RESUMO
Fig A) Radiografía de cráneo en proyección lateral: se observan múltiples lesiones radiolúcidas distribuidas en todo el cráneo. B) Acercamiento donde se evidencian múltiples lesiones en sacabocado, compatibles con mieloma múltiple(AU)
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Humanos , Masculino , Feminino , Neoplasias Cranianas/diagnóstico por imagem , Mieloma Múltiplo/diagnóstico por imagemRESUMO
Objectives The present study aims to categorize the prevalence of intracranial tumors surgically treated at the neurosurgery service of Hospital Universitário Evangélico Mackenzie (HUEM) between 2016 and 2018. Material and Methods This survey included patients surgically treated due to primary or metastatic intracranial neoplasia between 2016 and 2018 at a referral center in the city of Curitiba. These patients were analyzed for epidemiological, histopathological, and topographic data, and they underwent an assessment of the outcome at the time of hospital discharge. Results Atotal of 96patientsmet the inclusion criteria. Themost prevalent tumorwas the glioma, with 39.6% of the sample, with glioblastoma being themost prevalent histological type. Brainmetastases andmeningiomas represented, respectively, 21.9%and 18.8%of the total. There was a predominance of supratentorial and intra-axial tumors in our sample. Conclusion Glioma was the most commonly found tumor, directly associated with high morbidity and mortality. The development of new and more effective drugs with action directed at themolecular level of intracranial tumorsmay be the path to a longer survival and improvement in the quality of life of these patients.
Assuntos
Neoplasias Cranianas/epidemiologia , Neoplasias Supratentoriais/epidemiologia , Glioblastoma/epidemiologia , Metástase Neoplásica/diagnóstico , Neoplasias Cranianas/cirurgia , Neoplasias Cranianas/fisiopatologia , Perfil de Saúde , Prontuários Médicos , Estudos Retrospectivos , Interpretação Estatística de Dados , Glioblastoma/mortalidadeRESUMO
Introduction: A giant cell tumor (GCT) is a rare tumor, usually benign, which can be locally aggressive, with an almost unknown incidence in the skull. Case report: Case report of a pediatric patient diagnosed with Ewing's sarcoma (ES) and later GCT when sought medical care for an increased volume in the zygomatic arch and the right preauricular region. Imaging exams showed an expansive lesion in the zygomatic and squamous portion of the right temporal bone, with an extradural intracranial component in the middle fossa, with no evidence of infiltration. From the anatomopathological view, fusocelullar neoplasia was seen. The CD68 marker was positive and the S100 marker was negative. Tumor resection by microsurgery was performed. The patient remains in follow-up, with imaging exams at neurosurgery and orthopedics, the latest magnetic resonances of the skull showing a reduction in the size of the lesion. In addition, the patient did not submit to adjuvant therapy and is currently without complaints. Conclusion: This is an important case due to its rarity and clinical data that contributes for the understanding of the pathologies presented, allowing that, in the future, new studies are able to optimize the treatment, and the prognosis for these patients
Introdução: O tumor de células gigantes (TCG) é raro, geralmente benigno, e pode ser localmente agressivo, com incidência quase desconhecida no crânio. Relato do caso: Paciente pediátrico com diagnóstico de sarcoma de Ewing (SE) e posteriormente de TCG, quando procurou atendimento médico por conta do aumento de volume em arco zigomático e região préauricular à direita. Os exames de imagem evidenciaram lesão expansiva em porção zigomática e escamosa do osso temporal à direita, com componente intracraniano extradural em fossa média, sem evidências de infiltração. Do ponto de vista anatomopatológico, observou-se neoplasia fusocelular. O marcador CD68 foi positivo e o marcador S100, negativo. Realizouse microcirurgia para ressecção do tumor. O paciente permanece em acompanhamento com exames de imagem nos serviços de neurocirurgia e ortopedia, com as últimas ressonâncias magnéticas de crânio mostrando redução no tamanho da lesão. Além disso, não realiza terapia adjuvante e atualmente não apresenta queixas. Conclusão: Este é um caso importante em razão da sua raridade e dos dados clínicos que agregam informações sobre as patologias apresentadas, permitindo que, no futuro, novas pesquisas possam otimizar o tratamento da referida neoplasia e o prognóstico desses pacientes
Introducción: El tumor de células gigantes (TCG) es un tumor raro, generalmente benigno, que puede ser localmente agresivo, con una incidencia casi desconocida en el cráneo. Relato del caso: Paciente pediátrico diagnosticado con sarcoma de Ewing (SE) y posteriormente con TCG, cuando procuró atención médica por aumento de volumen en arco cigomático y región preauricular derecha. Los exámenes de imagen mostraron una lesión expansiva en la porción cigomática y escamosa del temporal derecho, con componente intracraneal extradural en la fosa media, sin evidencias de infiltración. Desde el punto de vista anatomopatológico, se observó neoplasia fusocelular. El marcador CD68 fue positivo y el marcador S100 negativo. Se realizó microcirugía para resecar el tumor. El paciente permanece en seguimiento con exámenes de imagen en los servicios de neurocirugía y ortopedia, con las últimas resonancias magnéticas de cráneo mostrando una reducción en el tamaño de la lesión. Además, no se somete a terapia adyuvante y actualmente no tiene quejas. Conclusión: Este es un caso importante por su rareza y datos clínicos que agregan informaciones sobre las patologías presentadas, permitiendo, en el futuro, nuevas investigaciones para optimizar el tratamiento de la neoplasia referida, y el pronóstico de estos pacientes
Assuntos
Humanos , Masculino , Feminino , Pré-Escolar , Criança , Adolescente , Sarcoma de Ewing , Neoplasias Cranianas , Relatos de Casos , Tumor de Células Gigantes do Osso , Fossa Craniana MédiaRESUMO
Introduction Endolymphatic sac tumor (ELST) is a slow-growing, low-grade, locallyinfiltrative tumor arising from the endolymphatic sac/duct, which is located in the posterior part of the petrous temporal bone. It may be sporadic in origin, or may be associated with Von-Hippel Lindau (VHL) syndrome. Case description A 40-year-old female patient with an ELST without VHL syndrome who was treated successfully by microsurgical extirpation of the tumor. Discussion We discuss the radiological features and the histopathology of this rare tumor and review the relevant literature. Conclusion The case herein reported adds to the previously-reported cases of this rare tumor.
Assuntos
Humanos , Feminino , Adulto , Paraganglioma/cirurgia , Osso Petroso/cirurgia , Neoplasias Cranianas/cirurgia , Saco Endolinfático/cirurgia , Paraganglioma/diagnóstico , Complicações Pós-Operatórias , Neoplasias Cranianas/diagnóstico por imagem , Saco Endolinfático/patologia , Saco Endolinfático/diagnóstico por imagem , Craniotomia/métodos , Doença de von Hippel-Lindau/patologiaRESUMO
OBJECTIVE: To report the case of an infant with infrequent cranial osteomyelitis as a complication of furuncular myiasis. CASE DESCRIPTION: The patient was a 4-month-old male who presented to the emergency department with a nodular skull lesion with edema, tenderness, pain, and purulent drainage, as well as progress of the ulcerated lesion and evidence of larvae inside. Antibiotic treatment was initiated, and the patient was taken to the operating room to remove the larvae, but he had no symptomatic improvement. A skull radiograph was taken to visualize the osteolytic lesion, and a 3D computed tomography scan showed osteomyelitis of the external parietal surface. Antibiotic management readjustment continued for a total of six weeks, and a skin flap was used with clinical improvement. COMMENTS: Myiasis is defined as the infestation of vertebrates with fly larvae. In mammals, larvae can feed on host tissue and cause a wide range of infestations depending on their location in the body. The cranial osteomyelitis as a complication of myiasis described in this report seems to be an exceptional case.
Assuntos
Miíase/complicações , Miíase/parasitologia , Osteomielite/etiologia , Neoplasias Cranianas/parasitologia , Animais , Antibacterianos/administração & dosagem , Antibacterianos/uso terapêutico , Antibióticos Antituberculose/administração & dosagem , Antibióticos Antituberculose/uso terapêutico , Clindamicina/administração & dosagem , Clindamicina/uso terapêutico , Terapia Combinada , Seguimentos , Humanos , Imageamento Tridimensional/instrumentação , Lactente , Larva/parasitologia , Masculino , Miíase/diagnóstico , Osteomielite/diagnóstico por imagem , Osteomielite/tratamento farmacológico , Alta do Paciente/normas , Radiografia/métodos , Rifampina/administração & dosagem , Rifampina/uso terapêutico , Neoplasias Cranianas/patologia , Retalhos Cirúrgicos/transplante , Tomografia Computadorizada por Raios X/métodosRESUMO
Osteosarcoma is a bone cancer considered rare to humans, but common in dogs. Dogs and humans share genetic homology and environmental risk factors. Improving the treatment of osteosarcoma in dogs could also be relevant to improve procedures in humans. Traditional treatments of osteosarcoma involve surgery and chemotherapy. Such treatments are commonly aggressive and not possible for many patients. Electrochemotherapy emerges as a minimally invasive, effective, and safe treatment alternative. Electrochemotherapy combines applications of high-intensity electric fields during short periods with anti-cancer drugs to improve its medicine cytotoxicity. Analyzing the electric field distribution, as well as electric current density, are essential to electrochemotherapy success. This paper brings the first case of a canine osteosarcoma treatment performed with bleomycin and electrochemotherapy. We performed in silico studies with finite element method software to observe the electric field distribution. In silico experiments help to verify possibilities and limitations of treating bone destruction and macro or micro tumor infiltrations around the primary tumor mass. Results show that both needle or plate electrodes are feasible to remove the tumor even with invasion into the bone. Plate electrodes perform well in treating micro infiltrations when associated with conductive gel and direct contact between electrode and bone (without soft tissues). Needle electrodes are effective in treating tumor infiltration on external cortical bone. Multiple applications are needed to cover all cranium layers with sufficient electric field intensity. Electrochemotherapy protocol with needle or plate electrodes does not present sufficient electric current density capable of affecting brain tissue, even in cases of bone destruction.
Assuntos
Bleomicina/administração & dosagem , Procedimentos Cirúrgicos de Citorredução/métodos , Eletroquimioterapia/veterinária , Osteossarcoma/veterinária , Neoplasias Cranianas/veterinária , Animais , Quimioterapia Adjuvante/instrumentação , Quimioterapia Adjuvante/métodos , Quimioterapia Adjuvante/veterinária , Simulação por Computador , Cães , Eletroquimioterapia/instrumentação , Eletroquimioterapia/métodos , Eletrodos , Feminino , Modelos Biológicos , Osteossarcoma/terapia , Neoplasias Cranianas/terapiaRESUMO
ABSTRACT Objective: To report the case of an infant with infrequent cranial osteomyelitis as a complication of furuncular myiasis. Case description: The patient was a 4-month-old male who presented to the emergency department with a nodular skull lesion with edema, tenderness, pain, and purulent drainage, as well as progress of the ulcerated lesion and evidence of larvae inside. Antibiotic treatment was initiated, and the patient was taken to the operating room to remove the larvae, but he had no symptomatic improvement. A skull radiograph was taken to visualize the osteolytic lesion, and a 3D computed tomography scan showed osteomyelitis of the external parietal surface. Antibiotic management readjustment continued for a total of six weeks, and a skin flap was used with clinical improvement. Comments: Myiasis is defined as the infestation of vertebrates with fly larvae. In mammals, larvae can feed on host tissue and cause a wide range of infestations depending on their location in the body. The cranial osteomyelitis as a complication of myiasis described in this report seems to be an exceptional case.
RESUMO Objetivo: Relatar um caso de criança com osteomielite craniana infrequente como complicação da miíase furuncular. Descrição do caso: Paciente do sexo masculino, com quatro meses de idade, que se apresentou no pronto-socorro com lesão nodular no crânio com edema, sensibilidade, dor e drenagem purulenta, com evolução da lesão ulcerada e evidência de larva no interior. O tratamento com antibióticos foi iniciado e o paciente foi levado à sala de cirurgia para remover as larvas, mas não houve melhora. Uma radiografia do crânio foi realizada para visualizar a lesão osteolítica e uma tomografia computadorizada em 3D mostrou osteomielite da superfície parietal externa. O reajuste do tratamento com antibióticos foi mantido por um total de seis semanas e um retalho cutâneo foi realizado com melhora clínica. Comentários: Miíase é definida como a infestação de vertebrados com larvas de moscas. Nos mamíferos, as larvas podem se alimentar do tecido hospedeiro e causar uma ampla variedade de infestações, dependendo da sua localização no corpo. A osteomielite como complicação da miíase, apresentada nesse caso, parece ser uma forma não usual de complicação dessa doença.
Assuntos
Humanos , Animais , Masculino , Lactente , Osteomielite/etiologia , Neoplasias Cranianas/parasitologia , Miíase/complicações , Miíase/parasitologia , Osteomielite/tratamento farmacológico , Osteomielite/diagnóstico por imagem , Alta do Paciente/normas , Rifampina/administração & dosagem , Rifampina/uso terapêutico , Neoplasias Cranianas/patologia , Retalhos Cirúrgicos/transplante , Clindamicina/administração & dosagem , Clindamicina/uso terapêutico , Radiografia/métodos , Tomografia Computadorizada por Raios X/métodos , Seguimentos , Terapia Combinada , Imageamento Tridimensional/instrumentação , Larva/parasitologia , Antibacterianos/administração & dosagem , Antibacterianos/uso terapêutico , Antibióticos Antituberculose/administração & dosagem , Antibióticos Antituberculose/uso terapêutico , Miíase/diagnósticoRESUMO
Introduction: Burkitt's lymphoma is a non- Hodgkin B-cell lymphoma whose cranial location is extremely rare. Clinical case: The case of a 35-year-old Peruvian man with a progressive parietal left cranial tumor is described. A biopsy with immunohistochemistry was performed for the diagnostic confirmation of Burkitt's lymphoma. First-line outpatient treatment with CODOX-M/IVAC was initiated, however, he stopped attending his treatment for 2 months. He returns, he is shown progression of the disease and is treated with rituximab, ifosfamide carboplatin and etoposide. Does not respond satisfactorily and dies. Conclusions: Burkitt's lymphoma is a very aggressive tumor that, if not treated in a timely manner, has high mortality, as happened with the patient in the case.
Introducción: El linfoma de Burkitt es un linfoma no Hodgkin de células B cuya ubicación craneal es extremadamente rara. Caso clínico: Se describe el caso de un hombre peruano de 35 años con una tumoración craneal parietal izquierda de crecimiento progresivo. Para la confirmación diagnóstica de linfoma de Burkitt se realizó una biopsia con inmunohistoquímica. Se inició tratamiento ambulatorio de primera línea con CODOX-M/IVAC, sin embargo, deja de acudir a su tratamiento por 2 meses. Retorna, se le evidencia progresión de la enfermedad y se le trata con rituximab, ifosfamida carboplatino y etopósido. No responde de forma satisfactoria y fallece. Conclusiones: El Linfoma de Burkitt es un tumor muy agresivo que si no es tratado oportunamente presenta alta mortalidad, tal como ocurrió con el paciente del caso.
Assuntos
Linfoma de Burkitt/diagnóstico , Neoplasias Cranianas/diagnóstico , Adulto , Biópsia , Evolução Fatal , Humanos , Imageamento por Ressonância Magnética , MasculinoRESUMO
INTRODUCTION: Melanotic neuroectodermal tumor of infancy is a rare neoplasm mainly seen in children under 1 year of life. The most common location of the tumor is the maxilla followed by the cranial vault. Surgery is the treatment of choice and outcome mainly depends on extent of resection. OBJECTIVES: To report an atypical case of an 8-year-old patient with a melanotic neuroectodermal tumor of infancy, to review the cases with melanotic neuroectodermal tumor of infancy arising from the skull published over the last 13 years, and to provide a diagnostic approach that may allow recognition of a pattern in these rare neoplastic lesions. METHODS: A case is reported with a description of the clinical, radiological, surgical, and histopathological features. Additionally, the literature was reviewed to identify reports of patients with melanotic neuroectodermal tumor of infancy arising from the cranial vault and all cases published in PubMed over the last 13 years were included. Only studies that evaluated clinical, radiological, surgical, and histopathological findings were included. CONCLUSION: Melanotic neuroectodermal tumor of infancy is a rare entity that may present with unusual features, but nevertheless has an identifiable pattern that allows the tumor to be considered in the differential diagnosis of intracranial space-occupying lesions in children.
Assuntos
Tumor Neuroectodérmico Melanótico , Neoplasias Cranianas , Criança , Diagnóstico Diferencial , Humanos , Lactente , Tumor Neuroectodérmico Melanótico/diagnóstico por imagem , Tumor Neuroectodérmico Melanótico/cirurgia , Crânio , Neoplasias Cranianas/diagnóstico por imagem , Neoplasias Cranianas/cirurgiaRESUMO
Osteosarcoma of the skull is a rare primary malignant bone tumour in children, representing 1-2% of all cranial tumours. We describe a case of a 17-year-old adolescent with chondroblastic osteosarcoma of the parietal-occipital bone and no distant metastases at presentation treated with neoadjuvant chemotherapy, surgery and, later, concurrent chemoradiotherapy. The patient suffered progressive disease and died 15 months after diagnosis. There are at least 15 paediatric cases of osteosarcoma of the skull described in the literature. Due to its rarity, there are no broad prospective studies on this entity, which has distinctive features when compared to other craniofacial tumours, carrying a worse prognosis. Complete surgical resection is needed for long-term survival, whereas chemotherapy and radiotherapy have still questionable indications.
Assuntos
Osteossarcoma/terapia , Neoplasias Cranianas/terapia , Adolescente , Terapia Combinada , Diagnóstico Diferencial , Evolução Fatal , Humanos , Imageamento por Ressonância Magnética , Masculino , Osteossarcoma/diagnóstico por imagem , Neoplasias Cranianas/diagnóstico por imagemAssuntos
Constrição Patológica/complicações , Osteoma/complicações , Pseudotumor Cerebral/etiologia , Neoplasias Cranianas/complicações , Constrição Patológica/diagnóstico por imagem , Cavidades Cranianas , Diagnóstico Diferencial , Feminino , Humanos , Processo Mastoide , Pessoa de Meia-Idade , Osteoma/diagnóstico por imagem , Pseudotumor Cerebral/diagnóstico por imagem , Neoplasias Cranianas/diagnóstico por imagemRESUMO
BACKGROUND: As the management of ventral skull-base pathology has transitioned from open to endonasal treatment, there has been an increased focus on the prevention and endoscopic endonasal management of internal carotid artery (ICA) and major vascular injury. The use of adenosine to induce transient hypotension or flow arrest has been previously described during intracranial aneurysm surgery; however, there have been no reports of the technique being used during endonasal skull-base surgery to achieve hemostasis following major vascular injury. METHODS: Case report (n = 1) and literature review. RESULTS: A 25-year-old female underwent attempted endoscopic endonasal resection of an advanced right-sided chondrosarcoma. During resection of the tumor, brisk arterial bleeding was encountered consistent with focal injury to the right cavernous ICA. Stable vascular hemostasis could not be achieved with tamponade. An intravenous bolus dose of adenosine was administered to induce a transient decrease in systemic blood pressure and facilitate placement of the muscle patch over the direct site of vascular injury. The patient subsequently underwent endovascular deconstruction of the right ICA. CONCLUSION: This is the first reported use of adenosine to induce transient hypotension for a major vascular injury sustained during endonasal skull-base surgery. Based on well-established safety data from neurosurgical application, adenosine has the potential to be used as a safe and effective adjunctive technique in similar endonasal circumstances and may represent an additional tool in the armamentarium of the skull-base surgeon. Surgeons should consider having adenosine available when a risk of ICA injury is anticipated.
Assuntos
Adenosina/administração & dosagem , Lesões das Artérias Carótidas/prevenção & controle , Condrossarcoma/diagnóstico , Procedimentos Neurocirúrgicos/efeitos adversos , Complicações Pós-Operatórias/prevenção & controle , Base do Crânio/cirurgia , Neoplasias Cranianas/diagnóstico , Administração Intravenosa , Adulto , Lesões das Artérias Carótidas/etiologia , Condrossarcoma/cirurgia , Diplopia , Endoscopia , Feminino , Hemostasia , Humanos , Hipotensão Controlada/métodos , Período Perioperatório , Neoplasias Cranianas/cirurgia , Retalhos CirúrgicosRESUMO
BACKGROUND Intraosseous cavernous skull hemangiomas are rare benign vascular tumors that are usually found incidentally on imaging, with an asymptomatic and slow-growing course. We present a case in which the patient had a mass on her forehead for many years, which began to grow rapidly after head trauma. Imaging characteristics play a crucial role in the diagnosis and description of this disease, and in differentiating it from other more common calvarial lesions that may present with a similar clinical picture. Here, we report an unusual presentation of a large skull hemangioma and discuss the different radiologic imaging findings and pathologic correlations. CASE REPORT A 58-year-old female with history of a lump on her forehead since childhood, which began to grow rapidly after experiencing a closed-head injury. Due to its large size, she went on to seek further management. Radiologic images revealed a frontal skull lesion suggestive of an intraosseous hemangioma. She underwent embolization of the tumor, and 2 days later underwent bilateral frontal craniectomy and cranioplasty. Histopathologic findings confirmed this diagnosis. CONCLUSIONS Intraosseous skull hemangioma may be confidently diagnosed and differentiated from other skull lesions by its imaging characteristics. An accurate diagnosis is essential to selecting correct management and avoiding complications.
Assuntos
Hemangioma Cavernoso/diagnóstico por imagem , Hemangioma Cavernoso/patologia , Neoplasias Cranianas/diagnóstico por imagem , Neoplasias Cranianas/patologia , Feminino , Traumatismos Cranianos Fechados/complicações , Hemangioma Cavernoso/cirurgia , Humanos , Imageamento por Ressonância Magnética , Pessoa de Meia-Idade , Neoplasias Cranianas/cirurgia , Tomografia Computadorizada por Raios XRESUMO
Background: Multilobular tumor of bone (MTB) is a primary bone neoplasm, uncommon in dogs. This tumor was called ofmany names for a long time, as: chondroma rodens, multilobular osteochondrosarcoma, multilobular osteoma, multilobularchondroma, calcificating aponeurotic fibroma, although MTB was preferred chosen, because these other name could becorrelated with humans tumors. This tumor is observed specially in skull bone, although it was reported in zygomaticarc, hard palate, axilla, spine and penis. Mostly happen in big breeds dogs, and middle to old age patients. Clinical signsdepending of region and how aggressive the tumor is, usually are related to compression of any structure. The growth ofMTB is frequently slow and progressive, locally invasive, occurring relapse after surgical revomal, although the tumorhas low to moderate metastatic potential. The aim of this study is to report a case of MTB in a female dog and describeanatomopathological changes.Case: A female dog, mixed breed, 13 year-old, of middleweight was admitted in Pathology Department of College of Agricultural Sciences and Veterinary Medicine (FCAV-Unesp), Campus of Jaboticabal - SP, to be undergone to necropsy. Thepatient have never shown any epileptic crisis or neurologic signs. In macroscopic examination was found a mass in skull,which invaded the orbit and frontal sinus, but it was not invading brain cavity. The neoplasm had and irregular surface, firmconsistent, color was white mixed to red areas, after cut it was granular and rough, and had some point mineralized areas.The lobs of lung had much firm masses, colored gray to white. In cytology it was observed fusiform to polyhedric isolatedmesenchymal cells, moderated pleomorphic, basophilic cytoplasm, thin granulated nuclear chromatin, and visible nucleolithat was involved by eosinophilic extracellular matrix...(AU)
Assuntos
Animais , Feminino , Cães , Neoplasias Ósseas/veterinária , Neoplasias Cranianas/veterináriaRESUMO
Background: Multilobular tumor of bone (MTB) is a primary bone neoplasm, uncommon in dogs. This tumor was called ofmany names for a long time, as: chondroma rodens, multilobular osteochondrosarcoma, multilobular osteoma, multilobularchondroma, calcificating aponeurotic fibroma, although MTB was preferred chosen, because these other name could becorrelated with humans tumors. This tumor is observed specially in skull bone, although it was reported in zygomaticarc, hard palate, axilla, spine and penis. Mostly happen in big breeds dogs, and middle to old age patients. Clinical signsdepending of region and how aggressive the tumor is, usually are related to compression of any structure. The growth ofMTB is frequently slow and progressive, locally invasive, occurring relapse after surgical revomal, although the tumorhas low to moderate metastatic potential. The aim of this study is to report a case of MTB in a female dog and describeanatomopathological changes.Case: A female dog, mixed breed, 13 year-old, of middleweight was admitted in Pathology Department of College of Agricultural Sciences and Veterinary Medicine (FCAV-Unesp), Campus of Jaboticabal - SP, to be undergone to necropsy. Thepatient have never shown any epileptic crisis or neurologic signs. In macroscopic examination was found a mass in skull,which invaded the orbit and frontal sinus, but it was not invading brain cavity. The neoplasm had and irregular surface, firmconsistent, color was white mixed to red areas, after cut it was granular and rough, and had some point mineralized areas.The lobs of lung had much firm masses, colored gray to white. In cytology it was observed fusiform to polyhedric isolatedmesenchymal cells, moderated pleomorphic, basophilic cytoplasm, thin granulated nuclear chromatin, and visible nucleolithat was involved by eosinophilic extracellular matrix...
Assuntos
Feminino , Animais , Cães , Neoplasias Cranianas/veterinária , Neoplasias Ósseas/veterináriaRESUMO
The case of a 27-year-old Hispanic female who presented with an occipito-parietal tumor after suffering trauma to the area. A physical examination revealed no tenderness to palpation and with evidence of healing ulcerations. The biopsy was consistent with a synovial sarcoma. A wide excision of the mass (15cm x 14cm x 6cm) followed by a pericranial flap was performed. A follow-up CT showed recurrence involving the parietal sagittal sinus. After a second biopsy the mass was determined to be a small-cell sarcoma, consistent with Ewing's sarcoma. Chemotherapy included 8 cycles of doxorubicin, vincristine, and cyclophosphamide, with alternating cycles of etoposide and ifosfamide. A year later, a second wide excision of the mass was performed, followed by bilaminate skin substitute and skin graft placement for reconstruction of the soft-tissue defect. After chemotherapy, a follow-up PET scan showed no signs of re-uptake in any soft tissue or skeletal structures. After 2 years, the patient remains in complete remission.
Assuntos
Sarcoma de Ewing , Neoplasias Cranianas , Adulto , Feminino , Humanos , Sarcoma de Ewing/diagnóstico , Sarcoma de Ewing/terapia , Neoplasias Cranianas/diagnóstico , Neoplasias Cranianas/terapiaRESUMO
El carcinoma epidermoide del hueso temporal es una neoplasia derivada de células epidérmicas del estrato espinoso, y que dado su baja incidencia, y presentación clínica similar a un cuadro de otitis media crónica colesteatomatosa, su diagnóstico es habitualmente tardío. El estudio del carcinoma epidermoide del hueso temporal se realiza con tomografía computarizada, la que evidencia erosión ósea. Sin embargo, existen distintos diagnósticos diferenciales, tanto malignos como benignos, que pueden provocar hallazgos similares en la tomografía computarizada. La resonancia magnética (RM) es un método de exploración de gran valor complementario para el estudio del carcinoma de oído medio. La RM con secuencia de difusión HASTE ha surgido como herramienta de estudio en patología de hueso temporal, tales como colesteatomas y teratomas de oído medio, pese a esto, no existen reportes en la literatura de la presentación imagenológica del carcinoma epidermoide de hueso temporal utilizando este método. En este artículo se presenta un caso clínico de una paciente con carcinoma epidermoide de oído medio, cuyo estudio preoperatorio incluyó RM-HASTE. Aun cuando se requiere un mayor número de casos para establecer el patrón imagenológico, se concluye que esta técnica es de utilidad para diferenciar este tumor de otitis media crónica colesteatomatosa.
Squamous cell carcinoma of the temporal bone (SCC) is a malignancy originated from epidermis spinous cells. Its low incidence and similar presentation to cholesteatomas, contributes to its late diagnosis. The most widely used study for this tumor is computed tomography (CT), which mainly evidences erosion of the temporal bone. There are several other diagnoses, malignant and benign, that could provoke similar findings at the CT. Magnetic resonance imaging (MRI) is a method of great value to study SCC. MRI with HASTE diffusion sequence has recently emerged as an important tool in the study of temporal bone pathologies, such as cholesteatoma and middle ear teratoma, despite this, there are no reports in the literature of the imaging presentation of SCC using this method. This article presents a clinical case of a patient with SCC, in whose preoperative study was performed HASTE-MRI. Although a larger number of cases are required to establish an imaging pattern, it is concluded that this technique is useful to differentiate this tumor from middle ear cholesteatomas.