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1.
World Neurosurg ; 135: 171-172, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31870821

RESUMO

Benign peripheral nerve sheath tumors are well known to neurosurgeons and a relatively commonly seen pathology. Intraneural ganglion cysts, once thought to be rare and poorly understood, are increasingly recognized in clinical practice and better understood based on the advent of high-resolution imaging. There are few reports of different nerve lesions in the same anatomic location appearing concurrently. Herein we present a patient with 2 distinct pathologies explaining 2 distinct symptom complexes-sensory changes in the superficial peroneal distribution (from a schwannoma of the superficial peroneal nerve) and mild motor weakness in the tibialis anterior (from an intraneural ganglion cyst arising from the superior tibiofibular joint affecting this motor branch). Recognition of the 2 pathologies allowed targeted surgical approaches, which led to resolution of the symptoms.


Assuntos
Cistos Glanglionares/diagnóstico por imagem , Neurilemoma/diagnóstico por imagem , Neoplasias do Sistema Nervoso Periférico/diagnóstico por imagem , Neuropatias Fibulares/diagnóstico por imagem , Idoso , Feminino , Cistos Glanglionares/complicações , Cistos Glanglionares/cirurgia , Humanos , Imagem por Ressonância Magnética , Neurilemoma/complicações , Neurilemoma/cirurgia , Neoplasias do Sistema Nervoso Periférico/complicações , Neoplasias do Sistema Nervoso Periférico/cirurgia , Nervo Fibular/diagnóstico por imagem , Nervo Fibular/cirurgia , Neuropatias Fibulares/complicações , Neuropatias Fibulares/cirurgia
2.
J Am Podiatr Med Assoc ; 109(4): 322-326, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31762309

RESUMO

A schwannoma is a solitary benign tumor composed of Schwann cells occurring anywhere in the peripheral nervous system. The diagnosis of a schwannoma is often difficult to make by clinical presentation and advanced imaging modalities. We present a case report of a 61-year-old Hispanic woman with a left-foot, third-digit, soft-tissue mass. The diagnosis of a schwannoma of the proper digital nerve was made postsurgically by means of histopathologic and immunohistochemistry parameters. This is a rare location for a schwannoma, and neurogenic tumor should be included in the differential diagnosis of soft-tissue mass, as there have been prior case reports.


Assuntos
Doenças do Pé/patologia , Neurilemoma/patologia , Neoplasias do Sistema Nervoso Periférico/patologia , Dedos do Pé/inervação , Feminino , Doenças do Pé/diagnóstico por imagem , Doenças do Pé/cirurgia , Humanos , Pessoa de Meia-Idade , Neurilemoma/diagnóstico por imagem , Neurilemoma/cirurgia , Neoplasias do Sistema Nervoso Periférico/diagnóstico por imagem , Neoplasias do Sistema Nervoso Periférico/cirurgia , Dedos do Pé/diagnóstico por imagem , Dedos do Pé/cirurgia , Ultrassonografia
3.
BMC Cancer ; 19(1): 888, 2019 Sep 05.
Artigo em Inglês | MEDLINE | ID: mdl-31488091

RESUMO

BACKGROUND: Glomus tumors in the digital nerve are extremely rare. Multiple intraneural glomus tumors in different digital nerve fascicles have not been previously reported. CASE PRESENTATION: We report the case of a 54-year-old male with a 1-year history of progressive numbness of the middle finger with point tenderness at the level of the middle phalanx. Surgical incision revealed the presence of two glomus tumors within different fascicles of the ulnar digital nerve of the middle finger. One tumor was excised along with surrounding fascicle, the other was removed leaving the fascicle intact. Subsequently, the patient regained function of the finger and no tumors have recurred. CONCLUSIONS: Patients and physicians should be aware of the properties of intraneural glomus tumors so that early diagnosis and treatment can be sought.


Assuntos
Dedos/patologia , Tumor Glômico/cirurgia , Paraganglioma Extrassuprarrenal/cirurgia , Neoplasias do Sistema Nervoso Periférico/cirurgia , Doenças Raras/cirurgia , Neuropatias Ulnares/cirurgia , Competência Clínica , Tumor Glômico/diagnóstico por imagem , Humanos , Imagem por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Paraganglioma Extrassuprarrenal/diagnóstico por imagem , Neoplasias do Sistema Nervoso Periférico/diagnóstico por imagem , Doenças Raras/diagnóstico por imagem , Resultado do Tratamento , Nervo Ulnar/patologia , Neuropatias Ulnares/diagnóstico por imagem
4.
Mymensingh Med J ; 28(3): 685-688, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31391445

RESUMO

Brachial plexus tumors are rare. Schwannomas are benign nerve sheath tumors and only about 5% arise from brachial plexus. Diagnosis of these tumors are challenging for radiologists as well as clinicians as they are rare and the anatomy of the neck is complex. We report a case of a middle aged woman who was admitted in Mymensingh Medical College in Neurosurgery Department on 15th December 2017 with right supraclavicular swelling; based on the clinical findings was provisionally diagnosed as supraclavicular lymphadenopathy; Ultrasonography and Magnetic Resonance Imaging suggested schwannoma. Complete excision of the mass through supraclavicular approach showed the origin of it from the brachial plexus, which subsequently was confirmed to be a schwannoma with histopathology.


Assuntos
Plexo Braquial , Neurilemoma , Neoplasias do Sistema Nervoso Periférico , Plexo Braquial/diagnóstico por imagem , Feminino , Humanos , Imagem por Ressonância Magnética , Pessoa de Meia-Idade , Neurilemoma/diagnóstico por imagem , Neoplasias do Sistema Nervoso Periférico/diagnóstico por imagem , Ultrassonografia
6.
Muscle Nerve ; 60(5): 544-548, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31361339

RESUMO

INTRODUCTION: Ultrasound (US) evaluation of peripheral nerves is a noninvasive, cost-effective approach to diagnosing focal mononeuropathies and guiding surgical management. We used the intranerve ratio to evaluate for possible cut-off values in diagnosis of fibular mononeuropathies (FNs). METHODS: A retrospective analysis of FN confirmed by electrodiagnosis (EDx) was performed to identify intranerve ratio values between affected and unaffected limbs at the fibular head and popliteal fossa. RESULTS: The optimal fibular head/popliteal fossa intranerve ratio to discriminate between limbs with and without disease was 1.25 (sensitivity, 51%; specificity, 71%). There was no statistically significant difference between affected vs unaffected limbs (ratio, 1.13; P = .15) nor in subgroup analyses. However, 25% of patients had structural lesions amenable to surgery. DISCUSSION: The utility of US in diagnosis of FN is limited using intranerve ratio data, but US has a distinct advantage over EDx for identifying treatable structural lesions.


Assuntos
Cistos Glanglionares/diagnóstico por imagem , Neoplasias da Bainha Neural/diagnóstico por imagem , Neoplasias do Sistema Nervoso Periférico/diagnóstico por imagem , Nervo Fibular/diagnóstico por imagem , Neuropatias Fibulares/diagnóstico por imagem , Eletrodiagnóstico , Feminino , Cistos Glanglionares/complicações , Cistos Glanglionares/cirurgia , Humanos , Joelho , Masculino , Pessoa de Meia-Idade , Neoplasias da Bainha Neural/complicações , Neoplasias da Bainha Neural/cirurgia , Condução Nervosa , Tamanho do Órgão , Neoplasias do Sistema Nervoso Periférico/complicações , Neoplasias do Sistema Nervoso Periférico/cirurgia , Nervo Fibular/patologia , Neuropatias Fibulares/etiologia , Neuropatias Fibulares/cirurgia , Estudos Retrospectivos
7.
BMC Cancer ; 19(1): 594, 2019 Jun 17.
Artigo em Inglês | MEDLINE | ID: mdl-31208357

RESUMO

BACKGROUND: Secondary central nervous system involvement of non-Hodgkin's lymphoma (NHL) is rare and with poor prognosis, the most common pathological type is diffuse large B cell lymphoma (DLBCL). Although it can occur in any part of central nervous system, it rarely directly infiltrates the spinal cord or cauda equina. CASE PRESENTATION: We present the case of 64-year-old immunocompetent man with a worsening pain of waist and left lower extremity, accompanied by numbness and paresis of bilateral lower extremity for 20 days. His previous medical history included a resection of painless mass in the left groin in another hospital 7 months ago, and the pathological diagnosis was non-Hodgkin small B cell lymphoma. Gd-enhanced MRI and F-18 FDG PET-CT scan demonstrated multiple infiltrations in the cauda equina. During the operation, we removed as many as 11 subdural-extramedullary bean-size lesions involving multiple nerve roots. The paralysis of his left leg recovered rapidly after the operation. During the follow-up period of more than one year, he underwent standard R-CHOP chemical therapy, no evidence of recurrence was noted until the 13th month, the patient died because of intracranial relapse. CONCLUSIONS: Imaging examination is important in the diagnosis of multiple secondary cauda equina non-Hodgkin's lymphoma, and we highlight the significance of gadolinium-enhanced MRI and F-18 FDG-PET/CT in preoperative diagnosis as well as the previous history.


Assuntos
Cauda Equina/patologia , Linfoma de Células B/patologia , Neoplasias do Sistema Nervoso Periférico/secundário , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Cauda Equina/diagnóstico por imagem , Meios de Contraste , Ciclofosfamida/uso terapêutico , Doxorrubicina/uso terapêutico , Encefalocele/mortalidade , Evolução Fatal , Seguimentos , Gadolínio/química , Humanos , Linfoma de Células B/cirurgia , Imagem por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/patologia , Neoplasias do Sistema Nervoso Periférico/diagnóstico por imagem , Neoplasias do Sistema Nervoso Periférico/tratamento farmacológico , Neoplasias do Sistema Nervoso Periférico/cirurgia , Tomografia Computadorizada com Tomografia por Emissão de Pósitrons , Prednisona/uso terapêutico , Rituximab/uso terapêutico , Recusa do Paciente ao Tratamento , Vincristina/uso terapêutico
8.
World Neurosurg ; 128: 55-61, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31054349

RESUMO

BACKGROUND: Presacral schwannomas are rare benign tumors that may reach large size before becoming symptomatic. Total surgical removal has been considered the best treatment option. Tumors arising from the presacral area are commonly managed through anterior approaches, whereas posterior approaches are used for pure intrasacral tumors or large lesions with both intrasacral and presacral extension, alone or in combination with anterior approaches. METHODS: We describe a quick and minimally invasive navigation-guided posterolateral approach to a right presacral L5 schwannoma. The lesion was microsurgically removed through high-speed drilling of the upper portion of the right sacral ala, under intraoperative neurophysiologic monitoring. RESULTS: The postoperative course was unremarkable, and the patient experienced improvement in his sensory disturbance. Postoperative magnetic resonance imaging and computed tomography scan showed the complete excision of the lesion and the removal of the upper sacral ala with preservation of the right L5-S1 articular complex. The histologic examination confirmed a schwannoma (World Health Organization grade I). CONCLUSIONS: The posterolateral transsacral ala approach may represent a minimally invasive option in the surgical management of presacral well-circumscribed benign tumors. Spinal navigation could be properly used to facilitate lesion exposure and to minimize the bone removal. The intraoperative neurophysiologic monitoring is an essential tool for the preservation of the lumbosacral nerve roots.


Assuntos
Microcirurgia/métodos , Neurilemoma/cirurgia , Procedimentos Neurocirúrgicos/métodos , Neoplasias do Sistema Nervoso Periférico/cirurgia , Raízes Nervosas Espinhais/cirurgia , Adulto , Humanos , Monitorização Neurofisiológica Intraoperatória , Vértebras Lombares , Imagem por Ressonância Magnética , Masculino , Neurilemoma/diagnóstico por imagem , Neoplasias do Sistema Nervoso Periférico/diagnóstico por imagem , Sacro , Raízes Nervosas Espinhais/diagnóstico por imagem , Tomografia Computadorizada por Raios X
9.
World Neurosurg ; 128: e970-e974, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31100516

RESUMO

OBJECTIVE: Tumors of the greater sciatic foramen remain difficult to treat. They often have both intrapelvic and extrapelvic components that may limit visualization and make safe resection of the tumor difficult. Therefore the goal of the present anatomic study was to quantitate how much additional surgical working space could be gained by transection of the sacrospinous and sacrotuberous ligaments. METHODS: Sixteen sides from 9 fresh-frozen Caucasian cadaveric torsos underwent transgluteal dissection and exposure of the greater sciatic foramen and associated liagments. With the piriformis in place, the vertical and horizontal diameters of the greater sciatic foramen were measured. Next, the sacrotuberous and sacrospinous ligaments were cut at their ischial attachments. The vertical diameter of the now confluent greater and lesser sciatic foramina (V2) was measured. RESULTS: The mean vertical diameter of the greater sciatic foramen (V1) was 54.8 ± 9.7 mm. The horizontal diameter of the greater sciatic foramen had a mean of 44.3 ± 6.1 mm with a range of 30-52 mm. After transection of the sacrotuberous and sacrospinous ligaments, the vertical distance of the greater and lesser sciatic foramina (V2) had a mean of 74.8 ± 6.8 mm with a range of 60.1-90 mm. The mean ratio of V2 to V1 was 1.40. CONCLUSIONS: The vertical length of the greater sciatic foramen increased, on average, 40% after resection of the sacrotuberous and sacrospinous ligaments. The results of this study support an alternative technique for resecting large intrapelvic tumors via a transgluteal approach.


Assuntos
Ligamentos/cirurgia , Procedimentos Neurocirúrgicos/métodos , Neoplasias do Sistema Nervoso Periférico/cirurgia , Nervo Isquiático/anatomia & histologia , Nervo Isquiático/cirurgia , Neuropatia Ciática/cirurgia , Adulto , Idoso , Idoso de 80 Anos ou mais , Cadáver , Feminino , Humanos , Ligamentos/diagnóstico por imagem , Lipossarcoma Mixoide/diagnóstico por imagem , Lipossarcoma Mixoide/patologia , Lipossarcoma Mixoide/cirurgia , Imagem por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Neoplasias do Sistema Nervoso Periférico/diagnóstico por imagem , Nervo Isquiático/diagnóstico por imagem , Neuropatia Ciática/diagnóstico por imagem , Resultado do Tratamento
10.
World Neurosurg ; 128: 196-199, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31082562

RESUMO

BACKGROUND: Atypical rhabdoid teratoid tumors are very rare embryonal tumors that typically affect children younger than 3 years old and are encountered intracranially. CASE DESCRIPTION: Here, we describe the case of a 19-year-old woman who presented with gait disturbances and coccydynia. Imaging revealed a cauda equina mass. The tumor was partially resected. Histology reported loss of SMARCB1/INI1 expression and therefore the diagnosis of atypical rhabdoid teratoid was established. The patient underwent radiation treatment, but within 3 months 2 relapses were manifested. CONCLUSIONS: Atypical rhabdoid teratoids are exceptionally rare in adults and are seldom found in spine; only 8 such cases have been reported in the medical literature. They are invariantly characterized by multiple relapses and dismal prognosis. The clinician must be attentive of leptomeningeal disseminations and 22q11 deletion-associated comorbidities.


Assuntos
Cauda Equina/diagnóstico por imagem , Neoplasias do Sistema Nervoso Periférico/diagnóstico por imagem , Tumor Rabdoide/diagnóstico por imagem , Teratoma/diagnóstico por imagem , Idade de Início , Cauda Equina/cirurgia , Feminino , Humanos , Laminectomia , Procedimentos Neurocirúrgicos , Neoplasias do Sistema Nervoso Periférico/metabolismo , Neoplasias do Sistema Nervoso Periférico/terapia , Radioterapia , Tumor Rabdoide/metabolismo , Tumor Rabdoide/terapia , Proteína SMARCB1/metabolismo , Teratoma/metabolismo , Teratoma/terapia , Adulto Jovem
11.
Acta Chir Plast ; 60(1): 9-13, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30939878

RESUMO

Magnetic resonance imaging (MRI) plays a crucial role in the diagnosis and morphological analysis of peripheral nerve tumours (PNTs). In recent years, a number of novel MRI sequences such as MR neurography (MRN), diffusion tensor imaging (DTI) or MR tractography (MRT) have emerged extending the range of conventional MRI techniques. These advanced sequences are able to provide detailed information concerning PNTs structure, including the course and function of individual neural fascicles. This data can then be utilized in tailoring a suitable surgical procedure, reducing the risks of postoperative neurological deficit. The following case report of a median nerve tumour demonstrates the range and practicality of current MRI techniques. With continuing advancement and perfection of these MRI techniques, we can expect their integration into standard diagnostic protocols of PNTs.


Assuntos
Imagem por Ressonância Magnética/métodos , Nervo Mediano/diagnóstico por imagem , Neoplasias do Sistema Nervoso Periférico/diagnóstico por imagem , Imagem de Tensor de Difusão , Humanos , Nervo Mediano/cirurgia
12.
Muscle Nerve ; 59(6): 707-711, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-30847944

RESUMO

INTRODUCTION: Brachial plexus trauma related to gunshot (GS) injury requires early examination and characterization to ensure appropriate treatment. Magnetic resonance imaging (MRI) may be contraindicated when there are metal fragments in a patient's body. Ultrasound (US) may present an alternative to imaging GS-related brachial plexus injury. METHODS: Three patients with GS-related brachial plexus injury who underwent US imaging evaluation at our institution were identified. A retrospective review of the patients' medical records was performed. RESULTS: US characterization of nerve abnormalities after GS injury to the brachial plexus was in agreement with electrodiagnostic and intraoperative findings. DISCUSSION: Information from the US reports was useful in preparation for brachial plexus reconstruction surgery. As such, US has unique utility when MRI cannot be performed. US imaging can provide useful characterization of the brachial plexus after GS injury when performed by an experienced operator. Muscle Nerve 59:707-711, 2019.


Assuntos
Plexo Braquial/diagnóstico por imagem , Traumatismos dos Nervos Periféricos/diagnóstico por imagem , Ferimentos por Arma de Fogo/diagnóstico por imagem , Adulto , Plexo Braquial/lesões , Plexo Braquial/fisiopatologia , Plexo Braquial/cirurgia , Neurite do Plexo Braquial/diagnóstico por imagem , Neurite do Plexo Braquial/etiologia , Neuropatias do Plexo Braquial/diagnóstico por imagem , Neuropatias do Plexo Braquial/etiologia , Eletromiografia , Humanos , Masculino , Neuroma/diagnóstico por imagem , Neuroma/etiologia , Procedimentos Neurocirúrgicos , Traumatismos dos Nervos Periféricos/complicações , Traumatismos dos Nervos Periféricos/fisiopatologia , Traumatismos dos Nervos Periféricos/cirurgia , Neoplasias do Sistema Nervoso Periférico/diagnóstico por imagem , Neoplasias do Sistema Nervoso Periférico/etiologia , Procedimentos Cirúrgicos Reconstrutivos , Estudos Retrospectivos , Ferimentos por Arma de Fogo/complicações , Ferimentos por Arma de Fogo/fisiopatologia , Ferimentos por Arma de Fogo/cirurgia , Adulto Jovem
13.
Turk Neurosurg ; 29(4): 594-597, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30875079

RESUMO

AIM: To describe the ultrasound-guided microsurgical excision technique and to evaluate the surgical outcomes of brachial plexus schwannomas. MATERIAL AND METHODS: Eleven patients who underwent ultrasound-guided microsurgery for small ( < 3 cm) brachial plexus schwannomas between 2013 and 2017 were included in our study. RESULTS: The mean age of the patients was 45 years (range: 30-68 years), with six tumors localized on the right and five on the left side. There were no perioperative or postoperative complications. No postoperative deficits were observed in the patients. CONCLUSION: Surgeons can safely and completely excise most of the benign ( < 3 cm and non-palpable) brachial plexus tumors by the ultrasound-guided microsurgical excision technique.


Assuntos
Plexo Braquial/diagnóstico por imagem , Plexo Braquial/cirurgia , Microcirurgia/métodos , Neurilemoma/diagnóstico por imagem , Neurilemoma/cirurgia , Ultrassonografia de Intervenção/métodos , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias do Sistema Nervoso Periférico/diagnóstico por imagem , Neoplasias do Sistema Nervoso Periférico/cirurgia , Complicações Pós-Operatórias/cirurgia , Resultado do Tratamento
14.
Neurocirugía (Soc. Luso-Esp. Neurocir.) ; 30(1): 28-32, ene.-feb. 2019. ilus
Artigo em Espanhol | IBECS | ID: ibc-181458

RESUMO

Se describe el caso de una paciente de 41 años con cuadro de dorsalgia crónica. Mediante RM se diagnosticó una lesión intradural extramedular bien delimitada con morfología en reloj de arena con gran componente paravertebral izquierdo en D5-D6. El tumor fue embolizado previo a la cirugía, realizándose posteriormente laminotomía D4-D6, costotransversectomía D5-D6 izquierdas y resección de la porción intrarraquídea extradural con sección del nervio D5 izquierdo. A continuación, se realizó una resección en bloque del componente extrarraquídeo por vía posterolateral. El diagnóstico anatomopatológico fue de schwannoma maligno, precisando posteriormente tratamiento radioterápico adyuvante. El schwannoma maligno es un tumor poco frecuente perteneciente al grupo de tumores malignos de la vaina del nervio periférico (MPNST), originado en las células de Schwann. Se asocia frecuentemente con la neurofibromatosis tipo 1. Los MPNST recurren con frecuencia a nivel locorregional y pueden dar metástasis a distancia


We report a case of a 41 years old patient complaining of chronic dorsalgia. MRI showed a well defined intradural extramedular dumbbell-shaped lesion, associated to a left paravertebral tumor at D5-D6 level. The tumor was embolizated prior to surgery. Following she underwent a D4-D6 laminotomy, left D5-D6 costotransversectomy and resection of the intracanal extradural part of the lesion with section of the left D5 nerve. Posteriorly, complete resection of the extracanal portion of the tumor was performed by a postero-lateral approach. The anatomopathologic diagnosis was a malignant schwannoma. After the surgery, the patient required adyuvant radiotherapic treatment. Malignant schwannoma is a very uncommon tumor which belongs to the malignant peripheral nerve sheath tumors (MPNST). It develops from Schwann cells. It is frequently associated with type 1 neurofibromatosis. MPNST usually present local recurrence and can metastatize


Assuntos
Humanos , Feminino , Adulto , Neurofibrossarcoma/diagnóstico por imagem , Neurofibrossarcoma/cirurgia , Neoplasias do Sistema Nervoso Periférico/diagnóstico por imagem , Neoplasias do Sistema Nervoso Periférico/cirurgia , Dor nas Costas/diagnóstico por imagem , Radioterapia Adjuvante/métodos , Radiografia Torácica , Neoplasias do Mediastino/diagnóstico por imagem , Diagnóstico Diferencial
15.
Semin Musculoskelet Radiol ; 23(1): 76-84, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30699454

RESUMO

Nerve tumors are rare and heterogeneous soft tissue tumors arising from a peripheral nerve or showing nerve sheath differentiation. In a radiologic setting it is necessary to recognize soft tissue lesions that are of neural origin, their association with a peripheral nerve, and whether they are a true tumor or a so-called pseudotumor such as a neuroma, fibrolipoma, or peripheral nerve sheath ganglion. Ultrasound (US) and magnetic resonance imaging are the best modalities to characterize these lesions. US can be used to guide biopsy in difficult and uncertain cases when the lesion is either indeterminate or possibly malignant. At present, no single imaging feature or reproducible criteria, or a combination, can differentiate reliably between a neurofibroma and a schwannoma or discriminate with certainty between benign and malignant neurogenic tumors. Adequate imaging and consultation with a nerve tumors/sarcoma unit is advised.


Assuntos
Neoplasias do Sistema Nervoso Periférico/diagnóstico por imagem , Meios de Contraste , Diagnóstico Diferencial , Humanos , Neoplasias do Sistema Nervoso Periférico/patologia
16.
J Back Musculoskelet Rehabil ; 32(2): 361-365, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30664501

RESUMO

INTRODUCTION: Running is one of the most common sports practices in the world due to the beneficial impact on the health, despite the relatively high risk of getting injuries. In fact, running is one of the most common sports capable to induce overuse injuries of the lower back and leg. In previous studies, the symptoms in the lower limb have been attributed to lumbosacral degenerative pathology. When the symptoms are unclear, they must be studied with great attention by carrying out an accurate process of screening and differential diagnosis. MATERIALS AND METHODS: A 42-year-old non-competitive male runner who complained of left leg pain was referred to a physiotherapist. He reported a continuous, deep, sharp, shooting pain of the left leg. The symptoms began one year earlier. Symptoms worsened during prolonged driving and long distance running. The patient had been previously diagnosed with lumbar radicular irradiation in the leg by a general practitioner. Initial management, in another physical therapy outpatient setting, was without any improvement. RESULTS: After surgical excision, symptoms gradually regressed shortly and the patient was referred to a physiotherapist in order to fully recover and restore work and running activities. CONCLUSION: This case report describes the history, assessment and treatment of a runner with a rare cause of leg pain. After surgery excision, treatment focused on education and loading the tissues over many weeks through a graded program of loaded exercises and running retraining.


Assuntos
Neurilemoma/diagnóstico por imagem , Neoplasias do Sistema Nervoso Periférico/diagnóstico por imagem , Nervo Fibular/diagnóstico por imagem , Radiculopatia/diagnóstico , Adulto , Transtornos Traumáticos Cumulativos/diagnóstico , Exercício Físico , Terapia por Exercício , Humanos , Região Lombossacral , Imagem por Ressonância Magnética , Masculino , Dor/etiologia , Corrida , Ultrassonografia
18.
PET Clin ; 14(1): 81-89, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30420224

RESUMO

PET has been founded as a useful technique in the staging, restaging, prognostication, and treatment planning for numerus cancers, with an incremental application in precision oncology. This paper summarized the current state-of-the-art application of PET/CT in the management of patients with peripheral nerve tumors. Furthermore, the potential clinical uses of emerging themes and technological advances are reviewed, consisting hybrid PET/MR imaging and alternative radiotracers for the application in peripheral nerve oncology.


Assuntos
Neoplasias do Sistema Nervoso Periférico/diagnóstico por imagem , Tomografia por Emissão de Pósitrons/métodos , Humanos , Nervos Periféricos/diagnóstico por imagem
19.
World Neurosurg ; 122: e487-e497, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30366145

RESUMO

BACKGROUND: Malignant peripheral nerve sheath tumors (MPNSTs) and cellular schwannomas (CSs) of the eighth cranial nerve are exceedingly rare. The purpose of the present study was to evaluate clinical and genetic characterization of these rare tumors. METHODS: The clinical and radiological features were analyzed retrospectively. The histopathological characteristics were assessed by hematoxylin and eosin staining and immunohistochemistry. Genomic abnormalities were evaluated using array comparative genomic hybridization. RESULTS: Of the 1287 surgeries for vestibular schwannomas from 2014 to 2017, 2 were for MPNSTs and 5 were for CSs. The mean age at diagnosis was older for patients with MPNSTs (57.0 ± 4.2 years) than that of patients with CS (35.8 ± 9.4 years; P = 0.03). Two patients with MPNST died of tumor recurrence. None of the patients with CS died. The 2-year overall and progression-free survival of patients with MPNSTs were worse than those for patients with CSs (overall survival, 50.0% ± 35.4% vs. 100%, P = 0.027; progression-free survival, 0% vs. 100%; P = 0.012). The Ki-67 index for the MPNSTs (29.0% ± 3.5%) was greater than that for the CSs (10.3% ± 3.1%; P = 0.001). The common alterations in MPNSTs mainly included gains of chromosomes 7p, 8p, 9q, 12, and 17 and loss of heterozygosity of 1p, 6 and 9p. The common alterations in CSs included gain of 4p16.3, loss of heterozygosity of 2p15-14, and 22q11.1-13.3. CONCLUSIONS: To the best of our knowledge, the present study is the first high-resolution genomic analysis of MPNSTs and CSs of the eighth cranial nerve and has shown a significant difference that might be more accurate to distinguish between these 2 types of rare tumors.


Assuntos
Genômica/métodos , Neoplasias da Bainha Neural/diagnóstico por imagem , Neurilemoma/diagnóstico por imagem , Neoplasias do Sistema Nervoso Periférico/diagnóstico por imagem , Nervo Vestibulococlear/diagnóstico por imagem , Adulto , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias da Bainha Neural/genética , Neoplasias da Bainha Neural/cirurgia , Neurilemoma/genética , Neurilemoma/cirurgia , Neoplasias do Sistema Nervoso Periférico/genética , Neoplasias do Sistema Nervoso Periférico/cirurgia , Nervo Vestibulococlear/cirurgia
20.
Br J Neurosurg ; 33(3): 281-282, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-28554231

RESUMO

We reported a rare peripheral nerve case, a patient developed carpal tunnel syndrome with a history of floating thumb in right hand. The median nerve was found expanded and spindle-shaped and a plexiform neurofibroma was diagnosed. Our case sheds light on anatomy and possible etiological association which may help clinical management.


Assuntos
Síndrome do Túnel Carpal/etiologia , Síndrome do Túnel Carpal/cirurgia , Neurofibroma Plexiforme/complicações , Neurofibroma Plexiforme/cirurgia , Neoplasias do Sistema Nervoso Periférico/complicações , Neoplasias do Sistema Nervoso Periférico/cirurgia , Adulto , Eletrodiagnóstico , Feminino , Humanos , Imagem por Ressonância Magnética , Nervo Mediano/patologia , Nervo Mediano/cirurgia , Neurofibroma Plexiforme/diagnóstico por imagem , Neoplasias do Sistema Nervoso Periférico/diagnóstico por imagem , Polegar/fisiopatologia , Resultado do Tratamento
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