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1.
Childs Nerv Syst ; 35(11): 2227-2231, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31079180

RESUMO

Neurenteric cysts are rare developmental lesions typically found outside the central nervous system but when they do, we most likely find them in a spinal (cervical or dorsal) intradural extramedular location, often associated with dysraphism. The more unusual intracranial cases have been published because of its rarity, occurring mostly as a posterior fossa extra-axial cyst, in adults. Supratentorial cases are distinctly infrequent, especially in children, resulting in few case reports and even fewer case reviews. We describe a case of a child with a supratentorial neurenteric cyst and present a brief review of the literature about these cysts in children, a noticeable gap in the literature.

4.
Acta Neurochir (Wien) ; 161(2): 351-354, 2019 02.
Artigo em Inglês | MEDLINE | ID: mdl-30617713

RESUMO

Choroid plexus tumors (CPT) can present in the baseline magnetic resonance imaging (MRI) with lesions compatible with leptomeningeal dissemination. Therapeutic strategy in this condition is controversial. We present a case of an infant with CPP and significant diffuse leptomeningeal contrast enhancement at diagnosis, which spontaneously resolved after removal of the primary tumor. In these challenging cases, several aspects, such as histopathological/molecular diagnosis and close radiological follow-up, should be taken into account to avoid unnecessary treatments.


Assuntos
Neoplasias Meníngeas/diagnóstico por imagem , Papiloma do Plexo Corióideo/diagnóstico por imagem , Plexo Corióideo/diagnóstico por imagem , Plexo Corióideo/patologia , Diagnóstico Diferencial , Feminino , Humanos , Lactente , Imagem por Ressonância Magnética , Meninges/diagnóstico por imagem , Meninges/patologia , Papiloma do Plexo Corióideo/patologia , Papiloma do Plexo Corióideo/cirurgia
6.
J Neurosurg Pediatr ; 22(6): 678-683, 2018 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-30192215

RESUMO

OBJECTIVEDiffuse intrinsic pontine glioma (DIPG) is a highly aggressive and lethal brainstem tumor in children. In the 1980s, routine biopsy at presentation was abandoned since it was claimed "unnecessary" for diagnosis. In the last decade, however, several groups have reincorporated this procedure as standard of care or in the context of clinical trials. Expert neurosurgical teams report no mortality and acceptable morbidity, and no relevant complications have been previously described. The aim of this study was to review needle tract dissemination as a potential complication in DIPG.METHODSThe authors retrospectively analyzed the incidence of dissemination through surgical tracts in DIPG patients who underwent biopsy procedures at diagnosis in 3 dedicated centers. Clinical records and images as well as radiation dosimetry from diagnosis to relapse were reviewed.RESULTSFour patients (2 boys and 2 girls, age range 6-12 years) had surgical tract dissemination: in 3 cases in the needle tract and in 1 case in the Ommaya catheter tract. The median time from biopsy to identification of dissemination was 5 months (range 4-6 months). The median overall survival was 11 months (range 7-12 months). Disseminated lesions were in the marginal radiotherapy field (n = 2), out of the field (n = 1), and in the radiotherapy field (n = 1).CONCLUSIONSAlthough surgical tract dissemination in DIPG is a rare complication (associated with 2.4% of procedures in this study), it should be mentioned to patients and family when procedures involving a surgical tract are proposed. The inclusion of the needle tract in the radiotherapy field may have only limited benefit. Future studies are warranted to explore the benefit of larger radiotherapy fields in patients with DIPG.


Assuntos
Biópsia/efeitos adversos , Neoplasias do Tronco Encefálico/patologia , Glioma/patologia , Invasividade Neoplásica/patologia , Ponte/patologia , Criança , Feminino , Humanos , Masculino
8.
Rev. neurol. (Ed. impr.) ; 65(3): 112-116, 1 ago., 2017. ilus
Artigo em Espanhol | IBECS | ID: ibc-165554

RESUMO

Introducción. La trisomía 9 es una cromosomopatía inusual en pacientes nacidos vivos, que frecuentemente se acompaña de anomalías funcionales y estructurales del sistema nervioso central. Entre otras muchas alteraciones, varios trabajos en la bibliografía anglosajona demuestran una asociación entre cromosomopatía 9 y patología de los plexos coroideos. Caso clínico. Varón de 4 meses de vida con mosaicismo de trisomía 9 asociado a hidrocefalia secundaria a hiperplasia de los plexos coroideos, que fue remitido por clínica de hipertensión intracraneal. El procedimiento derivativo de líquido cefalorraquídeo por el que optamos inicialmente provocó una ascitis masiva debida a la producción desmesurada de líquido cefalorraquídeo, y desembocó en una cascada de múltiples intervenciones quirúrgicas, entre las que se incluyeron procedimientos endoscópicos y derivativos. Conclusiones. Se trata de un ejemplo más de asociación entre patología de los plexos coroideos y cromosomopatía 9. Debido a su escasa incidencia, es difícil establecer el diagnóstico de hidrocefalia secundaria a hiperplasia de los plexos y, por tanto, el tratamiento más adecuado. En este tipo de hidrocefalia existe un doble mecanismo fisiopatológico, que implica un aumento de producción de líquido cefalorraquídeo y una disminución de su reabsorción. A pesar de tener en cuenta dicha consideración, el tratamiento de la hidrocefalia secundaria a hiperplasia de los plexos supone un verdadero reto que habitualmente pasa por múltiples procedimientos quirúrgicos, desde la plexectomía o coagulación de los plexos coroideos hasta la implantación de dispositivos de derivación de líquido cefalorraquídeo (AU)


Introduction. Trisomy 9 is an unusual chromosome abnormality in live-born patients, which is frequently accompanied by functional and structural anomalies of the central nervous system. Among many other alterations, several studies have been published in the English-speaking literature that show an association between chromosome 9 abnormality and pathologies affecting the choroid plexuses. Case report. We report the case of a 4-month-old male with trisomy 9 mosaicism associated to hydrocephalus secondary to choroid plexus hyperplasia, who was referred due to a clinical picture of intracranial hypertension. The cerebrospinal fluid (CSF) drainage procedure that was initially chosen caused massive ascites due to an excessive production of CSF, and led to a cascade of multiple surgical interventions, which included endoscopic and drainage procedures. Conclusions. This is another example of an association between choroid plexus pathologies and chromosome 9 abnormality. Due to its scarce incidence, diagnosis of hydrocephalus secondary to plexus hyperplasia is difficult, as is selecting its most suitable treatment. In this type of hydrocephalus there is a double pathophysiological mechanism, which involves an increase in CSF production and a decrease in its reabsorption. Despite taking these considerations into account, the treatment of hydrocephalus secondary to plexus hyperplasia is a real challenge that usually leads to multiple surgical interventions ranging from plexectomy or coagulation of the choroid plexuses to the implantation of CSF drainage devices (AU)


Assuntos
Humanos , Masculino , Lactente , Hidrocefalia/etiologia , Neoplasias do Plexo Corióideo/complicações , Trissomia/genética , Derivações do Líquido Cefalorraquidiano/métodos , Mosaicismo , Procedimentos Neurocirúrgicos/métodos
9.
Childs Nerv Syst ; 33(5): 849-852, 2017 May.
Artigo em Inglês | MEDLINE | ID: mdl-28251325

RESUMO

Diffuse intrinsic pontine glioma (DIPG) is an aggressive infiltrative glioma for which no curative therapy is available. Radiation therapy (RT) is the only potentially effective intervention in delaying tumor progression, but only transiently. At progression, re-irradiation is gaining popularity as an effective palliative therapy. However, at second progression, exclusive symptomatic treatment is usually offered. Here we report two patients with DIPG at second progression who were treated with a second re-irradiation course with good response. Importantly, treatment was well tolerated with no irradiation associated acute toxicity identified.


Assuntos
Neoplasias do Tronco Encefálico/radioterapia , Progressão da Doença , Glioma/radioterapia , Reirradiação/métodos , Neoplasias do Tronco Encefálico/diagnóstico por imagem , Criança , Pré-Escolar , Feminino , Glioma/diagnóstico por imagem , Humanos , Masculino
13.
Neurocir. - Soc. Luso-Esp. Neurocir ; 24(4): 178-182, jul.-ago. 2013. ilus, tab
Artigo em Espanhol | IBECS | ID: ibc-126841

RESUMO

El fibrosarcoma epitelioide esclerosante (SEF) es una variante poco frecuente de fibrosarcoma de bajo grado con características histológicas e inmunohistoquímicas bien definidas, caracterizado por su mal pronóstico. Presentamos un caso de SEF a nivel paraespinal en un paciente varón de 49 años con un tumor que se extiende hacia el foramen L4-L5 e invade la raíz L5. La histología de la pieza quirúrgica y el estudio inmunohistoquímico fueron compatibles con SEF. Este caso es particularmente inusual por su origen a nivel paraespinal e ilustra, a pesar de su bajo grado, el potencial de malignidad del SEF (AU)


Sclerosing epithelioid fibrosarcoma (SEF) is a rare variant of low-grade fibrosarcoma, with specific histological and immunohistochemical features and a poor prognosis. We report a case of SEF of the paravertebral column in a 49-year old male who presented a paraspinal mass with extension into the L4-L5 neural foramen and invasion of the L5 nerve root. Histology of the tumourectomy specimen and its immunohistochemical study led to the diagnosis of SEF. This case was particularly unusual due to its paravertebral column location and, despite its low grade, illustrates the malignant potential of SEF (AU)


Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Fibrossarcoma/diagnóstico , Neoplasias da Medula Espinal/diagnóstico , Metástase Neoplásica , Dor Lombar/etiologia , Espectroscopia de Ressonância Magnética , Fibroma/diagnóstico
14.
Neurocirugia (Astur) ; 24(4): 178-82, 2013.
Artigo em Espanhol | MEDLINE | ID: mdl-23154129

RESUMO

Sclerosing epithelioid fibrosarcoma (SEF) is a rare variant of low-grade fibrosarcoma, with specific histological and immunohistochemical features and a poor prognosis. We report a case of SEF of the paravertebral column in a 49-year old male who presented a paraspinal mass with extension into the L4-L5 neural foramen and invasion of the L5 nerve root. Histology of the tumourectomy specimen and its immunohistochemical study led to the diagnosis of SEF. This case was particularly unusual due to its paravertebral column location and, despite its low grade, illustrates the malignant potential of SEF.


Assuntos
Fibrossarcoma/patologia , Neoplasias de Tecidos Moles/patologia , Terapia Combinada , Evolução Fatal , Fibrossarcoma/radioterapia , Fibrossarcoma/secundário , Fibrossarcoma/cirurgia , Humanos , Dor Lombar/etiologia , Vértebras Lombares/patologia , Região Lombossacral , Neoplasias Pulmonares/secundário , Imagem por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Invasividade Neoplásica , Micrometástase de Neoplasia , Recidiva Local de Neoplasia/cirurgia , Cuidados Paliativos , Prognóstico , Radioterapia Adjuvante , Neoplasias de Tecidos Moles/radioterapia , Neoplasias de Tecidos Moles/cirurgia
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