RESUMO
Haemangiomas are rare benign tumors developing in cutaneous tissue and sometimes even in deep tissues. The existing literature reviewed, focusing on patients' age and gender, clinical features, diagnostics used, treatment, and, where available, follow-up data. Our review is the largest available at present time, including an additional case with a total of 41 patients.
Assuntos
Hemangioma , Hemangioma/diagnóstico por imagem , Hemangioma/cirurgia , Humanos , Nervos PeriféricosRESUMO
INTRODUCTION: Encephalocele is a rare congenital malformation of the central nervous system with protrusion of cranial content (meninges, brain, and ventricles in different combinations) beyond the normal confines of the skull. Anterior encephaloceles occur with a high frequency in Southeast Asia, while in the Western countries occipital encephaloceles prevail. The treatment of an anterior (naso-ethmoidal) encephalocele involves a neurosurgeon or a multidisciplinary team (neurosurgeon, maxillofacial surgeon, plastic surgeon, and ENT surgeon) dealing with craniofacial surgery. Goals of surgery include removal or repositioning of nonfunctional cerebral tissue, closure of the dura, and reconstruction of skeletal and cutaneous structures. The prognosis depends from the anatomical site, volume of neural contents, and the presence of coexisting malformations. CASE REPORT: We report the case of an Italian child suffering from a naso-ethmoidal encephalocele with bilateral orbital extension. The surgical treatment was performed in two steps. CONCLUSION: Sincipital encephalocele is a complex pathology without a unique standardized surgical treatment. Its low incidence in Western countries can make its management particularly tricky.
Assuntos
Encefalocele/congênito , Encefalocele/patologia , Encefalocele/cirurgia , Feminino , Humanos , Recém-Nascido , Itália , Imageamento por Ressonância Magnética , Procedimentos Neurocirúrgicos/métodos , Órbita/patologia , Procedimentos de Cirurgia Plástica , Crânio/anormalidades , Tomografia Computadorizada por Raios XRESUMO
BACKGROUND: Pituicytomas are rare low-grade glial neoplasms originating in the neurohypophysis or infundibulum that appear as solid, noninfiltrative masses occupying the sella turcica, the suprasellar space or both. Due to their high tendency to bleed and the possible firmness and adhesion to surrounding structures, preoperative diagnosis of pituicytoma is a goal for the surgeon, but it is actually a challenge because of the absence of distinctive clinical or neuroradiological findings. METHODS: We report the new cases of three patients who underwent transsphenoidal surgery for suspected pituitary adenomas, which were determined to be pituicytomas at histological and immunohistochemical analysis. We also review previously reported cases of pituicytoma in the literature. RESULTS: To date, 51 cases of pituicytoma have been reported in addition to our own cases. The natural history and clinical characteristics of this rare tumor are outlined. CONCLUSIONS: Macroscopic aspects are variable, and final diagnosis is made from the typical histological and immunohistochemical pattern. The therapy of choice is gross total surgical resection since subtotal removal can lead to local regrowth, but the time to recurrence is unpredictable and highly variable. The role of adjuvant therapy is currently undefined.
Assuntos
Doenças da Hipófise/patologia , Doenças da Hipófise/cirurgia , Neuro-Hipófise/patologia , Neuro-Hipófise/cirurgia , Neoplasias Hipofisárias/patologia , Neoplasias Hipofisárias/cirurgia , Adulto , Idoso , Craniotomia/métodos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Doenças da Hipófise/diagnóstico por imagem , Neuro-Hipófise/diagnóstico por imagem , Neoplasias Hipofisárias/diagnóstico por imagem , RadiografiaRESUMO
Infantile myofibromatosis is a mesenchymal disorder of early childhood characterized by the formation of tumors in the skin, muscle, viscera, bone, and subcutaneous tissue. Although relatively rare overall, it represents the most common fibrous tumor of infancy. The etiology of this disorder is unknown. Infantile myofibromatosis can present as a solitary or multicentric form. With the multicentric form, bone is often involved, but solitary bone lesions account for only 10% of the cases. Imaging findings are not pathognomonic, and the differential diagnosis usually includes eosinophilic granuloma (Langerhans cell histiocytosis), osteomyelitis, metastasis, osteoblastoma, epidermoid cyst, hemangioma, fibrous dysplasia, fibrosarcoma, and meningioma. A histological pattern is typical, but there are no histopathological differences between the solitary and multicentric forms. Solitary lesions generally have a favorable prognosis if totally removed, with a 10% recurrence rate; incompletely resected lesions recur. We report the case of a 9-year-old boy who came to our attention with a solitary infantile myofibroma of the calvarium, appearing as a tight-elastic, lightly tender mass in the left frontal area, eroding both the inner and the outer tables. Histopathologically, the specimens showed a spindle-cell tumor with dense reticulin fiber network and expression of smooth muscle actin. Fifty-eight months MR follow-up after total removal showed no residual or relapse.
Assuntos
Neoplasias Ósseas/patologia , Miofibroma/patologia , Miofibromatose/patologia , Neoplasias Cranianas/patologia , Neoplasias Ósseas/cirurgia , Criança , Diagnóstico Diferencial , Histiocitose de Células de Langerhans/patologia , Humanos , Masculino , Neoplasias Meníngeas/patologia , Meningioma/patologia , Miofibroma/cirurgia , Miofibromatose/cirurgia , Neoplasias Cranianas/cirurgiaRESUMO
BACKGROUND: Osteoblastoma is a benign bone-forming tumor, sometimes locally invasive, that may involve any bone. The highest incidence is between 20 and 30 years of age, and there are no cases described in the elderly. METHODS: We report a case of an elderly patient with a lesion in the lumbar spine in which osteoblastoma diagnosis was made. CONCLUSIONS: Osteoblastoma is a rare tumor older than 50 years of age, but it should be considered in the differential diagnosis of bone lesions of the spine in adulthood and in the elderly, to avoid a delay in the treatment.