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1.
Pan Afr Med J ; 38: 123, 2021.
Artigo em Francês | MEDLINE | ID: mdl-33912293

RESUMO

This study reports the case of a 45-year-old female patient who underwent brain CT scan which fortuitously revealed de novo lesion. She was diagnosed with left isodense intradiploid lesion in the pterional region with bone lysis uniformly enhancing after injection of contrast medium. Magnetic resonance imaging showed T1-weighted hypointense lesion, spontaneously hyperintense signal on T2-weighted images and FLAIR images, strongly enhancing after gadolinium injection. Total tumor excision was performed. Histological examination showed chordoid meningioma.


Assuntos
Neoplasias Meníngeas/diagnóstico por imagem , Meningioma/diagnóstico por imagem , Meios de Contraste/administração & dosagem , Feminino , Gadolínio/administração & dosagem , Humanos , Imagem por Ressonância Magnética , Neoplasias Meníngeas/patologia , Neoplasias Meníngeas/cirurgia , Meningioma/patologia , Meningioma/cirurgia , Pessoa de Meia-Idade , Tomografia Computadorizada por Raios X
2.
Pan Afr Med J ; 38: 128, 2021.
Artigo em Francês | MEDLINE | ID: mdl-33912298

RESUMO

Intraspinal tumors are uncommon. Positive diagnosis is based on medical imaging exams, in particular MRI. Anatomopathological examination allows for definitive diagnosis. Surgery is the treatment of choice for most of them. Prognosis is related to the histological type and patient´s initial clinical condition. We here report the histological profile and progression of intraspinal tumors in our department. We conducted a retrospective study over a period of 10 years. All operated patients with histology-confirmed intraspinal tumor (23 cases) were enrolled. Four unworkable records were excluded. The median time from symptom onset and first consultation was 79 days. Patients presented with spinal cord compression. In 11 cases this was characterized by slow onset. Seven CT scan and 14 MRI were performed, which showed 4 intramedullary tumors, 9 intradural, 1 extradural, and 5 of unknown site. Histological examination showed meningioma in 11 cases, neurinoma in 3 cases. In 7 cases, it confirmed the diagnosis based on Imaging tests (4 CT and 3 MRI). Macroscopically complete resection was performed in 14 cases; it was partial in 5 cases. After a 6-month follow-up period 6 patients had fully recovered, 9 partially. This study highlights diagnosis delays. MRI better defined the lesion, but its histological approach was limited. Meningiomas dominated. Complete resection was most often performed. The postoperative course was uneventful.


Assuntos
Neoplasias Meníngeas/patologia , Meningioma/patologia , Neurilemoma/patologia , Neoplasias da Coluna Vertebral/patologia , Adolescente , Adulto , Idoso , Criança , Progressão da Doença , Feminino , Humanos , Imagem por Ressonância Magnética , Masculino , Neoplasias Meníngeas/diagnóstico por imagem , Neoplasias Meníngeas/cirurgia , Meningioma/diagnóstico por imagem , Meningioma/cirurgia , Pessoa de Meia-Idade , Neurilemoma/diagnóstico por imagem , Neurilemoma/cirurgia , Estudos Retrospectivos , Compressão da Medula Espinal/etiologia , Neoplasias da Coluna Vertebral/diagnóstico por imagem , Neoplasias da Coluna Vertebral/cirurgia , Tomografia Computadorizada por Raios X , Adulto Jovem
3.
J Med Life ; 14(1): 2-6, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33767778

RESUMO

Meningiomas are common primary tumors of the central nervous system. The incidence at the age of fertility is low, although there are some hormonal mechanisms involved. Growth in size was observed during the luteal phase of the menstrual cycle, which could lead to developing new symptoms during pregnancy or worsening of the already existing ones. Visual impairment is the chief complaint, followed by headache, nausea, vomiting, and seizures. Diagnosis is based on neurological examination, ophthalmoscopy, imaging techniques like gadolinium-enhanced magnetic resonance imaging (MRI), and contrast-enhanced computed tomography (CT) scans, bearing in mind the patient's irradiation and prejudice on the fetus together with the histopathological examination. The objective of the review is to determine the influence of meningioma on pregnancy and vice-versa and provide a strategy of follow-up for maternal-fetal specialists and not only. We performed a systematic review by searching relevant information in PubMed and Wiley databases using keywords as meningioma, pregnancy, progesterone receptors. The results showed that besides a similar incidence of meningioma in pregnant and non-pregnant women, symptoms might flare during pregnancy due to water retention, engorgement of vessels, and the presence of sex hormone receptors on tumor cells. Meningioma may impact the route of pregnancy with adverse effects on the fetus. Thus, fetal monitoring by biophysical profile and cardiotocography (CTG) is needed. The preferred treatment option is surgery, but gestational age and the woman's status must be taken into consideration.


Assuntos
Neoplasias Meníngeas/terapia , Meningioma/terapia , Gestantes , Feminino , Monitorização Fetal , Seguimentos , Humanos , Neoplasias Meníngeas/diagnóstico , Neoplasias Meníngeas/diagnóstico por imagem , Neoplasias Meníngeas/cirurgia , Meningioma/diagnóstico por imagem , Meningioma/patologia , Meningioma/cirurgia , Gravidez
4.
Medicine (Baltimore) ; 100(11): e25167, 2021 Mar 19.
Artigo em Inglês | MEDLINE | ID: mdl-33726004

RESUMO

RATIONALE: Clear cell meningioma (CCM) is one of the rarest but most aggressive forms of meningioma, with a tendency to occur at a high recurrence rate. Intraspinal CCM, especially the nondura-based type, is even rarer than the intracranial CCM. PATIENT CONCERNS: We report a case of a 45-year-old woman who presented with a 1-month history of episodic pain in the lower back and in both thighs in the front side. Femoral nerve stretch tests were positive on both sides. Magnetic resonance imaging (MRI) demonstrated an intradural tumor at the L3 level, which was isointense on T1- and T2-weighted images (WI) and homogeneously enhanced on gadolinium-contrast T1 WI. DIAGNOSES: The space-occupying lesion was pathologically confirmed as CCM. INTERVENTIONS: During surgery, we found that the tumor adhered to a nerve root, without dural attachment. The nerve root was partially removed to achieve complete resection. OUTCOMES: The pain disappeared after the operation. The 1 year follow-up MRI revealed no evidence of tumor recurrence or metastasis. LESSONS: Nondura-based intraspinal CCM is easier to completely remove, and such complete removal should be achieved during the first operation. Although the recurrence rate of this particular type of meningioma appears to be lower than that of other types, close clinical and radiological follow-up is necessary.


Assuntos
Neoplasias Meníngeas/patologia , Meningioma/patologia , Dura-Máter/diagnóstico por imagem , Dura-Máter/patologia , Feminino , Humanos , Vértebras Lombares/diagnóstico por imagem , Vértebras Lombares/patologia , Imagem por Ressonância Magnética , Neoplasias Meníngeas/diagnóstico por imagem , Meningioma/diagnóstico por imagem , Pessoa de Meia-Idade , Raízes Nervosas Espinhais/diagnóstico por imagem , Raízes Nervosas Espinhais/patologia
5.
Eur J Radiol ; 138: 109673, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-33774441

RESUMO

PURPOSE: To evaluate the quality of radiomics studies on meningiomas, using a radiomics quality score (RQS), Transparent Reporting of a multivariable prediction model for Individual Prognosis Or Diagnosis (TRIPOD), and the Image Biomarker Standardization Initiative (IBSI). METHODS: PubMed MEDLINE and Embase were searched to identify radiomics studies on meningiomas. Of 138 identified articles, 25 relevant original research articles were included. Studies were scored according to the RQS, TRIPOD guidelines, and items in IBSI. RESULTS: Only four studies (16 %) performed external validation. The mean RQS was 5.6 out of 36 (15.4 %), and the basic adherence rate was 26.8 %. The adherence rate was low for stating biological correlation (4%), conducting calibration statistics (12 %), multiple segmentation (16 %), and stating potential clinical utility (16 %). None of the studies conducted a test‒retest or phantom study, stated a comparison to a 'gold standard', conducted prospective studies or cost-effectivity analysis, or opened code and data to the public, resulting in low RQS. The overall adherence rate for TRIPOD was 54.1 %, with low scores for reporting the title (4%), abstract (0%), blind assessment of the outcome (8%), and explaining the sample size (0%). According to IBSI items, only 6 (24 %), 6 (24 %), and 3 (12 %) studies performed N4 bias-field correction, isovoxel resampling, and grey-level discretization, respectively. No study performed skull stripping. CONCLUSION: The quality of radiomics studies for meningioma is insufficient. Acknowledgement of RQS, TRIPOD, and IBSI reporting guidelines may improve the quality of meningioma radiomics studies and enable their clinical application.


Assuntos
Neoplasias Meníngeas , Meningioma , Humanos , Neoplasias Meníngeas/diagnóstico por imagem , Meningioma/diagnóstico por imagem , Prognóstico , Estudos Prospectivos , Projetos de Pesquisa
7.
Medicine (Baltimore) ; 100(6): e24704, 2021 Feb 12.
Artigo em Inglês | MEDLINE | ID: mdl-33578608

RESUMO

RATIONALE: Foramen magnum meningiomas are very rare lesions. They frequently originate from the arachnoid cells at the dura matter of the craniocervical junction. Foramen magnum meningiomas are challenging for neurosurgeons because of the complex anatomy of foramen magnum. We present a rare case of FMM with excessive calcification and without the dura tail sign which made the lesion mimic a teratoma. PATIENTS CONCERNS: A 63 years old woman presented with progressive numbness and hyperesthesia of the shoulders and upper limbs for 2 and half years. She also experienced occasional headaches and dizziness with no nausea, vomiting or fever. DIAGNOSES: Computed tomography scan, and magnetic resonance imaging revealed a calcified mass at occipital cistern. The lesion did not show the usual "dura tail sign" which made it mimic a teratoma on magnetic resonance imaging. Histopathology established meningioma. INTERVENTION: The tumor was completely resected via suboccipital approach. OUTCOMES: Two years follow-up revealed no recurrence of the lesion and no neurological deficits. LESSONS: We advocate the use of electromyographic and auditory brainstem responses to monitor the inferior cranial nerves because the tumor often adheres to these nerves.


Assuntos
Forame Magno/patologia , Neoplasias Meníngeas/patologia , Meningioma/patologia , Calcinose/diagnóstico por imagem , Calcinose/patologia , Angiografia por Tomografia Computadorizada , Feminino , Forame Magno/diagnóstico por imagem , Humanos , Imagem por Ressonância Magnética , Neoplasias Meníngeas/diagnóstico por imagem , Meningioma/diagnóstico por imagem , Pessoa de Meia-Idade
8.
Zhonghua Bing Li Xue Za Zhi ; 50(2): 114-118, 2021 Feb 08.
Artigo em Chinês | MEDLINE | ID: mdl-33535305

RESUMO

Objective: To analyze the clinicopathological characteristics, diagnosis and prognosis of meningioangiomatosis (MA), and to investige the possible origion of spindle cells. Methods: Seventeen cases of MA were collected at Xuanwu Hospital of Capital Medical University and the First Affiliated Hospital of Fujian Medical University, from June 2012 to March 2020. The clinical manifestations, radiologic, histopathologic, immunohistochemical features and patients' outcome were analyzed. The presumed origin of spindle cells was evaluated by immunohistochemical staining. Results: Of the 17 patients, 9 were males and 8 were females. The age ranged from 3 to 56 years old. Thirteen patients presented with seizure as the initial symptom. The lesions were solitary and located in the cerebral cortex. Histopathologically, there were proliferation of small blood vessels and perivascular spindle cells in the cerebral cortex. The spindle cells had no obvious atypia, mitoses and necrosis. Four cases were combined with transitional meningioma. Immunohistochemically, the proliferative perivascular spindle cells were positive for vimentin in all cases, and focally positive for EMA and SSTR2. Ki-67 proliferation index was low. Neurofibrillary tangles were demonstrated by AT8. All 17 patients received surgical treatment and were followed up for one to 93 months. None had seizure attacks or tumor recurrence. Conclusions: MA is a rare slow-growing intracranial lesion, and the perivascular spindle cells could be derived from meningothelial cells, and MA is often associated with degeneration of the cerebral cortex and meningioma. The patients have good prognosis after surgical treatment.


Assuntos
Neoplasias Meníngeas , Meningioma , Adolescente , Adulto , Criança , Pré-Escolar , Feminino , Humanos , Imuno-Histoquímica , Masculino , Neoplasias Meníngeas/diagnóstico por imagem , Neoplasias Meníngeas/cirurgia , Meningioma/diagnóstico por imagem , Meningioma/cirurgia , Pessoa de Meia-Idade , Prognóstico , Vimentina , Adulto Jovem
9.
Turk Neurosurg ; 31(1): 142-147, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33372259

RESUMO

AIM: To present one-step customized cranioplasty for intraosseous meningiomas. CASE DESCRIPTION: The authors report the case of a 54-year-old woman with a consequent frontal intraosseous meningioma invading the superior sagittal sinus. The patient only suffered from local pain and cosmetic damage. A complete resection was scheduled with a one-step reconstruction of the frontal bone by a polyetheretherketone (PEEK) specific implant. This implant was computer-assisted designed and manufactured and verified by the surgeon before the intervention. During surgery, the resection was guided by a computer designed resection template and by the classic neuronavigation system. Cranioplasty has been considered optimal intraoperatively by surgeons. The patient, a few weeks after surgery, underwent a subcutaneous fluid collection, rapidly resolutive with a circumferential pressure bandage. Six months after surgery, the patient considered the surgery a success with a very good cosmetic result and a total regression of her local pain. CONCLUSION: One-step computer-assisted cranioplasty is a safe and effective procedure for large skull defects. PEEK specific implant for cranioplasty offer advantages compared to other materials that will be discussed under the scope of the one-step reconstruction.


Assuntos
Cetonas/administração & dosagem , Neoplasias Meníngeas/cirurgia , Meningioma/cirurgia , Polietilenoglicóis/administração & dosagem , Impressão Tridimensional , Próteses e Implantes , Neoplasias Cranianas/cirurgia , Materiais Biocompatíveis/administração & dosagem , Feminino , Osso Frontal/diagnóstico por imagem , Osso Frontal/cirurgia , Humanos , Neoplasias Meníngeas/diagnóstico por imagem , Meningioma/diagnóstico por imagem , Pessoa de Meia-Idade , Neuronavegação/métodos , Procedimentos Cirúrgicos Reconstrutivos/métodos , Crânio/diagnóstico por imagem , Crânio/cirurgia , Neoplasias Cranianas/diagnóstico por imagem
10.
Clin Nucl Med ; 46(3): 252-254, 2021 03 01.
Artigo em Inglês | MEDLINE | ID: mdl-33351510

RESUMO

ABSTRACT: A 62-year-old woman had progressively developing throbbing right neck pain for 1 year. The pain radiated to the right suboccipital area, sometimes accompanied by breathlessness. To rule out cancer, patient received FDG PET/CT, which showed an intraspinal cord intense FDG-avid calcified mass at the level of the first cervical spine, mimicking malignancy. MRI showed it effacing the medulla; surgery is probably a challenge. She received laminectomy with tumor removal; pathology showed psammomatous meningioma, World Health Organization grade I. This case suggests that benign spinal cord psammomatous meningioma with calcification may show high FDG uptake, mimicking malignancy.


Assuntos
Fluordesoxiglucose F18 , Neoplasias Meníngeas/diagnóstico por imagem , Meningioma/diagnóstico por imagem , Tomografia Computadorizada com Tomografia por Emissão de Pósitrons , Diagnóstico Diferencial , Feminino , Humanos , Neoplasias Meníngeas/patologia , Meningioma/patologia , Pessoa de Meia-Idade
11.
J Clin Neurosci ; 83: 43-48, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33342627

RESUMO

Angiomatous meningioma is a rare variant tumor classified as WHO grade 1 meningioma and accounts for about 2.1% of all meningioma. Their clinical presentation, surgical management, and prognosis are almost similar to the classical meningioma. Despite of benign nature and being comparatively small in size, they look aggressive on radiology images like massive peritumoral edema and intense contrast enhancement. Being a unique subtype of meningioma, the studies on angiomatous meningioma are very limited. In this cross sectional retrospective study, we described the clinical presentation, radiology, histopathological features and differential diagnosis of 30 cases of angiomatous meningioma from a single centre. The clinical parameters include demographic profile, symptoms and radiological findings including location, extent, pattern, histopathology with World Health Organization (WHO) grade-2016, extent of tumour excision, recurrence and surgical outcome. Incidence of angiomatous meningioma in our study was 2.46% with male predominance. The most common location in our study was convexity. 27 out of 30 had histopathology reports of angiomatous meningioma and 3 had lipoangiomatous meningioma. The high vascularity and disproportionate peri-tumoral edema makes it a surgical challenge for excision. The complications and surgical outcome were analysed. The radiological anticipation of tumour subtype, meticulous pre-operative planning and intraoperative precautions remains a key for success.


Assuntos
Neoplasias Meníngeas/diagnóstico , Neoplasias Meníngeas/patologia , Meningioma/diagnóstico , Meningioma/patologia , Adulto , Idoso , Estudos Transversais , Diagnóstico Diferencial , Feminino , Humanos , Masculino , Neoplasias Meníngeas/diagnóstico por imagem , Meningioma/diagnóstico por imagem , Meningioma/cirurgia , Pessoa de Meia-Idade , Recidiva Local de Neoplasia , Prognóstico , Radiografia , Radiologia , Estudos Retrospectivos
12.
Clin Nucl Med ; 46(1): 58-59, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33234918

RESUMO

A 68-year-old man in whom a prostate cancer biochemical recurrence was being investigated was referred for a full-body Ga-prostate-specific membrane antigen PET/CT. Focal uptake in a lesion on the choroid plexus projection was detected. Patient had no neurological complaints. A previous MRI performed 4 years ago showed the same lesion. According to the location and radiological and clinical characteristics, the diagnosis of meningioma was defined. The interpretation of prostate-specific membrane antigen PET/CT must take into account the low frequency of metastases in sites such as the central nervous system, and the possibility of intense uptake in lesions unrelated to prostate cancer.


Assuntos
Neoplasias do Plexo Corióideo/diagnóstico por imagem , Glicoproteínas de Membrana/metabolismo , Neoplasias Meníngeas/diagnóstico por imagem , Meningioma/diagnóstico por imagem , Compostos Organometálicos/metabolismo , Tomografia Computadorizada com Tomografia por Emissão de Pósitrons , Idoso , Transporte Biológico , Neoplasias do Plexo Corióideo/metabolismo , Humanos , Imagem por Ressonância Magnética , Masculino , Neoplasias Meníngeas/metabolismo , Meningioma/metabolismo , Pessoa de Meia-Idade
13.
Medicine (Baltimore) ; 99(50): e23504, 2020 Dec 11.
Artigo em Inglês | MEDLINE | ID: mdl-33327290

RESUMO

RATIONALE: Solitary fibrous tumor is a rare mesenchymal tumor. This case report describes the diagnosis and treatment of this tumor. PATIENT CONCERNS: A 31-year-old patient presented with epileptic seizure and headache 1 day prior to the visit and showed transient right limb hemiplegia for 6 hours that was resolved after intravenous infusion of mannitol. DIAGNOSES: Based on imaging, the provisional diagnosis was meningioma. Postsurgical histopathological diagnosis confirmed solitary fibrous tumor. INTERVENTIONS: The lesion was totally excised. The patient improved remarkably after the operation, without any signs of associated limb movement disorder. No epileptic seizure was observed or reported after the operation. OUTCOMES: Postoperation computed tomography (CT) scans showed no obvious residual tumor. The patient was followed up every 3 months for a total of 1 year following the operation, during which time the patient did not complain of headache or seizure. LESSONS: The manifestation of solitary fibrous tumor (SFT) through imaging methods has certain specific findings,butimmunohistochemistry is still very important for confirming the diagnosis.


Assuntos
Neoplasias Meníngeas/diagnóstico , Meningioma/diagnóstico , Adulto , Diagnóstico Diferencial , Cefaleia/etiologia , Hemiplegia/etiologia , Humanos , Imagem por Ressonância Magnética , Masculino , Neoplasias Meníngeas/complicações , Neoplasias Meníngeas/diagnóstico por imagem , Neoplasias Meníngeas/cirurgia , Meningioma/complicações , Meningioma/diagnóstico por imagem , Meningioma/cirurgia , Lobo Parietal , Convulsões/etiologia , Tomografia Computadorizada por Raios X
14.
Neurocirugía (Soc. Luso-Esp. Neurocir.) ; 31(6): 299-305, nov.-dic. 2020. ilus
Artigo em Espanhol | IBECS | ID: ibc-197924

RESUMO

INTRODUCCIÓN: El nevo de Ota y el nevo de Ito son melanocitosis dérmicas hiperpigmentarias que surgen como consecuencia de alteraciones o fallas en la migración de los melanocitos desde la cresta neural hacia la epidermis, tienen una etiopatogenia poco conocida y pueden ser congénitas o adquiridas. CASO CLÍNICO: Se trata de un paciente con diagnóstico simultáneo de nevo de Ota y nevo de Ito desde el nacimiento que acude al Servicio de Neurocirugía del hospital Carlos Andrade Marín de la ciudad de Quito y consulta por presentar cefalea súbita de gran intensidad asociada a hemiparesia braquiocrural izquierda. Evolución: Por medio de exámenes complementarios es diagnosticado de dos lesiones ocupantes intracraneales extraaxiales, una parasagital frontoparietal derecha y otra localizada en polo temporal derecho. Se planificó una resección quirúrgica de la lesión parasagital cuyo diagnóstico histopatológico fue melanocitosis meníngea. La lesión de polo temporal fue derivada para tratamiento con Gamma Knife(R). CONCLUSIÓN: Los tumores melanocíticos primarios son extremadamente raros, existe evidencia de su asociación con las melanocitosis dérmicas y en especial con el nevo de Ota. El caso presentado describe la coexistencia de dos melanocitosis dérmicas poco frecuentes (nevo de Ota - nevo de Ito) y un tumor melanocítico primario en el mismo paciente, un caso muy fuera de lo común


BACKGROUND: Nevus of Ota and nevus of Ito are hyperpigmentary dermal melanocytoses which develop as a consequence of disturbances or failures during migration of melanocytes from the neural crest towards the epidermis; they have a relatively unknown aetiopathogenesis and may be congenital or acquired. CASE REPORT: This case involves a male patient with a simultaneous diagnosis of nevus of Ota and nevus of Ito at birth. He attended the Neurosurgery department at Carlos Andrade Marín hospital (Quito) with sudden severe headache associated with left brachio-crural hemiparesis. PROGRESS: Investigations revealed two extra-axial space-occupying lesions, one parasagittal at the right frontal and parietal lobes and the other located at the right temporal lobe pole. A surgical resection was planned for the parasagittal lesion and the histopathological diagnosis was meningeal melanocytosis. The temporal pole lesion was referred for treatment with Gamma Knife(R). CONCLUSION: Primary melanocytic neoplasms are extremely rare. There is evidence of their association with dermal melanocytosis and, in particular, with nevus of Ota. This highly unusual case describes the coexistence of two very rare dermal melanocytoses (nevus of Ota and nevus of Ito) and a primary melanocytic neoplasms in the same patient


Assuntos
Humanos , Masculino , Adulto , Nevo de Ota/cirurgia , Neoplasias Cutâneas/cirurgia , Melanócitos/patologia , Nevo Pigmentado/cirurgia , Neoplasias Meníngeas/cirurgia , Nevo de Ota/patologia , Neoplasias Cutâneas/diagnóstico , Nevo Pigmentado/diagnóstico , Nevo Pigmentado/patologia , Cefaleia/etiologia , Paresia/complicações , Neoplasias Meníngeas/diagnóstico por imagem , Lobo Temporal/diagnóstico por imagem , Lobo Temporal/cirurgia , Biópsia
16.
No Shinkei Geka ; 48(10): 903-907, 2020 Oct.
Artigo em Japonês | MEDLINE | ID: mdl-33071225

RESUMO

DuraGen®, an absorbable, engineered collagen-based artificial graft was introduced in Japan in September 2019 for cranial, transsphenoidal, and spinal surgeries. In addition to its efficacy and safety profile, owing to sutureless dural repair, DuraGen® is widely accepted by neurosurgeons. Direct tenting with DuraGen® is occasionally required in patients with large dural defects, particularly in cases of tumors adherent to the dura. To overcome this limitation, we introduced a surgical technique for epidural tenting using DuraGen®. A 78-year-old man with a history of alexia underwent craniotomy for resection of a left temporal lobe metastatic tumor. We completely removed the recurrent tumor, which was strongly adherent to the dura in the middle cranial fossa. A layer of DuraGen® was used as a subdural underlay beneath the autologous dura to close the wide dural defect. To avoid postoperative epidural fluid collection, we retracted the DuraGen® from the epidural aspect and interposed several pieces of muscle, which were sutured on the subdural aspect to ensure that the muscle pieces securely plugged the dural defect. We placed an additional overlay of DuraGen® along the autologous dura. The patient's postoperative course was uneventful without cerebrospinal fluid leakage, tension pneumocephalus, or wound infection. Reoperations for tumor resection, particularly surgical procedures for refractory meningiomas and malignant tumors cause increasing fragility and wide defects of the dura. DuraGen® placement enables sutureless closure and is less time-consuming. Our technique of epidural direct tenting with DuraGen® using muscle pieces sutured on the subdural aspect could be useful in patients with significantly large dural defects and can prevent postoperative epidural fluid collection to ensure complete dural sealing.


Assuntos
Neoplasias Meníngeas , Recidiva Local de Neoplasia , Idoso , Dura-Máter/cirurgia , Humanos , Japão , Masculino , Neoplasias Meníngeas/diagnóstico por imagem , Neoplasias Meníngeas/cirurgia , Crânio
17.
Brain Nerve ; 72(10): 1105-1111, 2020 Oct.
Artigo em Japonês | MEDLINE | ID: mdl-33051400

RESUMO

Meningioma and glioma represent two common primary intracranial tumors. However, the coexistence of these two lesions in the same patient at the same location is rare. Here, we present a case of a fibroblastic meningioma with a secondary glioblastoma occurring at the same location. A 67-year-old woman underwent surgery for a left frontal parasagittal meningioma, and the tumor was subtotally removed. Two years and 11 months after the surgery, the patient had a tumor at the same location with invasion into the adjacent brain, suggesting recurrent meningioma with malignant transformation. The resected tumor was confirmed histopathologically as a glioblastoma. Genetic analysis revealed that the isocitrate dehydrogenase 1 and 2 genes were wild type, and the TERT promoter mutation was detected. The gene analysis suggests that the tumor was a de novo glioblastoma, not a secondary glioblastoma from a lower-grade glioma. (Received April 9, 2020; Accepted May 27, 2020; Published October 1, 2020).


Assuntos
Neoplasias Encefálicas , Glioblastoma , Neoplasias Meníngeas , Meningioma , Idoso , Neoplasias Encefálicas/diagnóstico por imagem , Neoplasias Encefálicas/genética , Feminino , Glioblastoma/diagnóstico por imagem , Glioblastoma/cirurgia , Humanos , Neoplasias Meníngeas/diagnóstico por imagem , Neoplasias Meníngeas/cirurgia , Meningioma/diagnóstico por imagem , Meningioma/cirurgia , Recidiva Local de Neoplasia/cirurgia
18.
Medicine (Baltimore) ; 99(44): e23028, 2020 Oct 30.
Artigo em Inglês | MEDLINE | ID: mdl-33126391

RESUMO

RATIONALE: Tumor-to-tumor metastasis is a rare clinical phenomenon. Although meningioma is the most common intracranial recipient of cancer metastasis, only a few cases have been reported. We present a case of metastasis of lung adenocarcinoma into intracranial meningioma and review the published literature. PATIENT CONCERNS: A 70-year-old woman was admitted to our hospital for a 1-month history of headache and pain in her lower extremities. DIAGNOSIS: Brain and lumbar vertebral magnetic resonance imaging showed an intracranial space-occupying lesion in the right occipital region and spinal canal stenosis. Pulmonary computed tomography showed an irregular mass in the right upper lobe of the lung. The postoperative histological examination demonstrated adenocarcinoma metastasis to meningioma. INTERVENTION: The patient underwent right occipital craniotomy for tumor removal and lumbar spinal canal decompression. OUTCOMES: There were no initial abnormal conditions after the operation. However, the patient died suddenly 7 days after surgery. LESSONS: Tumor-to-meningioma metastasis is a rare but important phenomenon. According to previous reports, it is associated with rapid onset of symptoms and a poor prognosis. Histological examination is of great importance in diagnosis. The history and process of malignant carcinoma should be closely monitored.


Assuntos
Adenocarcinoma/diagnóstico , Neoplasias Pulmonares/diagnóstico , Neoplasias Meníngeas/diagnóstico , Meningioma/diagnóstico , Adenocarcinoma/diagnóstico por imagem , Adenocarcinoma/secundário , Idoso , Craniotomia , Diagnóstico Diferencial , Feminino , Cefaleia/etiologia , Humanos , Neoplasias Pulmonares/diagnóstico por imagem , Neoplasias Pulmonares/patologia , Neoplasias Meníngeas/complicações , Neoplasias Meníngeas/diagnóstico por imagem , Neoplasias Meníngeas/secundário , Meningioma/complicações , Meningioma/diagnóstico por imagem , Meningioma/secundário , Metástase Neoplásica , Lobo Occipital
19.
Nat Commun ; 11(1): 4803, 2020 09 23.
Artigo em Inglês | MEDLINE | ID: mdl-32968068

RESUMO

Meningiomas are the most common primary intracranial tumors, but the molecular drivers of meningioma tumorigenesis are poorly understood. We hypothesized that investigating intratumor heterogeneity in meningiomas would elucidate biologic drivers and reveal new targets for molecular therapy. To test this hypothesis, here we perform multiplatform molecular profiling of 86 spatially-distinct samples from 13 human meningiomas. Our data reveal that regional alterations in chromosome structure underlie clonal transcriptomic, epigenomic, and histopathologic signatures in meningioma. Stereotactic co-registration of sample coordinates to preoperative magnetic resonance images further suggest that high apparent diffusion coefficient (ADC) distinguishes meningioma regions with proliferating cells enriched for developmental gene expression programs. To understand the function of these genes in meningioma, we develop a human cerebral organoid model of meningioma and validate the high ADC marker genes CDH2 and PTPRZ1 as potential targets for meningioma therapy using live imaging, single cell RNA sequencing, CRISPR interference, and pharmacology.


Assuntos
Neoplasias Encefálicas/genética , Neoplasias Encefálicas/metabolismo , Perfilação da Expressão Gênica/métodos , Heterogeneidade Genética , Imagem por Ressonância Magnética/métodos , Neoplasias Meníngeas/genética , Neoplasias Meníngeas/metabolismo , Idoso , Antígenos CD/genética , Neoplasias Encefálicas/diagnóstico por imagem , Neoplasias Encefálicas/patologia , Caderinas/genética , Imagem de Difusão por Ressonância Magnética/métodos , Epigenômica , Feminino , Marcadores Genéticos , Genômica , Humanos , Neoplasias Meníngeas/diagnóstico por imagem , Neoplasias Meníngeas/patologia , Proteínas Tirosina Fosfatases Classe 5 Semelhantes a Receptores/genética , Transcriptoma
20.
Clin Nucl Med ; 45(10): 784-786, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32796242

RESUMO

We presented a case of 64-year-old woman with pathologically diagnosed lung adenocarcinoma. Brain metastases were highly suspected due to the appearance of neurological symptoms. However, no abnormal finding in the brain was observed on F-FDG PET/CT. Contrast-enhanced MRI showed the presence of leptomeningeal metastases but with a negative cerebrospinal fluid analysis. For this reason, the patient underwent Ga-FAPI PET/CT, later fused with MRI scans that showed intense uptake of Ga-FAPI in leptomeningeal regions correspondent to the sites of gadolinium enhancement. This case highlights that Ga-FAPI would be promising for the identification of leptomeningeal involvement in patients with malignant disease.


Assuntos
Adenocarcinoma de Pulmão/patologia , Neoplasias Meníngeas/diagnóstico por imagem , Neoplasias Meníngeas/secundário , Tomografia Computadorizada com Tomografia por Emissão de Pósitrons , Quinolinas , Transporte Biológico , Feminino , Humanos , Imagem por Ressonância Magnética , Pessoa de Meia-Idade
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