Intraparenchymal Meningioma in the Basal Ganglia.

We herein report a rare case of intraparenchymal meningioma in the right basal ganglia. The tumor was located incidentally and preoperatively diagnosed as malignant glioma. Preoperative magnetic resonance imaging revealed that the tumor involved the lenticulostriate artery, and open biopsy was performed to avoid postoperative neurologic deficits. Pathologic diagnosis was fibrous meningioma, and the patient was treated with stereotactic radiation therapy using intensity-modulated radiation therapy. The case illustrates that preoperative evaluation of tumors in the basal ganglia is challenging and that intraparenchymal meningioma should be included in the differential diagnosis of basal ganglia tumors.

Radiotherapy of intracranial germinomas.

Between 1980 and 1992, 32 patients with intracranial germinomas were treated with radiation. All patients were confirmed histopathologically prior to treatment. Of the 32 intracranial germinomas reviewed, 14 were located in the suprasellar region, 12 in the basal ganglia and thalamus, four in the pineal, and two in both the pineal and suprasellar regions. Three patients had subarachnoid seeding. Craniospinal irradiation was undertaken for 29 patients. The median dose of 54 Gy was delivered to the tumor bed, 36 Gy to the whole brain and 24 Gy to the spinal axis. Five and 10-year survival rates were 96.9 and 96.9%, respectively. Local control was achieved in all patients except one who died of persistent tumor after 2 months following radiotherapy. No intracranial recurrence or spinal metastasis were found. Tumor site did not relate to the prognosis. One patient developed severe intellectual deterioration, three patients had vertebral growth impairment. The present study confirms the excellent result with radiotherapy alone for patients with germinomas.

Radiation-induced meningioma evaluated with positron emission tomography with fludeoxyglucose F 18.

We describe a patient with radiation-induced meningioma 12 years after cranial irradiation for ectopic germinoma. PET scans with fludeoxyglucose F 18 showed a high glucose metabolic rate in the meningioma despite a benign histologic appearance.

Stereotactic implantation of iridium192 into CNS neoplasms.

A new method of stereotactic implantation of Iridium192 into CNS neoplasms is presented along with a method for tumor localization by computerized axial tomography, stereotactic angiography and stereotactic serial biopsies. A case treated with this technique is presented with an encouraging short term result.

Germinoma of the basal ganglia: a case report and review of literature.

Germs cell tumors of extrapineal region are extremely uncommon. The clinicopathological features of germinoma in the basal ganglia, in a 21 year old male are presented in this report. Post-operative radiotherapy is advocated, in view of the good radiosensitivity of these tumors.

[Suspected germ cell tumor in bilateral basal ganglia with progressive dystonia].

We report an 11-year-old boy with left pyramidal signs followed by progressive dystonia, mental deterioration, bradykinesia and bradyarthria. Evaluation included a CT scan which showed bilateral lesions in the basal ganglia, and an elevated serum B-HCG. Those findings suggested a germ cell tumor. The patient was treated with radiation therapy with improvement in neurologic deficits, decreased size of the lesions on CT and a decline in serum B-HCG. The clinical response to radiation treatment is compatible with a germ cell tumor.

Cerebral thrombotic microangiopathy and antiphospholipid antibodies in Aicardi-Goutieres syndrome--report of two sisters.

Cerebral thrombotic microangiopathy was found at autopsy in one of two sisters with Aicardi-Goutieres syndrome, whereas the other revealed increased serum levels of anticardiolipin IgG antibodies (measured only in the living sister); both typical features of systemic lupus erythematosus. These findings add support to the suggestion that Aicardi-Goutieres syndrome and systemic lupus erythematosus are closely related disorders in which dysregulated production of interferon-alpha might play a crucial role.

Poikilothermia in a female patient with a germinoma in the basal ganglia.

An unusual association of poikilothermia and a germinoma originating in the left basal ganglia is described in a 17-year-old female. The tumour was found extending into the hypothalamic structures. Following irradiation therapy, the patient gradually regained her regulation of body temperature.