Primary Isolated Lymphoma of the Fourth Ventricle in an Immunocompetent Patient

Primary central nervous lymphoma (PCNSL) is a rare variant of extranodal non-Hodgkin's lymphoma with a especially poor prognosis. The diagnosis is usually encountered in immunodeficient patients but is also encountered, albeit uncommonly, in the immunocompetent. We present a 50-year-old male who developed signs and symptoms of increased intracranial pressure. Imaging revealed the presence of a fourth ventricle mass with obstructive hydrocephalus. First, the patient underwent emergency endoscopic third ventriculostomy followed, few days later, by complete tumor resection via a posterior fossa craniotomy. Postoperative histopathology revealed the lesion to be a PCNSL. He received adjuvant chemotherapy and radiation and remained with no recurrence on regular imaging studies for 18-month followup. We report herein the fourth case of isolated PCNSL lesion to the fourth ventricle in the literature and provide the rationale for our belief that craniotomy and tumor resection, if feasible, should be the initial line of management in similar cases to relieve hydrocephalus and achieve the diagnosis.

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Central neurocytomas of uncommon locations: report of two cases

Arquivos de Neuro-Psiquiatria ◽

10.1590/s0004-282x2006000600025 ◽

2006 ◽

Vol 64 (4) ◽

pp. 1015-1018 ◽

Cited By ~ 10

Author(s):

Francinaldo Lobato Gomes ◽

Luciano Ricardo França ◽

Samuel Tau Zymberg ◽

Sérgio Cavalheiro

Keyword(s):

Differential Diagnosis ◽

Intracranial Pressure ◽

Obstructive Hydrocephalus ◽

Signs And Symptoms ◽

Pineal Region ◽

Additional Treatment ◽

Third Ventriculostomy ◽

Increased Intracranial Pressure ◽

The Brain ◽

Uncommon Location

We report two patients with central neurocytomas at an uncommon location in the brain. The first, a 58-year-old man presenting with signs and symptoms of increased intracranial pressure, had a tumor located at the pineal region. The second, a 21-year-old woman with tumor in the aqueductal region had worsening migraine-like headaches and diplopia. Both patients had obstructive hydrocephalus treated by neuroendoscopic third ventriculostomy and biopsy of the tumors. No additional treatment was done. We conclude that neurocytomas should be considered in the differential diagnosis of tumors located in the pineal and aqueductal regions.

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Osteosarcoma of the jaws: a literature review

Current Medical Imaging Formerly Current Medical Imaging Reviews ◽

10.2174/1573405616666200806173948 ◽

2020 ◽

Vol 16 ◽

Author(s):

Francesco Ricotta ◽

Massimo Bassi ◽

Nicola Tomasetti ◽

Angelo Campobassi ◽

Vincenzo Maiolo ◽

...

Keyword(s):

Treatment Guidelines ◽

State Of The Art ◽

Bone Erosion ◽

Tumor Resection ◽

Bone Destruction ◽

Cell Type ◽

Complete Tumor Resection ◽

Predominant Cell Type ◽

Bone Changes ◽

Complete Tumor

: Osteosarcoma of the jaws (OSJ) is a relatively rare disease, accounting for between 2% and 10% of all cases of osteosarcoma, it is morphologically and radiologically identical to the trunk and extremity variant, but distinct in several crucial aspects. : The lesion is characterized by sarcomatous cells which produces a variable amount of osteoid bone. It arises centrally within the bone and can be subdivided into osteoblastic, chondroblastic and fibroblastic subtype, depending on the predominant cell type. : Radiographically, these tumors display a spectrum of bone changes from well-demarcated borders to lytic bone destruction with indefinite margins and variable cortical bone erosion or, in some cases, images of sclerotic bone. Therapeutic options for OSJ include surgery, chemotherapy and radiotherapy, which are employed according to age of the patient, histological classification and localization of the tumor. Today there is no a general consensus in the treatment guidelines for the OSJ though surgery represents the key of the treatment. The main prognostic factor deeply influencing the patient's prognosis remains the complete tumor resection with negative surgical margins. : The aim of the present review is to describe the state of the art regarding diagnostic and surgical treatment aspects of the primary osteosarcoma of the jaws.

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Fourth Ventricle Outlet Obstruction and Diverticular Enlargement of Luschka Foramina in a Child with Down Syndrome

Pediatric Neurosurgery ◽

10.1159/000511088 ◽

2020 ◽

pp. 1-4

Author(s):

Valentina Orlando ◽

Pietro Spennato ◽

Maria De Liso ◽

Vincenzo Trischitta ◽

Alessia Imperato ◽

...

Keyword(s):

Down Syndrome ◽

Fourth Ventricle ◽

Endoscopic Third Ventriculostomy ◽

Obstructive Hydrocephalus ◽

Radiological Finding ◽

Outlet Obstruction ◽

Third Ventriculostomy ◽

Viable Option ◽

Case Presentation

Introduction: Hydrocephalus is not usually part of Down syndrome (DS). Fourth ventricle outlet obstruction is a rare cause of obstructive hydrocephalus, difficult to diagnose, because tetraventricular dilatation may suggest a communicant/nonobstructive hydrocephalus. Case Presentation: We describe the case of a 6-year-old boy with obstructive tetraventricular hydrocephalus, caused by Luschka and Magendie foramina obstruction and diverticular enlargement of Luschka foramina (the so-called fourth ventricle outlet obstruction) associated with DS. He was treated with endoscopic third ventriculostomy (ETV) without complications, and a follow-up MRI revealed reduction of the ventricles, disappearance of the diverticula, and patency of the ventriculostomy. Conclusion: Diverticular enlargement of Luschka foramina is an important radiological finding for obstructive tetraventricular hydrocephalus. ETV is a viable option in tetraventricular obstructive hydrocephalus in DS.

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Hemangioma Calcificans in the Fourth Ventricle

Neurosurgery ◽

10.1227/00006123-198406000-00016 ◽

1984 ◽

Vol 14 (6) ◽

pp. 737-739 ◽

Cited By ~ 7

Author(s):

Kobayashi Hidenori ◽

Kawano Hirokazu ◽

Ito Haruhide ◽

Hayashi Minoru ◽

Yamamoto Shinjiro

Keyword(s):

Computed Tomography ◽

Intracranial Pressure ◽

Posterior Fossa ◽

Clinical Picture ◽

Fourth Ventricle ◽

Obstructive Hydrocephalus ◽

Increased Intracranial Pressure ◽

X Ray ◽

4Th Ventricle

Abstract A case of hemangioma calcificans in the 4th ventricle is reported. Skull x-ray films demonstrated a dense calcification in the posterior fossa. Computed tomography disclosed a hyperdense mass in the 4th ventricle. The clinical picture was of increased intracranial pressure due to obstructive hydrocephalus. An hemangioma calcificans in the 4th ventricle was removed successfully.

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Endoscopic Third Ventriculostomy in Previously Shunted Children

Minimally Invasive Surgery ◽

10.1155/2013/584567 ◽

2013 ◽

Vol 2013 ◽

pp. 1-4 ◽

Cited By ~ 6

Author(s):

Eva Brichtova ◽

Martin Chlachula ◽

Tomas Hrbac ◽

Radim Lipina

Keyword(s):

Success Rate ◽

Fourth Ventricle ◽

Pediatric Patients ◽

Endoscopic Third Ventriculostomy ◽

Obstructive Hydrocephalus ◽

Surgical Revision ◽

Clinical State ◽

Third Ventriculostomy ◽

Safe Procedure ◽

Shunt Implantation

Endoscopic third ventriculostomy (ETV) is a routine and safe procedure for therapy of obstructive hydrocephalus. The aim of our study is to evaluate ETV success rate in therapy of obstructive hydrocephalus in pediatric patients formerly treated by ventriculoperitoneal (V-P) shunt implantation. From 2001 till 2011, ETV was performed in 42 patients with former V-P drainage implantation. In all patients, the obstruction in aqueduct or outflow parts of the fourth ventricle was proved by MRI. During the surgery, V-P shunt was clipped and ETV was performed. In case of favourable clinical state and MRI functional stoma, the V-P shunt has been removed 3 months after ETV. These patients with V-P shunt possible removing were evaluated as successful. In our group of 42 patients we were successful in 29 patients (69%). There were two serious complications (4.7%)—one patient died 2.5 years and one patient died 1 year after surgery in consequence of delayed ETV failure. ETV is the method of choice in obstructive hydrocephalus even in patients with former V-P shunt implantation. In case of acute or scheduled V-P shunt surgical revision, MRI is feasible, and if ventricular system obstruction is diagnosed, the hydrocephalus may be solved endoscopically.

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Management of a primary cardiac leiomyosarcoma in a young woman

Turkish Journal of Thoracic and Cardiovascular Surgery ◽

10.5606/tgkdc.dergisi.2021.21040 ◽

2021 ◽

Vol 29 (2) ◽

pp. 267-270

Author(s):

Mehmet Akif Önalan ◽

Ahmet Demirkaya ◽

Kemal Behzatoglu ◽

Ersin Erek

Keyword(s):

Pulmonary Veins ◽

Tumor Resection ◽

Complete Tumor Resection ◽

The Right ◽

Tumor Remnant ◽

Invasive Techniques ◽

Right Lower Lobectomy ◽

Pathological Confirmation ◽

Complete Tumor

Cardiac leiomyosarcoma is an extremely rare tumor with a poor prognosis. An 18-year-old female patient was admitted to our clinic with a left atrial leiomyosarcoma extending to the right lower pulmonary veins. We performed complete tumor excision by the right anterolateral mini-thoracotomy approach using minimally invasive techniques. After pathological confirmation of the tumor, right lower lobectomy was performed with the same incision one week later to prevent recurrence. Although no tumor remnant was found in the lobectomy specimen, adjuvant chemotherapy was started. No recurrence was detected during the 12-month follow-up. In conclusion, the right submammarian minithoracotomy approach has the advantages of its less invasive nature and suitability for complete tumor resection with lobectomy.

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Oncologic outcomes after secondary surgery in recurrent clear-cell carcinoma of the ovary

International Journal of Gynecological Cancer ◽

10.1136/ijgc-2018-000142 ◽

2019 ◽

Vol 29 (5) ◽

pp. 910-915 ◽

Cited By ~ 3

Author(s):

Hiroaki Kajiyama ◽

Shiro Suzuki ◽

Nobuhisa Yoshikawa ◽

Michiyasu Kawai ◽

Kiyosumi Shibata ◽

...

Keyword(s):

Cell Carcinoma ◽

Cytoreductive Surgery ◽

Clear Cell ◽

Clear Cell Carcinoma ◽

Tumor Resection ◽

Ovarian Clear Cell Carcinoma ◽

Complete Tumor Resection ◽

Secondary Cytoreductive Surgery ◽

Disease Free ◽

Complete Tumor

ObjectiveComplete tumor resection is considered essential in the management of patients with ovarian clear-cell carcinoma. There is a debate regarding whether patients with recurrent ovarian clear-cell carcinoma benefit from secondary cytoreductive surgery.MethodsDetails of patients with clear-cell carcinoma were collected by the Tokai Ovarian Tumor Study Group (Nagoya University Hospital and 13 affiliated institutions) and evaluated between January 1990 and December 2015. Histology was confirmed after central pathological review. The primary endpoint of the study was disease-free survival after secondary cytoreductive surgery. Distributions of events were evaluated using the χ2 test. Survival analysis was based on the Kaplan-Meier method. Survival curves were compared using the log-rank test. A value of p<0.05 was considered significant.ResultsA total of 169 patients who underwent secondary cytoreductive surgery (N=25) or medical management (N=144) for recurrent clear-cell carcinoma were collected. The median age for patients undergoing secondary cytoreductive surgery was 50 years (range 35–66). Overall, 18 patients had complete resection. In patients who underwent secondary cytoreductive surgery, the median disease-free and post-recurrence survival periods were 10.9 months and 21.2 months, respectively. Moreover, among 18 patients who underwent complete resection, seven showed no evidence of disease during the observation periods. The median post-recurrence survival periods of patients with complete or incomplete resection were 30.1 months and 10.4 months, respectively (p=0.002). On stratification by the recurrence site, patients with intraperitoneal recurrence showed poorer post-recurrence survival than those with recurrence at other sites (p=0.016). However, comparison between the secondary cytoreductive surgery group versus the medical management group showed there was no difference in post-recurrence survival, even when considering complete tumor resection (p=0.114).ConclusionPatients with intraperitoneal recurrence or incomplete tumor resection had the worst survival after secondary cytoreductive surgery.

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Extensive Growth of an Anaplastic Meningioma

Case Reports in Neurological Medicine ◽

10.1155/2013/527184 ◽

2013 ◽

Vol 2013 ◽

pp. 1-4 ◽

Cited By ~ 1

Author(s):

Hajrullah Ahmeti ◽

Homajoun Maslehaty ◽

Athanasios K. Petridis ◽

Alexandros Doukas ◽

Mehran Mahvash ◽

...

Keyword(s):

Malignant Tumors ◽

Tumor Resection ◽

High Rate ◽

Complete Tumor Resection ◽

Calvarial Bone ◽

Anaplastic Meningioma ◽

Progressive Ataxia ◽

Extensive Growth ◽

Tumor Entity ◽

Complete Tumor

We present the case of a 30-year-old male patient with an almost complete destruction of the calvarial bone through an anaplastic meningioma diagnosed in line with dizziness. Neuroimaging revealed an extensive growing, contrast enhancing lesion expanding at the supra- and infratentorial convexity, infiltrating and destroying large parts of the skull, and infiltrating the skin. Due to progressive ataxia and dysarthria with proven tumor growth in the posterior fossa in the continuing course, parts of the tumor were resected. A surgical procedure with the aim of complete tumor resection in a curative manner was not possible. Six months after the first operation, due to a new tumor progression, most extensive tumor resection was performed. Due to the aggressive and destructive growth with a high rate of recurrence and tendency of metastases, anaplastic meningiomas can be termed as malignant tumors. The extrinsic growth masks the tumor until they reach a size, which makes these tumors almost unresectable. In the best case scenarios, the five-year survival is about 50%. With the presented case, we would like to show the aggressive behavior of anaplastic meningiomas in a very illustrative way. Chemotherapy, radiotherapy, and surgery reach their limits in this tumor entity.

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