports.

INTRODUCTION: The distal segment of the PICA (posterior inferior cerebellar artery) is a very rare localization for the occurrence of intracranial aneurysms. They are almost always presented with SAH (subarachnoid hemorrhage). Hydrocephalus often develops following intraventricular hemorrhage (IVH). The distal PICA segment is a quite difficult localization for neurosurgical procedures. The authors could not find any case report presenting multiple aneurysms on a distal segment of PICA in the literature. CASE 1: A 62-year-old male patient was admitted to the emergency room with complaints of sudden headache, vomiting and blackout of consciousness. Early CT scans demonstrated SAH and intraventricular hemorrhage (IVH). In his medical history, SAH had been determined in our clinic 3 month previously. He had carried out conservative treatment ever since the distal located PICA aneurysm had been determined. There was no determined symptom except for moderate neck stiffness in his physical examination. In his neurological examination, he was stuporous and he localized the pain in his left arm. A ventriculo-atrial shunt operation was performed after the external ventricular drainage which was applied at the acute period of hydrocephalus in his previous SAH. Both of the left distal PICA aneurysms were clipped via a left lateral suboccipital craniotomy. The patient was discharged from the hospital without neurological deficit in the seventh day postoperatively. His control examination was normal and there was not any fixed pathological filling in the control cerebral digital subtraction angiography (DSA). CASE 2: A 49-year-old female patient was admitted to the emergency service with the complaint of headache, dizziness and vomiting. She was neurologically intact except for neck stiffness. A cranial CT demonstrated triventricular hydrocephalus and a hemispheric cerebellar hematoma, which was about 1 x 1.5 cm in diameter. The cerebellar DSA was normal. The patient was discharged with no neurological impairment. In the examination of the control cerebral DSA, two aneurysmatic fillings were determined in the distal segments of right posterior inferior cerebellar artery (PICA). Both of the aneurysms were clipped through a microsurgical approach. No neurological deficit was determined in the postoperative early and late stages. In the control cerebral DSA, no aneurysmatic filling was seen. DISCUSSION: Distal PICA aneurysms constitute only 0.28-1.4% of all intracranial aneurysms. Most of the patients present with SAH and along with this; intraventricular hemorrhage is seen and later on, hydrocephalus develops. As for treatment, surgery and endovascular interference methods can be applied.