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1.
Folia Neuropathol ; 57(3): 295-300, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31588716

RESUMO

We report a case of atypical teratoid/rhabdoid tumour (AT/RT) in an adult patient in the deep grey matter with extension into the lateral ventricle. To our knowledge, this is the first example of AT/RT involving the lateral ventricle in an adult. The patient presented with headache and confusion, and subsequently required emergent surgery. His postoperative course was complicated by hemorrhage into the surgical site. The location and vascularity of the tumour affected the extent of resection achieved and likely contributed to postoperative complications. We discuss radiological features of AT/RT in adults and implications for investigations and management.


Assuntos
Neoplasias do Ventrículo Cerebral/patologia , Tumor Rabdoide/patologia , Teratoma/patologia , Adulto , Humanos , Masculino
2.
World Neurosurg ; 132: 7-11, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31442659

RESUMO

BACKGROUND: The rosette-forming glioneuronal tumor (RGNT) is a rare World Health Organization grade I tumor, most often originating in the fourth ventricle and characterized by a predominant glial component, as well as a neurocytic component. Despite its benign grading, there are a few documented cases of RGNT displaying more aggressive behavior with malignant characteristics. CASE DESCRIPTION: Herein, we describe a uniquely aggressive presentation of RGNT in a 49-year-old man initially presenting with obstructive hydrocephalus with lesions in the right frontal lobe, fourth ventricle, and left lateral ventricle. The patient was found to have 2 distinct intracranial entities: a right frontal meningioma and disseminated intraventricular RGNT. He underwent an anatomically limited resection of the fourth ventricular lesion with fourth ventricle-to-subarachnoid space shunting. His disease progressed thereafter, with diffuse intracranial dissemination and drop metastases in the lumbar spine. He was treated with craniospinal radiation and remains on palliative care 5 months after completion of radiotherapy. CONCLUSIONS: This case supplements and complements the handful of published cases available documenting the evolution of a particularly aggressive case of disseminated RGNT.


Assuntos
Neoplasias do Ventrículo Cerebral/cirurgia , Glioma/cirurgia , Neoplasias Primárias Múltiplas/cirurgia , Neoplasias Encefálicas/complicações , Neoplasias Encefálicas/diagnóstico por imagem , Neoplasias Encefálicas/patologia , Neoplasias Encefálicas/cirurgia , Neoplasias do Ventrículo Cerebral/complicações , Neoplasias do Ventrículo Cerebral/diagnóstico por imagem , Neoplasias do Ventrículo Cerebral/patologia , Quarto Ventrículo/diagnóstico por imagem , Quarto Ventrículo/cirurgia , Glioma/complicações , Glioma/diagnóstico por imagem , Glioma/secundário , Humanos , Hidrocefalia/diagnóstico por imagem , Hidrocefalia/etiologia , Hidrocefalia/cirurgia , Ventrículos Laterais/diagnóstico por imagem , Ventrículos Laterais/cirurgia , Masculino , Neoplasias Meníngeas/diagnóstico por imagem , Neoplasias Meníngeas/cirurgia , Meningioma/diagnóstico por imagem , Meningioma/cirurgia , Pessoa de Meia-Idade , Neoplasias Primárias Múltiplas/diagnóstico por imagem , Doenças Raras , Neoplasias da Medula Espinal/diagnóstico por imagem , Neoplasias da Medula Espinal/secundário , Derivação Ventriculoperitoneal
4.
World Neurosurg ; 129: e171-e176, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31121374

RESUMO

BACKGROUND: Cerebrospinal fluid (CSF) leak remains a significant complication of posterior fossa tumor surgery. The goal of this study was to evaluate the wound CSF leakage rate in pediatric patients who underwent fourth ventricle tumor resection in a single-site setting and to explore the association of CSF leakage with the length of stay in the intensive care unit (ICU) and with dural sealant application. METHODS: Two hundred and eleven patients who underwent fourth ventricle tumor surgery between 2008 and 2016 were included in this study. Patient data were evaluated retrospectively. RESULTS: Postoperative wound CSF leakage was observed in 6 patients (2.8%). One hundred and seventy-six patients (83.4%) stayed in the ICU for ≤1 day, and CSF leakage developed in 4 of these patients (2.3%). Thirty-five patients (16.6%) stayed in the ICU for >1 day, and CSF leakage was observed in 2 of these patients (5.7%). The observed difference was not statistically significant (P = 0.260). There were no statistically significant differences in the CSF leakage rates in groups with and without dural sealing before (n = 2 [3%] and n = 4 [2.8%], respectively; P = 0.99) and after (n = 2 [3.0%] and n = 4 [6.0%], respectively; P = 0.68) application of the propensity score matching algorithm. CONCLUSIONS: The low CSF leakage rate (2.8%) identified in this study was associated with a certain algorithm of patient management. There was no strong evidence that the CSF leakage rate was associated with the length of stay in the ICU or with dural sealant application.


Assuntos
Neoplasias do Ventrículo Cerebral/cirurgia , Vazamento de Líquido Cefalorraquidiano/etiologia , Fossa Craniana Posterior/cirurgia , Quarto Ventrículo/cirurgia , Glioma/cirurgia , Neoplasias Infratentoriais/cirurgia , Procedimentos Neurocirúrgicos/efeitos adversos , Adolescente , Neoplasias do Ventrículo Cerebral/patologia , Criança , Pré-Escolar , Fossa Craniana Posterior/patologia , Craniotomia/efeitos adversos , Feminino , Quarto Ventrículo/patologia , Glioma/patologia , Humanos , Lactente , Recém-Nascido , Neoplasias Infratentoriais/patologia , Masculino , Complicações Pós-Operatórias/etiologia , Estudos Retrospectivos
5.
World Neurosurg ; 129: e177-e190, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31121376

RESUMO

BACKGROUND: The aim of this study is to share our experiences on a series of 21 patients with intraventricular meningiomas (IVMs). Histopathologic examinations are reviewed in detail and the cell of origin of IVMs is discussed. METHODS: We retrospectively reviewed 1372 patients with intracranial meningioma who were surgically treated between September 1986 and July 2018. From this cohort, 21 patients with IVM were identified. The clinical, radiologic, surgical, and follow-up records were analyzed. The archival pathologic specimens were reviewed. Tissue microarray blocks were performed from the formalin-fixed, paraffin-embedded samples of all IVM cases, 2 choroid plexus tissue adjacent to the tumors, and 10 extraventricular fibrous meningioma cases selected as control randomly. Immunohistochemical staining with the antibodies S-100, SOX10, NGFR, and OTX2 was performed according to the protocols indicated by the manufacturers. RESULTS: Surgical complications included hemiparesis in 1 patient (5%), postoperative seizure in 1 patient (5%), sensorial aphasia in 1 patient (5%), and preexisting headache in 1 patient (5%). Seventeen (81%) of the IVMs had grade I pathology and 4 (19%) had grade II pathology. The immunoprofile of IVMs is identical to the immunoprofile of normal choroid plexus epithelium. CONCLUSIONS: Transcortical approaches using intraoperative ultrasonography and intraoperative monitoring with avoidance of eloquent cortical areas can achieve good outcomes. Resection of the choroidal attachments should be attempted. Our results indicate that IVMs do not show arachnoid cap cell phenotype and the findings support that IVMs originate from the choroid plexus epithelium or the progenitors of the choroid plexus epithelium.


Assuntos
Neoplasias do Ventrículo Cerebral/cirurgia , Plexo Corióideo/patologia , Meningioma/cirurgia , Procedimentos Neurocirúrgicos/métodos , Adolescente , Adulto , Idoso , Neoplasias do Ventrículo Cerebral/diagnóstico por imagem , Neoplasias do Ventrículo Cerebral/patologia , Plexo Corióideo/diagnóstico por imagem , Feminino , Humanos , Masculino , Meningioma/diagnóstico por imagem , Meningioma/patologia , Pessoa de Meia-Idade , Estudos Retrospectivos , Tomografia Computadorizada por Raios X , Resultado do Tratamento , Adulto Jovem
6.
Clin Neuropathol ; 38(4): 180-188, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30900987

RESUMO

INTRODUCTION: Rosette-forming glioneuronal tumors (RGNT) and papillary glioneuronal tumors (PGNT) account for < 1% of brain tumors. Genetic data regarding RGNT and PGNT is still evolving. We aimed to perform a detailed clinicopathological analysis on rosette-forming and papillary glioneuronal tumors and to evaluate these for common, known genetic mutations. MATERIALS AND METHODS: Our cohort consisted of 6 cases of these rare glioneuronal tumors diagnosed over a period of 5 years. IDH1, ATRX, p53, and BRAF V600E mutations were evaluated on immunohistochemistry, and cases of RGNT were screened for the mutations in PIK3CA gene at hotspots exon 4, 9, and 20. RESULTS AND CONCLUSIONS: Our findings confirm the presence of PIK3CA gene mutations in RGNT along with two novel mutations in PIK3CA gene, of which one is proposed to be of prognostic significance.
.


Assuntos
Neoplasias Encefálicas/patologia , Neoplasias do Ventrículo Cerebral/patologia , Neoplasias Neuroepiteliomatosas/patologia , Patologia Molecular , Adulto , Neoplasias Encefálicas/diagnóstico , Neoplasias do Sistema Nervoso Central/diagnóstico , Neoplasias do Sistema Nervoso Central/patologia , Neoplasias do Ventrículo Cerebral/diagnóstico , Feminino , Humanos , Imuno-Histoquímica/métodos , Masculino , Mutação/genética , Neoplasias Neuroepiteliomatosas/diagnóstico , Patologia Molecular/métodos , Prognóstico , Formação de Roseta/métodos , Adulto Jovem
7.
World Neurosurg ; 126: e208-e218, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30797910

RESUMO

OBJECTIVE: Frame-based stereotaxy represents the gold standard for biopsy of deep-seated lesions. Visual control of possible bleeding in these lesions is not possible. Neuroendoscopic biopsy represents an alternative procedure for tissue sampling in deep-seated intraventricular lesions. The authors present a technique for transventricular-navigated endoscopic biopsy of lesions that are located in the paraventricular region. METHODS: Biopsy of paraventricular pathologies was performed in 6 male and 6 female patients between March 2013 and September 2018. The patient age ranged from 18 to 82 years. All patients underwent a pure endoscopic procedure over a burr hole trepanation supported by frameless navigation of the sedan probe. RESULTS: Histologic diagnoses were established in all biopsies. In all patients, a direct control of the biopsy area was feasible, and hemostasis could be obtained. In 5 patients, endoscopic third ventriculostomy was performed first due to obstructive hydrocephalus. In 1 patient suffering from obstructive hydrocephalus, a pellucidotomy was performed. In 9 cases, the initial postoperative course was uneventful. Three patients suffered from persistent hydrocephalus and had to be treated with ventriculoperitoneal shunt insertion. CONCLUSIONS: Endoscopically conducted biopsies with the aid of navigated tracking of the probe represent a possible additional technique in selected paraventricular intraparenchymal pathologies. The endoscopic approach enables the direct visualization of the intraventricular surface and its vessels. In contrast to standard stereotactic biopsy, direct visual control of hemostasis can be obtained even in paraventricular tumors.


Assuntos
Biópsia por Agulha/métodos , Neoplasias do Ventrículo Cerebral/patologia , Neuroendoscopia/métodos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Biópsia por Agulha/instrumentação , Neoplasias do Ventrículo Cerebral/diagnóstico , Feminino , Humanos , Hidrocefalia/patologia , Hidrocefalia/cirurgia , Masculino , Pessoa de Meia-Idade , Neuroendoscopia/instrumentação , Neuronavegação/instrumentação , Neuronavegação/métodos , Procedimentos Neurocirúrgicos/instrumentação , Procedimentos Neurocirúrgicos/métodos , Técnicas Estereotáxicas , Terceiro Ventrículo/patologia , Terceiro Ventrículo/cirurgia , Trepanação , Derivação Ventriculoperitoneal , Ventriculostomia , Adulto Jovem
8.
J Neurooncol ; 141(2): 363-371, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30392089

RESUMO

BACKGROUND: The trans-eyebrow supraorbital keyhole approach, a minimal transcranial approach, has been widely used in different types of surgery for sellar and parasellar lesions. In this study, we investigated the outcome of this approach in the surgical treatment of suprasellar and third ventricular craniopharyngioma. METHODS: Twenty-seven patients with suprasellar and third ventricular craniopharyngioma underwent surgery via a supraorbital approach between June 2007 and June 2018. The medical data and follow-up results were retrospectively analyzed. RESULTS: All tumors were located in the suprasellar region and the third ventricle. The mean tumor size was 29.1 mm. The mean follow-up period was 49.6 months. Gross total resection (GTR) was achieved in 23 patients (85.2%). Of 17 patients with preoperative visual impairment, 12 patients (70.6%) showed improvement. Following surgery, 11 patients exhibited new-onset anterior hypopituitarism, ten developed diabetes insipidus, and two became overweight. One residual tumor relapsed 1 year after surgery. No perioperative death, cerebrospinal fluid (CSF) rhinorrhea, or meningitis occurred. All patients exhibited satisfactory cosmetic results. At the last follow-up, the Extended Glasgow Outcome Scale Score was 8 in 25 patients (92.6%). CONCLUSION: The supraorbital trans-eyebrow keyhole approach is characterized by minimal invasion and a satisfactory cosmetic outcome. According to our experience, craniopharyngiomas located in the suprasellar region and the third ventricle can be safely resected via a trans-eyebrow supraorbital keyhole approach.


Assuntos
Neoplasias do Ventrículo Cerebral/cirurgia , Craniofaringioma/cirurgia , Órbita/cirurgia , Neoplasias Hipofisárias/cirurgia , Adolescente , Adulto , Idoso , Neoplasias do Ventrículo Cerebral/patologia , Criança , Pré-Escolar , Craniofaringioma/patologia , Craniotomia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias Hipofisárias/patologia , Resultado do Tratamento , Adulto Jovem
9.
World Neurosurg ; 131: e1-e11, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-30500581

RESUMO

OBJECTIVE: Lateral intraventricular anaplastic meningiomas (LIAMs) are rare lesions. The aim of this study is to clarify clinical and radiologic characteristics and the optimal treatment strategies of LIAMs with long-term follow-up. METHODS: From September 2008 to September 2017, 5 patients with LIAM were enrolled in our study. The clinical profiles, radiologic features, treatment strategies, and outcomes were retrospectively analyzed. RESULTS: Five patients (all female; mean age, 48.8 years; range, 33-61 years) were included in this study. The most frequent symptoms were those related to increased intracranial pressure. Mean duration of symptoms was 6.7 months (range, 2 weeks-2 years). The average tumor size was 4.98 cm at the maximal diameter (range, 3.0-6.2 cm). All were confirmed with a diagnosis of anaplastic meningioma. Gross total resection was achieved in all 5 patients. All patients experienced improvement of symptoms. Recurrence and progression were identified in only 2 patients. At the last follow-up, the mean recurrence-free survival was 13 months (range, 7-21 months) and the mean overall survival was 16.25 months (range, 8-21 months). One patient was lost to follow-up. CONCLUSIONS: Female and right trigone area predominance were found in our case series. Shorter duration of symptoms, irregular tumor shape, peritumoral edema, and heterogeneous enhancement may indicate an aggressive feature. Maximal safe resection followed by radiation therapy may be the best strategy for patients with LIAM. Long-term clinical follow-up and serial imaging are recommended.


Assuntos
Neoplasias do Ventrículo Cerebral/cirurgia , Ventrículos Laterais/cirurgia , Neoplasias Meníngeas/cirurgia , Meningioma/cirurgia , Adulto , Anaplasia , Neoplasias do Ventrículo Cerebral/diagnóstico por imagem , Neoplasias do Ventrículo Cerebral/patologia , Intervalo Livre de Doença , Feminino , Humanos , Ventrículos Laterais/diagnóstico por imagem , Masculino , Neoplasias Meníngeas/diagnóstico por imagem , Neoplasias Meníngeas/patologia , Meningioma/diagnóstico por imagem , Meningioma/patologia , Pessoa de Meia-Idade , Complicações Pós-Operatórias/epidemiologia , Prognóstico , Radioterapia Adjuvante , Fatores de Tempo , Carga Tumoral
10.
Br J Neurosurg ; 33(3): 261-263, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-28497995

RESUMO

Our case report involves a Chinese patient who was presented to our hospital with the chief complaint of dizziness and double vision for one week. He was diagnosed with small cell carcinoma of lung in the past. The patient undertook various test at our hospital. His MR scan revealed an intraventricular metastasis from small cell carcinoma of lung which is very rare. We have analyzed the clinical data of this patient and related literature. We report this case to increase the awareness of this rare metastasis of small cell carcinoma of lung.


Assuntos
Carcinoma de Células Pequenas/secundário , Neoplasias do Ventrículo Cerebral/secundário , Neoplasias Pulmonares/patologia , Encéfalo/diagnóstico por imagem , Carcinoma de Células Pequenas/patologia , Neoplasias do Ventrículo Cerebral/patologia , Neoplasias do Ventrículo Cerebral/cirurgia , Humanos , Imagem por Ressonância Magnética , Masculino , Meningioma/patologia , Pessoa de Meia-Idade , Metástase Neoplásica
11.
Br J Neurosurg ; 33(5): 581-583, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-28992740

RESUMO

Subependymomas are rare benign tumours arising from subependymal glial precursors that usually remain asymptomatic or may present due to obstruction of cerebrospinal fluid pathways. We describe the first report of intraventricular haemorrhage from subependymoma and cavernous-like malformation collision tumour in a 74-year-old male presented with an impaired level of consciousness.


Assuntos
Malformações Vasculares do Sistema Nervoso Central/complicações , Neoplasias do Ventrículo Cerebral/complicações , Glioma Subependimal/complicações , Idoso , Hemorragia Cerebral/complicações , Hemorragia Cerebral/patologia , Neoplasias do Ventrículo Cerebral/patologia , Neoplasias do Ventrículo Cerebral/cirurgia , Craniotomia/métodos , Glioma Subependimal/cirurgia , Humanos , Ventrículos Laterais/patologia , Imagem por Ressonância Magnética , Masculino , Acidente Vascular Cerebral/etiologia , Acidente Vascular Cerebral/patologia , Inconsciência/etiologia
12.
World Neurosurg ; 122: 441-450, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30448577

RESUMO

Different tumors can be encountered in the paraventricular regions, and whereas their deep location often make them difficult to access surgically, they may be amenable to chemotherapy and/or radiotherapy. Therefore, tumor biopsy and histologic diagnosis are mandatory to optimize treatment. Different technical procedures have been recommended; the neuroendoscopic approach is accepted and widely used, in particular with an enlarged ventricular system. However, specifically with paraventricular tumors, tissue sampling may be challenging. In such a scenario, the use of intraoperative ultrasonography technique can add some advantages regarding diagnostic accuracy and procedure safety. Accordingly, in this study we describe a novel technical procedure in 7 selected patients in whom tumor tissue biopsy was performed in a coupled neuroendoscopic and ultrasound-guided environment. We define a neuroendoscopic intraoperative ultrasound technique. The main advantages of this technique are the identification of the tumor that may not been clearly identified underneath the ventricular ependymal through the neuroendoscopic window alone, and furthermore, that this technique gives the possibility to detect the depth of the needle advance∖ment in the selected tissue while labeling the lesion beneath the ventricular ependyma. Moreover, intraoperative ultrasonography can reveal in a real-time fashion intracranial hemorrhages that may occur after tissue biopsy, therefore providing a useful tool to achieve valid and directed hemostasis when needed.


Assuntos
Biópsia/métodos , Neoplasias do Ventrículo Cerebral/diagnóstico , Neoplasias do Ventrículo Cerebral/cirurgia , Neuroendoscopia/métodos , Ultrassonografia de Intervenção/métodos , Ventriculostomia/métodos , Adulto , Neoplasias do Ventrículo Cerebral/patologia , Feminino , Seguimentos , Glioma/diagnóstico , Glioma/patologia , Glioma/cirurgia , Humanos , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias , Estudos Retrospectivos , Adulto Jovem
13.
J Neuropathol Exp Neurol ; 78(2): 187-190, 2019 02 01.
Artigo em Inglês | MEDLINE | ID: mdl-30561708

RESUMO

Rare pilocytic astrocytomas (PA) have been described to arise in the ventricles of children. They are even less common in this location for the adult population. We present the case of a 44-year old man presenting with vision and mental status changes. Brain imaging revealed an intraventricular mass within the right ventricular atrium, most consistent with a meningioma. Microscopic examination revealed a neoplasm composed of elongated to plump bipolar astrocytes arranged in a fascicular architecture, accompanied by foci containing numerous Rosenthal fibers. By immunohistochemistry, the tumor cells were positive for vimentin and glial fibrillary acid protein, whereas negative for epithelial membrane antigen. Isocitrate dehydrogenase 1 (R132H) was also negative. By fluorescence in situ hybridization, we detected a KIAA1549/BRAF fusion gene. These findings supported the diagnosis of intraventricular PA arising in an adult.


Assuntos
Astrocitoma/genética , Astrocitoma/patologia , Neoplasias do Ventrículo Cerebral/genética , Neoplasias do Ventrículo Cerebral/patologia , Proteínas de Fusão Oncogênica/genética , Adulto , Humanos , Masculino
15.
Pediatr Neurosurg ; 53(6): 401-406, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30391955

RESUMO

Choroid plexus papilloma (CPP) is a rare benign tumor of the central nervous system. Bilateral lateral ventricle CPP is extremely uncommon. In this case report, we described a case of bilateral lateral ventricle CPP in a 4-month-old female patient conceived by in vitro fertilization (IVF). Neurological examination and imaging were performed. In neurological examination, meningeal irritation signs and sunset phenomenon were positive. Brain computed tomography (CT) and magnetic resonance imaging (MRI) displayed masses located in the trigone of the bilateral lateral ventricle with hydrocephalus. Contrast-enhanced MRI showed intense homogeneous enhancement. The diagnoses of bilateral lateral ventricle CPP related to hydrocephalus and extravasation of cerebrospinal fluid (CSF) were made. Repeated surgical procedures via parietotemporal craniotomy were performed, and the diagnosis was confirmed by histopathology examination. The patient presented with delayed development during a follow-up period of 1 year. In conclusion, imaging is an effective approach of investigation. CPP could be highly suspected according to the features of hydrocephalus, lobulated appearance, and homogeneous enhancement on imaging. Total surgical removal is a valid curative method for CPP.


Assuntos
Neoplasias do Ventrículo Cerebral/cirurgia , Ventrículos Laterais/diagnóstico por imagem , Ventrículos Laterais/patologia , Papiloma do Plexo Corióideo/diagnóstico por imagem , Papiloma do Plexo Corióideo/patologia , Neoplasias do Ventrículo Cerebral/patologia , Feminino , Fertilização In Vitro , Humanos , Hidrocefalia/líquido cefalorraquidiano , Hidrocefalia/patologia , Hidrocefalia/cirurgia , Lactente , Ventrículos Laterais/cirurgia , Imagem por Ressonância Magnética , Papiloma do Plexo Corióideo/cirurgia , Tomografia Computadorizada por Raios X
16.
Clin Imaging ; 52: 226-239, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30138862

RESUMO

The MRI appearance of intraventricular neoplasms is often nonspecific, however knowledge of patient age and tumor location facilitates the formulation of a differential diagnosis. Imaging and pertinent clinical features of the following intraventricular neoplasms are reviewed: ependymoma, subependymoma, central neurocytoma, subependymal giant cell tumor, choroid plexus tumors, medulloblastoma, meningioma, chordoid glioma, rosette-forming glioneuronal tumor, central nervous system lymphoma, and metastasis.


Assuntos
Neoplasias do Ventrículo Cerebral/diagnóstico por imagem , Glioma/diagnóstico por imagem , Imagem por Ressonância Magnética , Neoplasias Meníngeas/diagnóstico por imagem , Meningioma/diagnóstico por imagem , Neoplasias do Ventrículo Cerebral/patologia , Diagnóstico Diferencial , Ependimoma , Glioma/patologia , Humanos , Neoplasias Meníngeas/patologia , Meningioma/patologia
17.
World Neurosurg ; 120: 372-381, 2018 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-30144612

RESUMO

BACKGROUND: Primary intracranial squamous cell carcinoma (PISCC) is extremely rare, and most cases are caused by malignant changes in an epidermoid cyst or a dermoid cyst. We report a case of intracranial squamous cell carcinoma (SCC) that arose without a preexisting tumor. In addition, the literature on PISCC is reviewed. CASE DESCRIPTION: A 20-year-old man presented with a 4-day history of headache. Magnetic resonance imaging of the brain showed a heterogeneous and irregularly marginated solid-cystic lesion in the left lateral ventricle, which enhanced dramatically. The patient underwent removal of the lesion, and a postoperative histologic examination showed SCC. The patient did not undergo postoperative radiotherapy and was admitted to the hospital again 40 days later because of dizziness, right lower extremity pain, and difficulty in bending. Computed tomography showed hydrocephalus. The cerebrospinal fluid examination confirmed an intracranial infection. The patient was discharged after treatment. The patient survived for 9 months from the onset of the disease. CONCLUSIONS: Most cases of PISCC arise from the malignant transformation of epidermoid cysts. However, SCC arising de novo is even less common. Although rare, the malignant transformation of intracranial epithelial cysts has a poor prognosis. Future prospective trials are necessary to evaluate the optimal treatment modality for patients with PISCC.


Assuntos
Carcinoma de Células Escamosas/cirurgia , Neoplasias do Ventrículo Cerebral/cirurgia , Ventrículos Laterais/cirurgia , Biomarcadores Tumorais/análise , Carcinoma de Células Escamosas/diagnóstico por imagem , Carcinoma de Células Escamosas/patologia , Neoplasias do Ventrículo Cerebral/diagnóstico por imagem , Neoplasias do Ventrículo Cerebral/patologia , Craniotomia , Humanos , Imuno-Histoquímica , Ventrículos Laterais/diagnóstico por imagem , Ventrículos Laterais/patologia , Imagem por Ressonância Magnética , Masculino , Adulto Jovem
19.
Neuropathology ; 38(5): 542-548, 2018 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-30039530

RESUMO

Central neurocytoma is a rare neuronal tumor that typically occurs in young adults. Infrequently, these tumors exhibit advanced neuronal maturation and glial differentiation, giving rise to a histologically diverse tumor, in contrast to a typical central neurocytoma. We present a novel case of intraventricular central neurocytoma with prominent gangliogliomatous differentiation that developed atypical features upon recurrence after 10 years of follow up in a 10-year-old boy. Our case provides insight into the divergent differentiation capability of a neurocytic tumor and illustrates the diverse histological features of this rare entity.


Assuntos
Neoplasias do Ventrículo Cerebral/patologia , Ganglioglioma/patologia , Recidiva Local de Neoplasia/patologia , Neurocitoma/patologia , Diferenciação Celular , Criança , Seguimentos , Humanos , Masculino , Adulto Jovem
20.
J Neurosurg Pediatr ; 22(4): 393-396, 2018 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-29957141

RESUMO

Craniopharyngiomas frequently recur locally or less commonly along the path of prior resection. Ectopic recurrence is rare, although cases are reported along the neuraxis spanning from the subgaleal space down to the S1 nerve root. This case reports on a girl with a history of craniopharyngioma first resected at 23 months of age with two local suprasellar recurrences managed with repeat craniotomy and external beam radiation therapy. At age 14 she complained of worsening headaches and brain MRI demonstrated an enhancing 1.2-cm cystic lesion in the posterior body of the left lateral ventricle. Pathology following endoscopic resection of the lesion was consistent with an adamantinomatous craniopharyngioma. This case report serves to describe the first reported recurrence of a craniopharyngioma in the lateral ventricle and emphasizes the need for a high index of suspicion along with long-term follow-up of patients with a history of craniopharyngioma.


Assuntos
Neoplasias do Ventrículo Cerebral/patologia , Craniofaringioma/patologia , Recidiva Local de Neoplasia/patologia , Neoplasias Hipofisárias/patologia , Adolescente , Criança , Pré-Escolar , Feminino , Humanos
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