scholarly journals Mesenchymal Chondrosarcoma of the Brain with Metastasis: A Case Report with Literature Review

2020 ◽  
Vol 11 (02) ◽  
pp. 344-348
Author(s):  
Sandeep Bhardwaj ◽  
Ashish Sharma ◽  
Akangsha Sharma
Keyword(s):  
Left Lung ◽  
Lumbar Vertebrae ◽  
Lateral Wall ◽  
Mesenchymal Chondrosarcoma ◽  
Radical Excision ◽  
Temporal Region ◽  
Ct Guided ◽  
Dismal Prognosis ◽  
Extraskeletal Mesenchymal Chondrosarcoma ◽  
The Brain

AbstractMesenchymal chondrosarcoma of the brain is one of the rarest tumors with dismal prognosis. A 26-year-old man presented with headache, vomiting, and diplopia. On evaluation, a moderately enhancing extra-axial lesion was seen in right temporal region involving right greater wing of sphenoid, adjacent right maxillary sinus, and lateral wall of right orbit. Patient underwent magnetic resonance imaging of the spine and computed tomography (CT) of the chest for possible metastasis which showed lesion in lumbar vertebrae and left lung. Patient was planned for CT-guided lung biopsy which proved inconclusive. The patient was further planned for craniotomy and underwent craniotomy with microscopic excision of the mass. Histoimmunochemistry was suggestive of extraskeletal mesenchymal chondrosarcoma. Mesenchymal chondrosarcoma of the brain is highly aggressive tumors which are difficult to differentiate radiologically. Radical excision followed by chemoradiotherapy is optimal treatment of choice.

CASE REPORT: SURGICAL MANAGEMENT OF LUMBAR COMPRESSION FRACTURE

2019 ◽  
Vol 1 (4) ◽  
Author(s):  
Yustinus Robby Budiman Gondowardojo ◽  
Tjokorda Gde Bagus Mahadewa
Keyword(s):  
Spinal Cord ◽  
Left Lung ◽  
Lumbar Vertebrae ◽  
Compression Fracture ◽  
High Mobility ◽  
Early Mobilization ◽  
Cord Injury ◽  
Cardiothoracic Surgeon ◽  
The Right

The lumbar vertebrae are the most common site for fracture incident because of its high mobility. The spinal cord injury usually happened as a result of a direct traumatic blow to the spine causing fractured and compressed spinal cord. A 38-year-old man presented with lumbar spine’s compression fracture at L2 level. In this patient, decompression laminectomy, stabilization, and fusion were done by posterior approach. The operation was successful, according to the X-Ray and patient’s early mobilization. Pneumothorax of the right lung and pleural effusion of the left lung occurred in this patient, so consultation was made to a cardiothoracic surgeon. Chest tube and WSD insertion were performed to treat the comorbidities. Although the patient had multiple trauma that threat a patient’s life, the management was done quickly, so the problems could be solved thus saving the patient’s life. After two months follow up, the patient could already walk and do daily activities independently.

Drusen in the Peripheral Retina of the Alzheimer’s Eye

2018 ◽  
Vol 15 (8) ◽  
pp. 743-750 ◽  
Author(s):  
Kresimir Ukalovic ◽  
Sijia Cao ◽  
Sieun Lee ◽  
Qiaoyue Tang ◽  
Mirza Faisal Beg ◽  
...  
Keyword(s):  
Peripheral Retina ◽  
Amyloid Angiopathy ◽  
Temporal Region ◽  
Future Studies ◽  
Eye Tissues ◽  
Neuropathological Diagnosis ◽  
Ocular Imaging ◽  
Cerebral Amyloid ◽  
The Brain ◽  
Oil Red O

Background: Recent work on Alzheimer's disease (AD) diagnosis focuses on neuroimaging modalities; however, these methods are expensive, invasive, and not available to all patients. Ocular imaging of biomarkers, such as drusen in the peripheral retina, could provide an alternative method to diagnose AD. Objective: This study compares macular and peripheral drusen load in control and AD eyes. Methods: Postmortem eye tissues were obtained from donors with a neuropathological diagnosis of AD. Retina from normal donors were processed and categorized into younger (<55 years) and older (>55 years) groups. After fixation and dissection, 3-6 mm punches of RPE/choroid were taken in macular and peripheral (temporal, superior, and inferior) retinal regions. Oil red O positive drusen were counted and grouped into two size categories: small (<63 μm) and intermediate (63-125 μm). Results: There was a significant increase in the total number of macular and peripheral hard drusen in older, compared to younger, normal eyes (p<0.05). Intermediate hard drusen were more commonly found in the temporal region of AD eyes compared to older normal eyes, even after controlling for age (p<0.05). Among the brain and eye tissues from AD donors, there was a significant relationship between cerebral amyloid angiopathy (CAA) severity and number of temporal intermediate hard drusen (r=0.78, p<0.05). Conclusion: Imaging temporal drusen in the eye may have benefit for diagnosing and monitoring progression of AD. Our results on CAA severity and temporal intermediate drusen in the AD eye are novel. Future studies are needed to further understand the interactions among CAA and drusen formation.

scholarly journals Medico-Legal Opinion Based on Autopsy Findings of a Victim of an Explosion Involving Mass Fatality

2020 ◽  
Vol 10 (3-4) ◽  
pp. 158-165
Author(s):  
Yalini Thivaharan ◽  
Indira Deepthi Gamage Kitulwatte
Keyword(s):  
Legal Issues ◽  
Temporal Region ◽  
Skull Fractures ◽  
Autopsy Findings ◽  
Parietal Lobes ◽  
Event Reconstruction ◽  
Police Personnel ◽  
Autopsy Examination ◽  
Mass Fatality ◽  
The Brain

Introduction: Investigation into explosions is one of the major areas in forensic medicine and pathology. Medico legal issues associated with these deaths are diverse and forensic experts are often expected to make clarifications. Assistance of a methodical scientific investigation of such a death in evaluation of unanswered medico legal issues, of an autopsy of one of the victims of Easter Sunday explosions is discussed. Case history: The deceased was a 15-year-old girl who was participating in the Easter mass at St. Sebastian’s Church - Kattuwapaitya, Negombo, Sri Lanka when a suicide bomber blew himself up. The mother of the deceased noticed the deceased being rushed to the hospital. However, she was pronounced dead on admission. Pre-autopsy radiology revealed spherical shrapnel in the temporal region. At autopsy, the fatal injury was found on the head and a detailed study revealed skull fractures associated with penetration by 3 shrapnels. There was a keyhole lesion among the penetrations. Internal examination revealed an extensive dural tear underlying the compound fracture. The brain was grossly edematous with lacerations on the frontal and parietal lobes associated with localized subarachnoid hemorrhage. There were multiple underlying contusions on bilateral frontal white matter. Small subarachnoid haemorrhage was noted on the basal aspect of the brain. Discussion: Careful evaluation of the autopsy findings assisted in formulating the opinion scientifically on event reconstruction including the proximity of the victim to the epicenter of explosion and nature of explosive device, period of survival, mechanism of causation of skull fractures and the mechanism of death in addition to the cause of death. Conclusion: A forensic pathologist following a meticulous autopsy examination, along with a team of ballistic experts and specially trained police personnel play a pivotal task in analyzing a scene of explosion and an autopsy of a victim, in concluding the case and in bringing justice to all the victims and survivors of the catastrophe.

scholarly journals Metastatic Extraskeletal Mesenchymal Chondrosarcoma of the Pancreas: Report of an Unusual Case with Review of Literature

2021 ◽  
Author(s):  
Saloni Naresh Shah ◽  
Ashok Parameswaran ◽  
Prasanna Kumar Reddy
Keyword(s):  
Unusual Case ◽  
English Literature ◽  
Latency Period ◽  
Sudden Onset ◽  
Mesenchymal Chondrosarcoma ◽  
Pancreatic Tumors ◽  
Good Survival ◽  
Review Of Literature ◽  
Long Latency ◽  
Extraskeletal Mesenchymal Chondrosarcoma

AbstractExtraskeletal mesenchymal chondrosarcoma (ESMC) metastasizing to the pancreas in isolation is a rare occurrence. We report a 49-year-old gentleman who had undergone excision of an ESMC of the thigh in 2009 and presented with sudden onset abdominal pain and icterus in 2019. Radiological imaging revealed calcified mass of the pancreas with multiple nodules with extension into the adipose tissue. Distal pancreatectomy was performed and the pathology revealed a bimorphic tumor composed of undifferentiated round blue cells with abrupt transition to hyaline cartilage, typical of mesenchymal chondrosarcoma. To the best of our knowledge, there are only seven prior cases of metastatic ESMC of the pancreas in the English literature. Surgical intervention appears to be the preferred modality of treatment for metastatic pancreatic tumors. These patients may have long latency period before metastasizing and seem to have a good survival period post excision.

scholarly journals Differences in Radiation Exposure of CT-Guided Percutaneous Manual and Powered Drill Bone Biopsy

2021 ◽  
Author(s):  
Sebastian Zensen ◽  
Sumitha Selvaretnam ◽  
Marcel Opitz ◽  
Denise Bos ◽  
Johannes Haubold ◽  
...  
Keyword(s):  
Radiation Exposure ◽  
Diagnostic Yield ◽  
Bone Biopsy ◽  
Lumbar Vertebrae ◽  
Bone Lesions ◽  
Anatomical Location ◽  
Thoracic Vertebrae ◽  
Level Of Evidence ◽  
Ct Guided ◽  
Bone Biopsies

Abstract Purpose Apart from the commonly applied manual needle biopsy, CT-guided percutaneous biopsies of bone lesions can be performed with battery-powered drill biopsy systems. Due to assumably different radiation doses and procedural durations, the aim of this study is to examine radiation exposure and establish local diagnostic reference levels (DRLs) of CT-guided bone biopsies of different anatomical regions. Methods In this retrospective study, dose data of 187 patients who underwent CT-guided bone biopsy with a manual or powered drill biopsy system performed at one of three different multi-slice CT were analyzed. Between January 2012 and November 2019, a total of 27 femur (A), 74 ilium (B), 27 sacrum (C), 28 thoracic vertebrae (D) and 31 lumbar vertebrae (E) biopsies were included. Radiation exposure was reported for volume-weighted CT dose index (CTDIvol) and dose–length product (DLP). Results CTDIvol and DLP of manual versus powered drill biopsy were (median, IQR): A: 56.9(41.4–128.5)/66.7(37.6–76.2)mGy, 410(203–683)/303(128–403)mGy·cm, B: 83.5(62.1–128.5)/59.4(46.2–79.8)mGy, 489(322–472)/400(329–695)mGy·cm, C: 97.5(71.6–149.2)/63.1(49.1–83.7)mGy, 627(496–740)/404(316–515)mGy·cm, D: 67.0(40.3–86.6)/39.7(29.9–89.0)mGy, 392(267–596)/207(166–402)mGy·cm and E: 100.1(66.5–162.6)/62.5(48.0–90.0)mGy, 521(385–619)/315(240–452)mGy·cm. Radiation exposure with powered drill was significantly lower for ilium and sacrum, while procedural duration was not increased for any anatomical location. Local DRLs could be depicted as follows (CTDIvol/DLP): A: 91 mGy/522 mGy·cm, B: 90 mGy/530 mGy·cm, C: 116 mGy/740 mGy·cm, D: 87 mGy/578 mGy·cm and E: 115 mGy/546 mGy·cm. The diagnostic yield was 82.4% for manual and 89.4% for powered drill biopsies. Conclusion Use of powered drill bone biopsy systems for CT-guided percutaneous bone biopsies can significantly reduce the radiation burden compared to manual biopsy for specific anatomical locations such as ilium and sacrum and does not increase radiation dose or procedural duration for any of the investigated locations. Level of Evidence Level 3.

scholarly journals Late presentation of unilateral lung agenesis in adulthood

2021 ◽  
Vol 52 (1) ◽  
Author(s):  
Arshed Hussain Parry ◽  
Mujahed Abdulsattar Ibrahim Raheem ◽  
Hussam Hassan Ismail ◽  
Osama Sharaf
Keyword(s):  
Main Bronchus ◽  
Left Lung ◽  
Left Hemithorax ◽  
Late Adulthood ◽  
Pulmonary Agenesis ◽  
Opaque Hemithorax ◽  
Dismal Prognosis ◽  
Mediastinal Shift ◽  
Lung Agenesis ◽  
Unilateral Pulmonary Agenesis

Abstract Background Pulmonary agenesis is a rare congenital anomaly with a reported prevalence of about 1 in 100,000 births. It may be bilateral or unilateral. Among the unilateral form, left lung agenesis is more common (70%); however, it is the right lung agenesis which carries a dismal prognosis due to the frequent association with a gamut of other congenital anomalies and greater degree of mediastinal shift leading to tracheo-bronchial and vascular distortion. The patients of unilateral pulmonary agenesis usually present in infancy or early childhood. Presentation in late adulthood as seen in our patient is rare. We present a case of left pulmonary agenesis that was diagnosed in 4th decade of life. Case presentation A 36-year-old male presented with gradually progressive exertional dyspnea of 1 month duration. Clinical examination revealed tachycardia and tachypnea. Chest radiograph showed opaque left hemithorax with ipsilateral mediastinal shift. Computed tomography clinched the diagnosis by demonstrating absence of left main bronchus, lung and left pulmonary artery with shift of heart, and great mediastinal vessels into left hemithorax. The patient was managed conservatively and discharged with attachment to out-patient department for regular follow-up. Conclusion Presentation of unilateral lung agenesis in late adulthood, as seen in the present case is extremely rare. This case report highlights that, a rare condition like unilateral pulmonary agenesis, should be considered in the list of differentials in an adult presenting with opaque hemithorax with ipsilateral mediastinal shift on radiography.

scholarly journals Extraskeletal Mesenchymal Chondrosarcoma

2018 ◽  
Vol 142 (11) ◽  
pp. 1421-1424 ◽  
Author(s):  
Komal Arora ◽  
Nicole D. Riddle
Keyword(s):  
Soft Tissue ◽  
Soft Tissue Sarcoma ◽  
Soft Tissues ◽  
Hyaline Cartilage ◽  
Mesenchymal Chondrosarcoma ◽  
Small Cells ◽  
Diagnostic Challenge ◽  
Biphasic Pattern ◽  
Biopsy Specimens ◽  
Extraskeletal Mesenchymal Chondrosarcoma

Extraskeletal mesenchymal chondrosarcoma is a rare soft tissue sarcoma arising from soft tissues, mainly of the lower extremities, meninges, and orbits. It usually presents during the second to third decades of life, and has a slight predominance in females. Histologically, it has a typical biphasic pattern comprising small cells and islands of hyaline cartilage. It can pose a diagnostic challenge in small biopsy specimens where 1 of the 2 components can be absent. The prognosis is extremely variable; survival varies depending on the location of the tumor.

scholarly journals Primary Intracranial Extraskeletal Mesenchymal Chondrosarcoma: Clinical Mimicry as Glomus Jugulare

2017 ◽  
Vol 24 (3) ◽  
pp. 181-186 ◽  
Author(s):  
Rajesh Chhabra ◽  
Manjul Tripathi ◽  
Devi Prasad Patra ◽  
Narendra Kumar ◽  
Bishan Radotra ◽  
...  
Keyword(s):  
Mesenchymal Chondrosarcoma ◽  
Glomus Jugulare ◽  
Extraskeletal Mesenchymal Chondrosarcoma

scholarly journals Rare Primary Spinal Mesenchymal Chondrosarcoma: A Case Report

2020 ◽  
Vol 42 (3) ◽  
pp. 102-105
Author(s):  
Sushil Paudel ◽  
Shirish Adhikari ◽  
Sharad C Adhikari ◽  
Rohit K Pokharel
Keyword(s):  
Magnetic Resonance Imaging ◽  
Case Report ◽  
Magnetic Resonance ◽  
Postoperative Radiotherapy ◽  
Mesenchymal Chondrosarcoma ◽  
Radical Excision ◽  
Resonance Imaging ◽  
Lumbosacral Region ◽  
High Tendency ◽  
Magnetic Resonance Imaging Mri

Primary extradural mesenchymal chondrosarcoma (MCS) is a very rare intraspinal tumor. Proper clinical evaluation with magnetic resonance imaging (MRI) followed by biopsy of the mass can confirm the diagnosis. Since MCS has a high tendency of recurrence and metastasis, the prognosis is guarded. We report a 52 years old male with primary extradural MCS in the lumbosacral region (L5-S3). Subtotal excision and biopsy were performed which confirmed the diagnosis. The patient received post excisional radiotherapy but expired after four months. Though rare, this tumor should be kept in differentials which helps in early diagnosis and thus can be treated with radical excision of the mass along with postoperative radiotherapy.

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