Clinical outcome of adult choroid plexus tumors: retrospective analysis of a single institute.

BACKGROUND: Choroid plexus tumors are rare brain tumors with clinical features that vary according to the histological grade. We reviewed the treatment outcomes of 15 adult patients with choroid plexus tumors, focusing on surgical outcomes and current therapeutic strategies. METHOD: Patient demographic and clinical characteristics, operative findings, adjuvant therapies, disease progression and survival rates were reviewed. RESULTS: The median age at diagnosis was 33.7 ± 10 years (19-59 years) for patients with choroid plexus tumors. Postoperative chemotherapy was given to 26.7 % of patients, and 13.3 % of patients received radiotherapy. The Ki-67 labeling index and mitotic index increased at higher histological grades. All of the choroid plexus papilloma and atypical choroid plexus papilloma patients have survived. The overall survival rate of patients with choroid plexus carcinoma was 50 % in the first year, but none of the patients survived to the second year. Five patients underwent permanent cerebrospinal fluid diversion surgery because of hydrocephalus or subdural effusion. CONCLUSIONS: Choroid plexus papilloma and atypical choroid plexus papilloma patients can be treated with complete surgical resection. Choroid plexus carcinoma has a poor prognosis, and aggressive multi-modal treatments are generally needed for treatment. Chemotherapy and radiotherapy are important adjuvant therapies for choroid plexus carcinoma. If hydrocephalus and/or subdural effusion occur, permanent cerebrospinal fluid (CSF) diversion should be added to the therapeutic strategy.

Alkaptonuric patient presenting with "black" disc: a case report.

Although intervertebral disc degeneration usually occurs in the natural course of alkaptonuria, detection of the disease by black disc material in a patient without any other sign of alkaptonuria is an extremely rare condition. The authors report a 45-year-old previously healthy female patient who was operated on for prolapsed lumbar disc herniation, and in whom the nucleus pulposus was discovered to be black intraoperatively. The alkaptonuria was diagnosed after histopathological examination of the black disc material. Elevated urinary concentration of homogentisic acid confirmed the diagnosis.

Solitary lumbar osteochondroma presenting with foot-drop: a case report.

Although osteochondroma is the most common benign bone tumor, the lumbar spine is anuncommon localization for solitary osteochondroma. Solitary lumbar osteochondromas rarely affect the neurological structures, because most of the lesions grow out of the spinal canal. We report a 48-year-old patient suffering from right foot-drop due to acute compression of right L4 nerve root by a lesion expanding into the spinal canal, originating from the right inferior articular facet of the third lumbar vertebrae. The symptoms improved after surgical removal of the lesion and histopathological examination of the lesion confirmed the diagnosis of osteochondroma. To the best of our knowledge, this is a unique case report in the literature.

Lumbar solitary osteochondroma presenting with cauda equina syndrome: a case report.

Although spinal osteochondromas can cause various clinical signs, the spinal cord or nerve root compression by solitary lumbar osteochondromas are rare clinical entities. We present a 62-year-old female patient with lower-back pain, progressive left leg paresis, numbness on the both lower extremities and urinary incontinence. The patient's clinical picture made us suspect the possibility of cauda equina syndrome. Radiological examination revealed a lesion originating from the left inferior articular facet of the second lumbar vertebrae. Urgent surgical decompression was performed and the lesion was removed totally. Histopathological examination confirmed the diagnosis of benign osteochondroma.

A rare cause of "foot drop": spinal epidural brucella granuloma.

Spinal epidural abscess is rare but serious medical condition which may cause permanent neurological deficits, or even death, if not treated. Staphylococcus aureus is the responsible microorganism in most spinal abscess cases. However, rarely other microorganisms like Brucella may be responsible. Brucellosis, a zoonotic infection endemic in the Mediterranean Region, Middle East; and South and Central America, most frequently involves the reticuloendothelial and musculoskeletal systems. Vertebral involvement is rarely seen; and its differential diagnosis is rather difficult. Spondylodiscitis and rarely spinal abscess or development of a granuloma are the main pathologies. Spinal epidural granulomas due to brucellosis may cause neurologic deficits. In this case presentation, a spinal epidural brucella granuloma causing foot drop is discussed taking other reports into account.

Lumbar radiculopathy due to unilateral facet hypertrophy following lumbar disc hernia operation: a case report.

OBJECTIVE: To present a radiculopathy case due to unilateral facet hypertrophy developing three years after a lumbar disc hernia operation. CASE REPORT: A fifty two-year-old female patient, who had been operated on for a left L5-S1 herniated lumbar disc three years ago, was hospitalized and re-operated with a diagnosis of unilateral facet hypertrophy. She had complaints of left leg pain and walking restrictions for the last six months. Left Straight Leg Raising test was positive at 40 degrees , left ankle dorsiflexion muscle strength was 4/5, left Extensor Hallucis Longus muscle strength was 3/5, and left Achilles reflex was hypoactive. Lumbar spinal Magnetic Resonance Imaging revealed left L5-S1 facet hypertrophy. RESULTS AND CONCLUSIONS: Lumbar radiculopathy due to lumbar facet hypertrophy is a well-known neurological condition. Radicular pain develops during the late postoperative period following lumbar disc hernia operations that are often related to recurrent disc herniation or to formation of post-operative scar tissue. In addition, it can be speculated that unilateral facet hypertrophy, which may develop after a disc hernia operation, might also be one of the causes of radiculopathy.

Diagnostic and surgical pitfalls of an unusual primary central nervous system lymphoma.

BACKGROUND: Here we describe a case of PCNSL which was located peripherally as a single lesion and showed no evidence of pathological findings of lymphoma at the first biopsy. CASE DESCRIPTION: A 56-year-old man was admitted to the hospital with a talking disorder and attention deficit. The neurological examination was normal. There was a left temporoparietal, 24 x 20 mm. enhanced lesion on MRI. The patient underwent a craniotomy and the lesion was excised totally. The pathological examination revealed glial tissue which showed reactive astrocyte proliferations. A month later, an MRI was performed and a recurrent tumor was seen near the first lesion's location. The second operation was performed via the same craniotomy, the tumor was excised totally and the second pathological examination revealed diffuse large-cell, B-lymphoma. There were no pathological findings on abdominal, thoracic and bone marrow investigations. CONCLUSION: PCNSL may show various biological behaviors. Using steroids before the biopsy may lead to diagnostic and therapeutic failure.

Solitary intraspinal lumbar vertebral osteochondroma: a case report.

1-4% of osteochondromas involve the spine. They are commonly found in the posterior elements of the vertebra and can cause radicular symptoms. We report a 35 year-old man, suffering from right leg pain, which became worse over five years. His neurological examination revealed a positive right straight leg raising test and L4-L5 hypoesthesia. Lumbar computerised tomography (CT) and magnetic resonance imaging (MRI) studies revealed an exophytic, pedunculated bony projection. Osteochondroma should be considered while evaluating a patient with low back pain or radiculopathy without a CT or MRI appearance of a herniated lumbar disc.