Right frontal meningioma presenting as delusional parasitosis

Central nervous system tumours can occasionally present with psychiatric symptoms as the only manifestation and can often pose diagnostic challenges. A man in his early 60s presented to the psychiatry outpatient department with delusional parasitosis. His old age and an episode of urinary and faecal incontinence made the clinician consider neuroimaging at the very first visit itself. He was detected to have a right frontal meningioma with features of intracranial hypertension with midline shift, and he underwent emergency surgery. His delusional symptoms completely resolved after surgery and did not recur during the follow-up period of 2.5 years. A right frontal meningioma presenting as delusional parasitosis has probably not been reported in the literature before, and the case is being reported to highlight the rarity of its presentation, the importance of eliciting a detailed clinical history and the need for early neuroimaging in these cases.

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Endocrinological outcome in children and adolescents survivors of central nervous system tumours after a 5 year follow-up

Anales de Pediatría (English Edition) ◽

10.1016/j.anpede.2013.06.002 ◽

2014 ◽

Vol 80 (6) ◽

pp. 357-364

Author(s):

M. Güemes Hidalgo ◽

M.T. Muñoz Calvo ◽

L. Fuente Blanco ◽

C. Villalba Castaño ◽

G.A. Martos Moreno ◽

...

Keyword(s):

Central Nervous System ◽

Nervous System ◽

Children And Adolescents ◽

Central Nervous System Tumours

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Faculty Opinions recommendation of Molecular pathology of paediatric central nervous system tumours.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.726820734.793530284 ◽

2017 ◽

Author(s):

Scott Pomeroy ◽

Soma Sengupta

Keyword(s):

Central Nervous System ◽

Nervous System ◽

Molecular Pathology ◽

Central Nervous System Tumours

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High-grade astrocytoma with piloid features (HGAP): the Charité experience with a new central nervous system tumor entity

Journal of Neuro-Oncology ◽

10.1007/s11060-021-03749-z ◽

2021 ◽

Author(s):

Katja Bender ◽

Eilís Perez ◽

Mihaela Chirica ◽

Julia Onken ◽

Johannes Kahn ◽

...

Keyword(s):

Dna Methylation ◽

Central Nervous System ◽

Nervous System ◽

World Health ◽

Central Nervous System Tumor ◽

High Grade ◽

Thoracic Spinal Cord ◽

High Grade Astrocytoma ◽

Tumor Entity

Abstract Purpose High-grade astrocytoma with piloid features (HGAP) is a recently described brain tumor entity defined by a specific DNA methylation profile. HGAP has been proposed to be integrated in the upcoming World Health Organization classification of central nervous system tumors expected in 2021. In this series, we present the first single-center experience with this new entity. Methods During 2017 and 2020, six HGAP were identified. Clinical course, surgical procedure, histopathology, genome-wide DNA methylation analysis, imaging, and adjuvant therapy were collected. Results Tumors were localized in the brain stem (n = 1), cerebellar peduncle (n = 1), diencephalon (n = 1), mesencephalon (n = 1), cerebrum (n = 1) and the thoracic spinal cord (n = 2). The lesions typically presented as T1w hypo- to isointense and T2w hyperintense with inhomogeneous contrast enhancement on MRI. All patients underwent initial surgical intervention. Three patients received adjuvant radiochemotherapy, and one patient adjuvant radiotherapy alone. Four patients died of disease, with an overall survival of 1.8, 9.1, 14.8 and 18.1 months. One patient was alive at the time of last follow-up, 14.6 months after surgery, and one patient was lost to follow-up. Apart from one tumor, the lesions did not present with high grade histology, however patients showed poor clinical outcomes. Conclusions Here, we provide detailed clinical, neuroradiological, histological, and molecular pathological information which might aid in clinical decision making until larger case series are published. With the exception of one case, the tumors did not present with high-grade histology but patients still showed short intervals between diagnosis and tumor progression or death even after extensive multimodal therapy.

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Diagnosis, treatment, and misdiagnosis analysis of 28 cases of central nervous system echinococcosis

Chinese Neurosurgical Journal ◽

10.1186/s41016-021-00248-y ◽

2021 ◽

Vol 7 (1) ◽

Author(s):

Guojia Du ◽

Yandong Li ◽

Pan Wu ◽

Xin Wang ◽

Riqing Su ◽

...

Keyword(s):

Spinal Cord ◽

Central Nervous System ◽

Nervous System ◽

Clinical Features ◽

Multiple Organ ◽

Pathological Examination ◽

Surgical Removal ◽

Surgical Treatments

Abstract Background To explore central nervous system (CNS) involvement in this disease, from the perspectives of diagnosis, treatment, and misdiagnosis Methods Twenty-eight patients with CNS echinococcosis were included in this retrospective study, including 18 males (64.3%) and 10 (35.7%) females. The average age of all the patients were 23.5 years (ranged 4–60 years). Twenty-three (23) patients (82.1%) received the first surgical resection in our hospital. Five (5) patients (17.9%) gave up surgical treatment for multiple-organ hydatidosis and previous surgery history at other hospitals, and albendazole was applied for a long-term (3–6 months) adjunct therapy for the 5 patients. The average follow-up time was 8 years. Results For the 28 patients, 23 cases received surgical treatments, and the diagnosis was confirmed by pathological examinations. The diagnosis of 4 cases of brain echinococcosis and 2 cases of spinal cord echinococcosis could not be confirmed, resulting in a misdiagnosis rate of 21.4% (6/28). For the pathological examination, a total of 17 cases were infected with Echinococcus granulosus (including 2 cases of spinal cord echinococcosis), and 6 cases were infected with Echinococcus alveolaris. Conclusion The diagnosis should be specifically considered in endemic regions. The clinical features of CNS hydatidosis were intracranial space-occupying lesions. For the treatment, the surgical removal of cysts should be necessary. In addition, the adjuvant therapy with drug and intraoperative prophylaxis is also suggested. The misdiagnosis may have resulted from atypical clinical features and radiographic manifestations, as well as the accuracy of hydatid immunologic test.

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Histological subtypes of symptomatic central nervous system tumours in Singapore

Journal of Neurology Neurosurgery & Psychiatry ◽

10.1136/jnnp.68.3.372 ◽

2000 ◽

Vol 68 (3) ◽

pp. 372-374 ◽

Cited By ~ 5

Author(s):

A Das

Keyword(s):

Central Nervous System ◽

Nervous System ◽

Histological Subtypes ◽

Central Nervous System Tumours

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Multidisciplinary treatment for central nervous system tumours with nitrosourea compounds

Acta Neurochirurgica ◽

10.1007/bf01811342 ◽

1978 ◽

Vol 41 (4) ◽

pp. 287-299 ◽

Cited By ~ 11

Author(s):

P. Paoletti ◽

G. Robustelli della Cuna ◽

R. Knerich ◽

M. R. Strada

Keyword(s):

Central Nervous System ◽

Nervous System ◽

Multidisciplinary Treatment ◽

Central Nervous System Tumours

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LINC-39. PERFORMANCE STATUS OF PEDIATRIC PATIENTS WITH CENTRAL NERVOUS SYSTEM TUMORS TREATED IN MEXICO, A SINGLE-CENTER EXPERIENCE

Neuro-Oncology ◽

10.1093/neuonc/noaa222.472 ◽

2020 ◽

Vol 22 (Supplement_3) ◽

pp. iii385-iii386

Author(s):

Claudia Madrigal-Avila ◽

Alfonso Perez-Bañuelos ◽

Rafael Ruvalcaba-Sanchez ◽

Lourdes Vega-Vega ◽

Gabriela Escamilla-Asiain

Keyword(s):

Central Nervous System ◽

Nervous System ◽

Multidisciplinary Approach ◽

Pediatric Patients ◽

Performance Status ◽

Retrospective Chart Review ◽

Cns Tumors ◽

Surgical Morbidity ◽

Tertiary Center

Abstract BACKGROUND Central nervous system (CNS) tumors are the most common solid neoplasms in the pediatric age, they comprise about a quarter of all cancers at this age. Little is known about the specific epidemiology of this group in Mexico and there are no reports of results focused on the Performance Status of patients who are treated in a multidisciplinary setting. OBJECTIVE To describe the Performance Status of CNS pediatric patients after being treated with a multidisciplinary approach in a tertiary center. METHODS We report a retrospective chart review of all pediatric patients who presented to the Neuro-Oncology Clinic at Teleton Pediatric Oncology Hospital in Queretaro, Mexico, from December 2014 to January 2020. We analyzed age, gender, the extent of surgical resection and histopathology. Performance Status was assessed using ECOG and Karnofsky/Lansky scores during every patient’s last follow-up visit. RESULTS A total of 56 patients were treated, epidemiology and histopathology variants are similar to those described in the international literature. With a median follow-up of 33 months, 35 patients are alive (62.5%), 28 of them (74.2%) have an excellent Performance Status (ECOG score 0 or Lansky/Karnofsky ≥ 90), 5 (14.2%) scored ECOG 1–2 and only 4 (11.4%) scored ECOG 3–4. CONCLUSIONS A multidisciplinary approach with a focus on Performance Status and the potential for neurological recovery is essential in the management of pediatric patients with CNS tumors. Efforts should be aimed at reducing post-surgical morbidity and early rehabilitation to reintegrate patients into society in the long term.

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Solitary Fibrous Tumors in the Central Nervous System

Archives of Pathology & Laboratory Medicine ◽

10.5858/2003-127-0432-sftitc ◽

2003 ◽

Vol 127 (4) ◽

pp. 432-439 ◽

Cited By ~ 10

Author(s):

Tarik Tihan ◽

Michael Viglione ◽

Marc K. Rosenblum ◽

Alessandro Olivi ◽

Peter C. Burger

Keyword(s):

Central Nervous System ◽

Nervous System ◽

Biological Behavior ◽

Clinicopathologic Features ◽

Distinct Entity ◽

Total Resection ◽

Solitary Fibrous Tumors ◽

The Central Nervous System ◽

Extracranial Metastases

Abstract Context.—Solitary fibrous tumors (SFTs) of the central nervous system are rare neoplasms that usually present as dura-based masses and clinically resemble meningiomas. Histologically, they can be similar to fibrous meningioma or hemangiopericytoma (HPC). In particular, densely cellular regions seen in some SFTs can be indistinguishable from HPC. Little is known about the biological behavior of SFTs, although most seem amenable to total resection. Objectives.—To define the clinicopathologic spectrum of SFTs in the central nervous system and to outline their differences from HPC and meningioma. Design.—We present the clinicopathologic features of 18 patients with SFT and compare them with those of an age- and sex-matched cohort of HPCs. Results.—Eleven SFTs were supratentorial, 3 were infratentorial, and 4 were intraspinal. Four of the 18 tumors were intra-axial (2 in the lateral ventricles and 2 within the spinal cord). Histologically, SFTs were similar to their soft tissue counterparts. Six tumors (6/18) had densely cellular regions, and 1 tumor showed frankly anaplastic features. All but 3 patients underwent gross total resection, and there were no metastases or tumor-related mortalities during the median follow-up of 40 months. In contrast, there were 15 local recurrences (83%), 5 extracranial metastases (27%), and 4 tumor-related deaths (22%) in the HPC cohort. Conclusions.—Our study presents the clinicopathologic features of SFT as a distinct entity from both meningioma and HPC. We also present unusual examples of anaplastic, intraventricular, and intramedullary spinal SFTs that expand the clinicopathologic spectrum of these uncommon and sometimes diagnostically difficult neoplasms.

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