Tumoral form of cerebral schistosomiasis mansoni. A report of four cases and a review of the literature.

We describe four cases of the tumoral form of cerebral schistosomiasis mansoni. The patients had symptoms of increased intracranial pressure and focal neurological signs that varied according to the site of the lesion. Computerized tomography showed a hyperdense, enhancing lesion located in the cerebellum (2 patients), frontal lobe and thalamus (1 patient), and temporal subdural region (1 patient), with associated mass effects. The lesion was resected in three patients and a stereotactic biopsy was performed in one. Histopathologic specimens of all four patients revealed multiple schistosomal granulomas in various evolutive phases. Two of these patients differ from previously described cases; one because of the subdural location of the lesion, mimicking a meningioma, and the other one because two lesions were present.

Giant posterior cerebral artery aneurysm in a 4-year-old child: case report.

Posterior cerebral artery aneurysms in children aged 5 years or less are very rare. We were able to find only 10 cases previously described in the literature. We present a case of giant bilobulated aneurysm of the distal right posterior cerebral artery in a 4-year-old child with an initial history of spontaneous subarachnoid hemorrhage. The aneurysm was clipped and the patient had full recovery. Based on the literature review, we discuss the characteristics of these rare aneurysms, making a comparison with different age groups.

Congenital inclusion cysts of the anterior fontanelle.

BACKGROUND: Congenital inclusion cysts of the anterior fontanelle are rare lesions. Both dermoid and epidermoid cysts are located in the midline of the scalp and occupy the subgaleal space. METHODS: We report 7 cases, 4 boys (57.1%), and 3 girls (42.9%), with ages ranging from 3 months to 16 years (mean 40.85 +/- 68.56 months; median 10 months). Four patients (57.1%) were white and 3 (42.9%) were Afro-Brazilian. RESULTS: The cysts had manifested soon after birth in all patients. They gradually enlarged, with no intracranial extensions. Four patients had dermoid cysts and the others had epidermoid cysts. All of them underwent surgery with complete excision of the cyst and no capsular rupture. There were no complications and no deaths. CONCLUSIONS: Congenital inclusion cysts of the anterior fontanelle are rare lesions that usually manifest at birth. The diagnosis is usually easy and surgery is mandatory, with a good prognosis. Recurrence is rare.

[Ganglioglioma of the pineal region: case report]. / Ganglioglioma da região da pineal: relato de caso.

Ganglioglioma are tumors presenting neoplastic glial cells and nerve cells, very rarely found in the pineal region. Only eight cases have been previously published in the literature. We present the case of a 14 years-old male patient with a ganglioglioma of the pineal region. The patient was treated surgically by a suboccipital transtentorial approach with complete removal. Histopathologic specimens with immunostaining revealed a ganglioglioma grade I. We conclude that these tumors are rare and should be treated surgically aiming total remove. If it is not possible or in case of reocurrence the patient should be followed and radiotherapy could be considered.

[Carotid body tumors: review of 8 cases and surgical approach]. / Tumores do corpo carotídeo: revisão de oito casos e abordagem cirúrgica.

Carotid body tumors are rather uncommon. Even though there is a great amount of literature on the subject, the controversy regarding its biological behavior and therapeutics and mainly, the surgical management still remains. We present eight patients with carotid body tumors (total of 9 tumors, one bilateral) surgically treated at the Neurosurgery Department of Santa Casa in Belo Horizonte, from 1989 to 1999. The age ranged from 11 to 66-years-old (35,6+/-17.7). Four patients were women and four were men. We had satisfactory postoperative results with low morbidity and no deaths. Based on our experience and on the review of the literature, some aspects of this disease are discussed. We conclude that carotid body tumors are uncommon and should be treat with carefully surgery techniques to obtain low morbi-mortality rates.

[Raeder paratrigeminal neuralgia as expression form of intracavernous giant aneurysm]. / Nevralgia paratrigeminal de Raeder como forma de expressão de aneurisma gigante intracavernoso.

The authors report the case of a 50-year-old female patient with right orbital headache secondary to a giant intracavernous aneurysm, diagnosed as Raeder paratrigeminal neuralgia. The patient was surgically treated with internal carotid artery trapping together with brain revascularization (superficial temporal artery to a deep branch of the middle cerebral artery). The patient had an excellent outcome. The identity of the syndrome and the differential diagnosis are discussed based on literature review.

[Lipoma of the cerebellopontine angle: case report]. / Lipoma do ângulo pontocerebelar: relato de caso.

Lipoma of the cerebellopontine angle is a very rare tumor. We report the case of a 14-years-old female, with left side deafness during three years, associated with headache. CT scan showed an hypodense mass, without enhancement at the cerebellopontine angle. The patient was treated surgically by left retrosigmoid approach. The lesion involved the eighth and seventh cranial nerves and only a partial removal was performed. The postoperative course was uneventful. She had no more headache; the deafness of the left side remained unchanged. Asymptomatic lipoma of the cerebellopontine angle can be treated conservatively, although those with progressive symptoms should be treated surgically, with total or partial remove based on their neurovascular involvement.

[Cavernoma of the lateral ventricle: case report]. / Cavernoma do ventrículo lateral: relato de caso.

UNLABELLED: Cavernous malformations are uncommon lesions that are usually present in the cerebral hemispheres. They occur rarely in the ventricular system, and even more rarely in the lateral ventricle. Only 28 cases have been previously reported in the literature. CASE: We present one case of lateral ventricle cavernoma in a 15-years-old female patient, who suffered of mild chronic headache for 8 months, followed by two episodes of sudden intensive headache and stupor with complete recovery after 48 hours. CT scan was performed and revealed a voluminous size, hiperdense mass in the frontal horn of the lateral ventricle. The surgical access to site was through transcallosal interhemisphere approach. The patient had a good recovery without complications. CONCLUSION: Although lateral ventricle cavernomas are rare they should be considered in the differential diagnosis of intraventricular tumors. A wrong preoperative diagnosis has sometimes induced a wrong therapy, such as radiotherapy, for these surgically curable benign lesions.

[Isolated metastasis of squamous cell carcinoma of the esophagus in the terminal ileum. Report of a case]. / Metástase isolada de carcinoma espino-celular do esôfago no íleo terminal. Relato de um caso.

Squamous cell carcinoma of the esophagus, with isolated metastasis to the terminal ileum, is a rare finding. Only 18 of such cases have been reported in the medical literature, all of them found at necropsies. The accurate examination of the abdominal cavity, after performing a gastrostomy, showed a neoplastic lesion in the terminal ileum, which was then resected. The histopathological examination revealed the metastatic nature of the lesion. The authors emphasize the importance of a complete and accurate revision of the abdominal cavity on patients with esophagus squamous cell carcinoma.

[Adenocarcinoma of the cecal appendix. Report of a case of the colic type]. / Adenocarcinoma do apêndice cecal. Relato de um caso do tipo cólico.

Regarding the event of an adenocarcinoma of the colic type of the cecal appendix, operated on at the ABC Medical College Hospital, the authors summarize the subject stating that, among the appendiceal carcinoma, this particular one tends to spread, by the veins or lymphatics, besides spreading by contiguity. This carcinoma hardly presents a symptomology of its own. It appears fairly often as acute appendicitis. The authors also state the difficulty for a macroscopic diagnosis. Thus, its real nature is determined, in general, only after the histologic exam of the removed part. The right hemicolectomy is the most indicated surgery and best results are obtained in the first surgery or 30 days afterwards. About the reported case the patient was operated on with the pre and intra operatory diagnosis of appendicitis and the histologic exam, on top of confirming it, pointed out the presence of neoplasm. After the indication for reoperation, the prompt spreading of the neoplastic disease offered no means to perform any other surgery disclosing its malignant potential.

Adenocarcinoma do apendice cecal. Relato de um caso do tipo colico. / Adenocarcinoma of the cecal appendix.Report of a case of the colic type

A proposito de um caso de adenocarcinoma do tipo colico do apendice cecal, operado no Hospital de Ensino da Faculdade de Medicina do ABC, e feita uma revisao do assundo, assinalando que, dentre os carcinomas do apendice, este tem tendencia a metastizacao por via linfatica e venosa, alem de se propagar por contiguidade. Praticamente destituido os sintomatologia propria, revela-se, na maioria das vezes, por manifestacoes de apendicite aguda. Sao ressaltadas as dificuldades de diagnostico macroscopico, o que faz com que a sua real natureza seja estabelecida, em geral, apos o exame histopatologico da peca cirurgica.A hemicolectomia direita e a operacao indicada e cujos melhores resultados sao obtidos como primeira intervencao ou dentro de 30 dias desta. No caso estudado, o paciente foi operado com o diagnostico pre e intra-operatorio de apendicite aguda e o exame histopatologico alem de confirma-lo, demonstrou a presenca da neoplasia. Indicada a reintervencao, a rapida propagacao da doenca neoplasica impediu a realizacao de qualquer procedimento desejado, demonstrando o grande potencial maligno da afeccao