MPC-16 RAPID PROGRESSIVE SPINAL DIFFUSE MIDLINE GLIOMA, A CASE REPORT

Abstract A 17-year-old boy presented with a 2-week history of lower back pain, progressive gait difficulty and sensory deficit of bilateral lower limbs. Magnetic resonance imaging of neuroaxis showed intramedullary tumor with spinal cord expansion from Th12 to L2 and irregular areas of enhancement. Emergent laminoplasty and biopsy was performed. Histopathological examination showed small atypical cells, but most cells had too much degeneration and necrosis to confirm the diagnosis definitively. Leptomeningeal dissemination caused conscious disturbance, nuchal rigidity and epilepsy. 2 weeks after decompression, we performed cordotomy again for advanced diagnosis, to be found diffuse midline glioma, H3K27M mutant by immunohistopathological examination and DAN sequence. He was treated with combination of whole brain and spine radiation therapy and chemotherapy with temozolomide and bevacizumab. He is still alive over 6 months. The clinical significance of H3K27M mutant in spinal gliomas is unclear. Further examinations are needed.

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Multiple extradural spinal arachnoid cysts: A case report

Surgical Neurology International ◽

10.25259/sni_105_2021 ◽

2021 ◽

Vol 12 ◽

pp. 101

Author(s):

Joaquim Francisco Cavalcante-Neto ◽

Lúcio Soares e Silva-Neto ◽

Paulo Roberto Lacerda Leal ◽

Cláudio Henrique Souza Moreira ◽

Espártaco Moraes Lima Ribeiro ◽

...

Keyword(s):

Magnetic Resonance Imaging ◽

Histopathological Examination ◽

Sensory Function ◽

Lower Limbs ◽

Arachnoid Cysts ◽

Type I ◽

Case Description ◽

Resonance Imaging ◽

Complete Surgical Resection ◽

History Of

Background: Extradural spinal arachnoid cysts (SACs) rarely cause neural compression and disability. Case Description: A 38-year-old female presented with a history of two episodes of falling due to transient weakness in the lower limbs. The neurological examination showed normal motor and sensory function, but hyperreflexia. The thoracic magnetic resonance imaging revealed multiple extradural SACs between the T3-L1 levels. Following complete surgical resection of the most symptomatic cyst, she did well. The histopathological examination confirmed a Type I extradural SAC. Conclusion: Here, we discussed one case and reviewed the literature on the diagnosis and treatment of multiple extradural SACs.

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An Untypical Case of Gouty Infiltration of Both Peroneal Tendons and a Longitudinal Lesion of the Peroneus Brevis Tendon Mimicking Synovial Sarcoma

Case Reports in Orthopedics ◽

10.1155/2018/8790916 ◽

2018 ◽

Vol 2018 ◽

pp. 1-3 ◽

Cited By ~ 1

Author(s):

Konstantinos Anagnostakos ◽

Andreas Thiery ◽

Christof Meyer ◽

Octavian Tapos

Keyword(s):

Synovial Sarcoma ◽

Histopathological Examination ◽

Soft Tissue Tumors ◽

Resonance Imaging ◽

Open Biopsy ◽

Tissue Samples ◽

Peroneal Tendons ◽

Orthopedic Surgeons ◽

History Of ◽

Peroneus Brevis

We present a case of a 70-year-old male patient with an untypical gout infiltration of the peroneal tendons mimicking synovial sarcoma. The patient had a negative history of gout at initial presentation in our department. Magnetic resonance imaging of the region revealed a finding highly suspicious for synovial sarcoma of the peroneal tendons. Open biopsy was performed. Histopathological examination of the tissue samples demonstrated the presence of gout with no signs of malignancy. The gout infiltration was excised in a subsequent surgery. Orthopedic surgeons should be aware of the potential manifestation of gout in tendons and bear this in mind in the differential diagnosis of soft tissue tumors.

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Long segment cervicothoracic intramedullary dermoid with concomitant conal lesion – A case report

Surgical Neurology International ◽

10.25259/sni_474_2020 ◽

2020 ◽

Vol 11 ◽

pp. 268

Author(s):

Andrew Aranha ◽

Pankaj Kumar ◽

Ajay Choudhary ◽

Purnima Paliwal

Keyword(s):

Histopathological Examination ◽

Case Reports ◽

Benign Tumors ◽

Resonance Imaging ◽

Tumor Capsule ◽

Neural Tissues ◽

History Of ◽

Intramedullary Dermoid Cyst ◽

Similar Intensity ◽

Surgical Extirpation

Background: Spinal dermoid cysts are benign tumors that result from congenital or acquired ectodermal inclusions. Long segment intramedullary involvement of the spinal cord is exceedingly rare, and there are only a handful of case reports found in the literature. Case Description: A 30-year-old female presented with a 3-month history of myelopathy characterized by progressive quadriparesis and urinary incontinence. Magnetic resonance imaging revealed multifocal heterogeneous intramedullary masses extending from C2 to T4 and at T12–L1 with similar intensity lesions seen within the central cord from T5 to T11 level. Following tumor decompression, she showed significant improvement in neurological function 1 month later. The histopathological examination confirmed the diagnosis of a multifocal intramedullary dermoid cyst. Conclusion: Partial surgical extirpation is a reasonable treatment for long segment intramedullary dermoid cysts, particularly when the tumor capsule is adherent to critical adjacent neural tissues.

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Intracranial subdural osteoma

European Journal of Inflammation ◽

10.1177/2058739220926854 ◽

2020 ◽

Vol 18 ◽

pp. 205873922092685

Author(s):

Yunna Yang ◽

Zheng Gu ◽

Yinglun Song

Keyword(s):

Dura Mater ◽

Histopathological Examination ◽

Surgical Excision ◽

Benign Neoplasms ◽

Resonance Imaging ◽

Inner Surface ◽

History Of ◽

Magnetic Resonance Imaging Mri ◽

T1 Hyperintensity ◽

The Right

Subdural osteomas are extremely rare benign neoplasms. Here, we report the case of a 35-year-old female patient with a right frontal and parietal subdural osteoma. The patient presented with a 2-year history of intermittent headache and fatigue. Computerized tomography (CT) scan showed a high-density lesion attached to the inner surface of the right frontal and parietal skull. Magnetic resonance imaging (MRI) demonstrated T1 hyperintensity and T2 hypointensity of the lesion. Intraoperatively, the hard mass was located in subdural space and attached to the dura mater. Histopathological examination revealed lamellated bony trabeculae lined by osteoblasts and the intertrabecular marrow spaces occupied by adipose tissue. The patient underwent neurosurgical resection and recovered without complication. Surgical excision is recommended to extract the symptomatic lesions with overlying dura mater.

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Surgical treatment of a cerebral brain abscess in a cat

Veterinary and Comparative Orthopaedics and Traumatology ◽

10.3415/vcot-10-02-0018 ◽

2011 ◽

Vol 24 (01) ◽

pp. 72-75 ◽

Cited By ~ 7

Author(s):

M. Beukers ◽

L. F. H. Theyse ◽

E. G. H. Wouters

Keyword(s):

Magnetic Resonance Imaging ◽

Histopathological Examination ◽

Resonance Imaging ◽

Ataxic Gait ◽

Pupillary Light ◽

Small Defect ◽

History Of ◽

The Right ◽

Extensive Necrosis ◽

Temporal Lobe Lesion

SummaryA nine-year-old male castrated European Shorthair cat was presented with a six-day history of progressive depression and ataxic gait. Neurological examination revealed depression, absent menace in the left eye, absent pupillary light reflex in the right eye, anisocoria, circling to the right, and delayed proprioception in all limbs. Magnetic resonance imaging showed a space-occupying right temporal lobe lesion adjacent to a small defect in the temporal bone suggestive of a meningo-encephalitis with concurrent abscess formation. The site was surgically approached by a rostrotentorial craniectomy. A cerebral abscess was found and debrided. Histopathological examination of the removed tissue demonstrated a subacute to chronic purulent encephalitis with extensive necrosis of brain tissue. Neurological symptoms resolved completely within two weeks and full recovery was observed four weeks after surgery.

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Post-mortem diagnosis of intravascular large B-cell lymphoma

Journal of International Medical Research ◽

10.1177/0300060520924262 ◽

2020 ◽

Vol 48 (6) ◽

pp. 030006052092426

Author(s):

Aniello Maiese ◽

Raffaele La Russa ◽

Alessandra De Matteis ◽

Paola Frati ◽

Vittorio Fineschi

Keyword(s):

B Cell ◽

Cell Lymphoma ◽

B Cell Lymphoma ◽

Lymphoid Cells ◽

Resonance Imaging ◽

Large B Cell Lymphoma ◽

Positron Emission ◽

Atypical Cells ◽

History Of ◽

Large B Cell

Intravascular large B-cell lymphoma (IVLBCL) is a rare (<1%), typically aggressive extranodal variant of mature non-Hodgkin B-cell lymphoma. IVLBCL is characterized by malignant lymphoid cells lodged within blood vessels, particularly capillary channels. Herein, we present a case of a 50-year-old man with a history of myeloradiculitis (∼1 year) and paraparesis requiring hospitalization. During the course of his hospital stay, computed tomography (CT), magnetic resonance imaging, CT-positron emission tomography, and biopsy failed to establish a diagnosis. The patient died 2 months later from bilateral pneumonia. Postmortem examination was undertaken to determine the cause of death. Histologic sections of the patient’s brain, heart, lung, and liver showed aggregates of highly atypical cells bearing enlarged, pleomorphic, and hyperchromatic nuclei. Strong intravascular positivity for CD45 and CD20 markers indicated the cells were of B-cell origin, supporting a diagnosis of IVLBCL.

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Giant Endometrial Polyp in a Postmenopausal Woman without Hormone/Drug Use and Vaginal Bleeding

Case Reports in Obstetrics and Gynecology ◽

10.1155/2014/518398 ◽

2014 ◽

Vol 2014 ◽

pp. 1-4

Author(s):

Betül Ünal ◽

Selen Doğan ◽

Fatma Şeyda Karaveli ◽

Tayup Şimşek ◽

Gülgün Erdoğan ◽

...

Keyword(s):

Postmenopausal Woman ◽

Drug Use ◽

Vaginal Bleeding ◽

Clinical Presentation ◽

Histopathological Examination ◽

Uterine Cavity ◽

Endometrial Polyp ◽

Lower Back ◽

History Of

The objective of this study is to determine and discuss the causes of a giant endometrial polyp in a postmenopausal woman without hormone/drug use and to submit interesting clinical presentation. Here we report a seventy-year-old female patient who was admitted to our hospital with lower back pain. There were no other complaints from her. Physical examination was normal. For further examination, computed tomography was performed and a heterogeneous mass, with a diameter of 10×9 centimeters, was detected in the uterine cavity. Hysterectomy because of suspected endometrial cancer was performed. Histopathological examination showed us a giant endometrial polyp with edematous and focal fibrotic stroma, large thick walled blood vessels between normal sized and cystically dilated endometrial glands. To the best of our knowledge, this is the first report of a giant endometrial polyp which is unrelated to use of drugs such as tamoxifen and raloxifene; however, based on the history of the patient it may be associated with long-term consumption of thyme, which is a kind of phytoestrogen.

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Fourth Ventricular Schwannoma: Identical Clinicopathologic Features as Schwann Cell-Derived Schwannoma with Unique Etiopathologic Origins

Case Reports in Medicine ◽

10.1155/2011/165954 ◽

2011 ◽

Vol 2011 ◽

pp. 1-4 ◽

Cited By ~ 8

Author(s):

Tiffany R. Hodges ◽

Isaac O. Karikari ◽

Shahid M. Nimjee ◽

June Tibaleka ◽

Thomas J. Cummings ◽

...

Keyword(s):

Natural History ◽

Histopathological Examination ◽

Resonance Imaging ◽

Who Grade ◽

Suboccipital Craniotomy ◽

Nerve Sheath ◽

History Of ◽

Intraventricular Tumors ◽

Memory Disturbance ◽

Magnetic Resonance Imaging Mri

Background. To our knowledge, this is the sixth reported case in the literature of fourth ventricular schwannoma. The etiology and natural history of intraventricular schwannomas is not well understood. A thorough review of potential etiopathogenic mechanisms is provided in this case report.Case Description. A 69-year-old man presented with an incidentally found fourth ventricular tumor during an evaluation for generalized weakness, gait instability, and memory disturbance. Magnetic resonance imaging (MRI) revealed a heterogeneously enhancing lesion in the fourth ventricle. A suboccipital craniotomy was performed to resect the lesion. Histopathological examination confirmed the diagnosis of schwannoma (WHO grade I).Conclusions. Schwannomas should be considered in the differential diagnosis of intraventricular tumors. Although the embryologic origins may be different from nerve sheath-derived schwannomas, the histologic, clinical, and natural history appear identical and thus should be managed similarly.

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Atypical Meningioma in the Medulla Oblongata Parenchyma

10.21203/rs.3.rs-112925/v1 ◽

2020 ◽

Author(s):

Qiushi Xu ◽

Ziang Pan ◽

Meidan Hou ◽

Fang Peng

Keyword(s):

Magnetic Resonance Imaging ◽

Medulla Oblongata ◽

Preoperative Diagnosis ◽

Histopathological Examination ◽

Atypical Meningioma ◽

Resonance Imaging ◽

Case Presentation ◽

First Case ◽

History Of ◽

Atypical Meningiomas

Abstract Background: Glioma is the most common tumor occurring in the brainstem. A primary intraparenchymal meningioma located in the brainstem without dura attachment is rare. Meanwhile, atypical meningiomas that occur in the medulla oblongata parenchyma, and without dura coverage, are extremely rare. In this study, we report the first case of atypical meningioma in the medulla oblongata parenchyma and review the existing literature.Case presentation: A 38-year-old female was admitted at our hospital with a 2-week history of progressive neck and occipital pain. Magnetic resonance imaging revealed a presence of a 1.5x0.9cm mass lesion, located in the left side of the medulla oblongata, which was hypointense on T1-weighted and hyperintense on T2-weighted images, and with inhomogeneous enhancement following gadolinium-diethylenet-riamine pentaacetic acid (Gd-DTPA) administration. The initial preoperative diagnosis was glioma or angioblastoma. The patient underwent a total surgical resection of the left medulla oblongata tumor and the histopathological examination indicated that the lesion was an atypical meningioma. The patient returned to normal life after surgery.Conclusions: Although glioma is the most common tumor occurring in the brainstem parenchyma, the possibility of meningioma cannot be ruled out in this area.

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Spinal Cord Diffuse Midline Glioma With Histone H3 K27M Mutation in a Pediatric Patient

Frontiers in Surgery ◽

10.3389/fsurg.2021.616334 ◽

2021 ◽

Vol 8 ◽

Author(s):

Ran Cheng ◽

Da-Peng Li ◽

Nan Zhang ◽

Ji-Yin Zhang ◽

Di Zhang ◽

...

Keyword(s):

Spinal Cord ◽

Neck Pain ◽

Pediatric Patient ◽

Histopathological Examination ◽

Histone H3 ◽

World Health ◽

Who Grade ◽

K27m Mutation ◽

History Of ◽

Diffuse Midline Glioma

Background: Diffuse midline glioma (DMG) with histone H3 K27M mutation is a recently identified entity documented in the 2016 World Health Organization (WHO) Classification of Tumors of the Central Nervous System. Spinal cord DMGs with H3 K27M-mutant are commonly reported in adults. Herein, we reported a pediatric patient with spinal cord H3 K27M-mutant DMG.Case Report: A 7-year-old girl with 1-month history of neck pain and 3-week history of progressive weakness in the right hand was presented. Spinal magnetic resonance imaging showed an intramedullary lesion with slight enhancement at the C2-7 levels. With intraoperative neuroelectrophysiological monitoring, the lesion was subtotally resected. Histopathological examination revealed a DMG with histone H3 K27M mutation corresponding to WHO grade IV. Postoperatively, the neck pain was relieved, and the upper-extremity weakness remained unchanged. Oral temozolomide was administrated for 7 months, and radiotherapy was performed for 22 courses. After an 18-month follow-up, no tumor recurrence was noted.Conclusion: Spinal cord H3 K27M-mutant DMGs are extremely rare in pediatric patients. Preoperative differential diagnosis is challenging, and surgical resection with postoperative chemoradiotherapy may be an effective treatment.

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