Cerebellar liponeurocytoma with an unusually aggressive clinical course: case report.

OBJECTIVE AND IMPORTANCE: Liponeurocytomas are rare cerebellar neoplasms in adults, with benign histological features and a favorable clinical prognosis. Current clinical opinion is based on a total of less than 20 published cases and suggests that gross total resection and long-term follow-up monitoring, with possible additional surgery and radiotherapy for treatment of recurrent tumors, represent the best treatment approach for this relatively benign tumor type. CLINICAL PRESENTATION: A 51-year-old Caucasian woman presented with worsening unsteady gait and headaches, suggesting increased intracranial pressure. INTERVENTION: The patient underwent subtotal resection of a cerebellar liponeurocytoma, followed by fractionated radiotherapy (total dose of 54 Gy). She experienced a local recurrence of the tumor 12 months later and underwent additional surgery for removal of the cerebellar mass. A second recurrent tumor was diagnosed on magnetic resonance imaging scans 3 months later and was surgically resected. The tumor histological findings were consistently devoid of atypical features, apart from leptomeningeal invasion noted in the first surgical specimen. CONCLUSION: This unusual case demonstrated an atypical clinical course of a highly aggressive and radiation-resistant tumor, despite the consistent absence of aggressive histological features. Cerebellar liponeurocytomas may not be as benign as the current literature and typical low-grade cytological and histological features suggest.

Cerebral oedema following EVD insertion for delayed hydrocephalus after foramen magnum decompression in Chiari I malformation.

CASE REPORT: A case of Chiari I malformation is reported, in which foramen magnum decompression was followed by delayed onset of acute hydrocephalus after a week. Initial treatment of the hydrocephalus was further complicated by severe cerebral oedema. DISCUSSION: A short survey of the literature suggests that both complications are extremely uncommon. The possible mechanism of development of cerebral oedema through stretch of the cerebral vasculature before ventricular decompression is discussed. This report further adds to the list of complications following surgery for Chiari malformations.

Thoracolumbar teratoma associated with meningomyelocele: common aetiology or coincidence?

INTRODUCTION: The association of teratoma and neural tube defects is very rare. CASE REPORT AND DISCUSSION: A case of teratoma resembling bowel within a meningomyelocele is presented and the literature reviewed. CONCLUSION: The hypotheses of a possible common aetiology for this association include a single dysembryogenic process and neoplastic transformation of heterotopic primordial elements incorporated in the defect.