Operative Procedure in a Suprasellar Paediatric Lesion of the Optic Chiasm with Hydrocephalus Caused by a Papillary Glioneuronal Tumour

2021 ◽  
pp. 1-9
Author(s):  
Athanasios Saratziotis ◽  
Claudia Zanotti ◽  
Sara Munari ◽  
Chiara Pavone ◽  
Diego Cazzador ◽  
...  
Keyword(s):  
Obstructive Hydrocephalus ◽  
Operative Procedure ◽  
Optic Chiasm ◽  
External Ventricular Drainage ◽  
Endoscopic Endonasal ◽  
Case Presentation ◽  
Paediatric Tumours ◽  
Immediate Placement ◽  
Feasible Option

<b><i>Introduction:</i></b> Paediatric tumours in the sellar and parasellar regions present clinical and surgical challenges due to anatomical position and behaviour. We illustrate a rare case which caused obstructive hydrocephalus. <b><i>Case Presentation:</i></b> The study included a 14-year-old girl with a glioneuronal tumour (40 mm) originating from the optic chiasm, obliterating the aqueduct, with consequent triventricular hydrocephalus. The patient underwent extended endoscopic endonasal surgery and repair of the skull-base deficiency using a multi-layer technique with fascia lata. The 12-month follow-up showed no complications or recurrences, with recovery in visual acuity. <b><i>Conclusion:</i></b> The immediate placement of external ventricular drainage, in combination with an extended trans-sphenoidal approach, is a safe and feasible option to treat suprasellar paediatric lesions with hydrocephalus.

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

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

<b><i>Introduction:</i></b> 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. <b><i>Case Presentation:</i></b> 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. <b><i>Conclusion:</i></b> 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.

Vaginal delivery after laparotomic myomectomy during pregnancy

2019 ◽  
Vol 8 (2) ◽  
Author(s):  
Anna Garofalo ◽  
Paolo Petruzzelli ◽  
Michela Chiadò Fiorio Tin ◽  
Silvia Parisi ◽  
Giulia Garofalo ◽  
...  
Keyword(s):  
Acute Abdomen ◽  
Vaginal Delivery ◽  
Best Practice ◽  
Adverse Pregnancy Outcome ◽  
Case Reports ◽  
Rare Condition ◽  
Case Presentation ◽  
Feasible Option ◽  
Adverse Pregnancy

Abstract Background Symptomatic myomas during pregnancy are a rare condition that could however turn into an emergency because of torsion, necrosis, growth and compression leading to acute abdomen, potentially threating for pregnancy. Surgeons are usually reluctant to perform myomectomy during pregnancy because of an increased uterine blood flow and volume can give rise to a potential risk for haemorrhagic complications, while uterine manipulation can determine adverse pregnancy outcome. However, in some rare cases surgery is compulsory. Case presentation Here, we described a case of a successful laparotomic myomectomy performed during pregnancy at 11 weeks of gestation when an acute abdomen occurred. Surgery was followed by regular obstetrics follow-up ended with a spontaneous vaginal delivery with no pregnancy complications. Conclusion Although few case reports are described in literature, other authors have performed a myomectomy during pregnancy, and fewer cases have had a subsequent vaginal delivery, so that nowadays there is no clinical evidence on which to base best practice. This case shows that vaginal delivery after a laparotomic myomectomy performed during pregnancy, in selected cases, can be considered as a feasible option.

Temporary ventricular drainage and emergency radiotherapy in the management of hydrocephalus associated with germinoma

2002 ◽  
Vol 96 (6) ◽  
pp. 1020-1022 ◽  
Author(s):  
John M. Buatti ◽  
William A. Friedman
Keyword(s):  
Obstructive Hydrocephalus ◽  
External Ventricular Drainage ◽  
Tumor Control ◽  
Ventricular Drainage ◽  
Content Type ◽  
Fractionated Radiotherapy ◽  
Novel Strategy ◽  
Emergency Radiotherapy ◽  
Fine Print

Object. The authors used an alternative strategy to avoid shunt placement for hydrocephalus associated with germinoma, and the ensuing complications. Methods. Between 1998 and 2000, five patients presenting with germinomas of the pineal area and symptomatic obstructive hydrocephalus were treated with a novel strategy. On arrival, they underwent ventriculostomy placement and one of several surgical procedures to obtain tissue for diagnosis. Within several days of the initial diagnosis, stereotactically guided fractionated radiotherapy was started. All patients experienced rapid tumor shrinkage and resolution of hydrocephalus, allowing discontinuation of external ventricular drainage without the need for permanent shunting of cerebrospinal fluid. To date, follow up reveals 100% radiographically and clinically confirmed tumor control. Conclusions. Prompt resolution of hydrocephalus and absence of complications make this a potentially valuable therapy for control of germinomas and their symptoms.

scholarly journals Endoscopic Endonasal Transplanum–Transtuberculum Sellae Approach for the Resection of a Diaphragma Sellae Meningioma

2018 ◽  
Vol 79 (S 03) ◽  
pp. S271-S272 ◽  
Author(s):  
Juan Barbero ◽  
Alaa Montaser ◽  
Alexandre Todeschini ◽  
Mostafa Shahein ◽  
Bradley Otto ◽  
...  
Keyword(s):  
Histopathological Examination ◽  
Collagen Matrix ◽  
Field Testing ◽  
Optic Chiasm ◽  
Direct Access ◽  
Endoscopic Endonasal ◽  
Who Grade ◽  
Stable Vision ◽  
Diaphragma Sellae

AbstractThe endoscopic endonasal approach (EEA) provides a direct access to diaphragma sellae meningiomas. We present a case of a 56-year-old-female with an incidentally diagnosed sellar/suprasellar lesion with no hormonal deficit; thus, she opted for conservative management initially. During her annual follow-up appointment with her ophthalmologist, it was noticed that the patient had right eye peripheral deficit on formal visual field testing. Magnetic resonance imaging (MRI) revealed an enlargement of the sellar/suprasellar mass, causing displacement of the optic chiasm. A transplanum–transtuberculum EEA was performed. Gross-total removal was achieved and closure was done in a multilayer fashion using a collagen matrix, nasoseptal flap. Histopathological examination confirmed a meningioma WHO grade I. There were no intra- or postoperative complications. At 4-year-follow-up, the patient has stable vision and MRI brain showed no recurrence.The link to the video can be found at: https://youtu.be/xY8T9hotlDs.

scholarly journals Vagus-Preserving Proximal Gastrectomy with Double- Flap Technique for Gastrointestinal Stromal Tumor involving the Esophagogastric Junction：A Case Report

2021 ◽  
Author(s):  
Wei Peng ◽  
Yi-Kai Huang ◽  
Yong-You Wu ◽  
Wei Gong ◽  
Zheng-Rong Chen ◽  
...  
Keyword(s):  
Gastrointestinal Stromal Tumor ◽  
Proximal Gastrectomy ◽  
Partial Solution ◽  
Stromal Tumor ◽  
Case Presentation ◽  
Flap Technique ◽  
Enhanced Ct ◽  
Feasible Option

Abstract Background: Gastrointestinal stromal tumor (GIST) involving the esophagogastric junction (EGJ) is a relatively rare but thorny problem. It represents a dilemma between complete resection and impairment of quality of life (QOL) for loss of cardiac sphincter or even the whole stomach. Thus, emergence of function preserving gastrectomy is necessary and may provide partial solution to this hot potato. Here, we would like to introduce a method which successfully settle this matter through a clinical case. Case presentation: A 46-year-old male complaining of a progressive dysphagia. A huge GIST with 120mm in diameter was diagnosed by enhanced CT scan and pathological exam. Imatinib mesylate (IM) was initially prescribed, the tumor was shrank to a large extent while drug resistance emerged 6 months after therapy, leaving a mass approximately 90mm in diameter. We applied a method of vagus preserving proximal gastrectomy (VP-PG) and esophagogastrostomy with double-flap technique (DFT) for the patient. The operation was smooth and postoperative courses within a 12-months follow-up were uneventful. The patient had no digestive symptoms but slight leucopenia due to IM toxicity during this medication period. Conclusion: We consider that the application of VP-PG and DFT subsequent to neoadjuvant therapy with IM is likely to be an effective and feasible option for GISTs with EGJ involvement.

scholarly journals Spontaneous haemorrhage of an adrenal angiomyolipoma: case report

2019 ◽  
Vol 25 (1) ◽  
Author(s):  
Danielle Whiting ◽  
Ian Rudd ◽  
Amit Goel ◽  
Seshadri Sriprasad ◽  
Sanjeev Madaan
Keyword(s):  
Case Reports ◽  
Case Presentation ◽  
Open Adrenalectomy ◽  
Large Size ◽  
History Of ◽  
Loin Pain ◽  
Benign Tumours ◽  
Spontaneous Haemorrhage ◽  
Mesenchymal Tumours

Abstract Background Angiomyolipomas are rare mesenchymal tumours arising from the perivascular epithelioid cells consisting of variable amounts of adipose, thick-walled blood vessels and smooth muscle cells. These benign tumours commonly occur in the kidney with only a few case reports of adrenal angiomyolipomas which have the potential to reach a large size and haemorrhage. Case presentation A 45-year-old lady presented with a 3-week history of right loin pain, nausea and vomiting. A CT scan revealed a right adrenal angiomyolipoma measuring 6.3 × 6.8 cm with associated haemorrhage. The lesion was successfully treated with right open adrenalectomy, and histology confirmed the diagnosis of adrenal angiomyolipoma. The patient remained well with no evidence of recurrence at the 36-month follow-up. Conclusion Adrenal angiomyolipomas are rare benign tumours that have the ability to reach a large size and potential to bleed. Here, we report the second case of spontaneous haemorrhage in an adrenal angiomyolipoma, which was successfully treated with open adrenalectomy.

scholarly journals Bladder hamartoma in Peutz-Jeghers syndrome: a rare case report

2021 ◽  
Vol 27 (1) ◽  
Author(s):  
Jai Kumar ◽  
Mohammad Irfaan Albeerdy ◽  
Nadeem Ahmed Shaikh ◽  
Abdul Hafeez Qureshi
Keyword(s):  
Urinary Bladder ◽  
Filling Defect ◽  
Hamartomatous Polyps ◽  
Case Presentation ◽  
Rare Case Report ◽  
Mucocutaneous Pigmentation ◽  
Dominant Disease ◽  
Peutz Jeghers Syndrome ◽  
Comprehensive Compilation

Abstract Background Peutz-Jeghers syndrome is an autosomal dominant disease characterized by mucocutaneous pigmentation and hamartomatous polyps in the gastrointestinal tract (GIT). There have also been cases of extra GIT polyps such as the renal pelvis, urinary bladder, lungs and nares. Bladder hamartoma is an extremely rare finding, with only 12 cases described in the literature up to now. The rarity of the condition necessitates a comprehensive compilation of managements up to now so as to provide a better tool for the treatment of such conditions in the future. Case presentation A twenty-year-old male, known to have Peutz-Jeghers syndrome, presented to us complaining of obstructive urinary symptoms. A urethrogram done showed a filling defect at the base of the urinary bladder. The mass was resected transurethrally, and histopathology revealed a hamartoma of the bladder. The patient has since remained tumor-free on follow-up. Conclusions Transurethral resection of the bladder mass proved to be an effective therapy in this patient with no recurrence on the patient’s follow-up till now. There is still, however, a dearth of knowledge regarding the management of bladder hamartomas owing to the extreme rarity of the case.

scholarly journals Duodenal adenocarcinoma with skin metastasis as initial manifestation: A case report

2021 ◽  
Vol 16 (1) ◽  
pp. 395-398
Author(s):  
Yixiao Fu ◽  
Cuiping Zheng ◽  
Jian Huang ◽  
Shenghao Wu ◽  
Yanyan Dai
Keyword(s):  
Oral Treatment ◽  
Duodenal Biopsy ◽  
Skin Metastasis ◽  
Metastatic Adenocarcinoma ◽  
Duodenal Adenocarcinoma ◽  
Initial Manifestation ◽  
Case Presentation ◽  
Replacement Treatment ◽  
Lost To Follow Up

Abstract Background Duodenal adenocarcinoma (DA) with skin metastasis as initial manifestation is clinically rare. In this study, we report a rare case of skin metastasis of DA. Case presentation An 84-year-old male patient developed multiple ecchymoses on the trunk and lower extremities. Physical examination showed that the ecchymosis was dark red and had a hard texture, but showed no bulging, rupture, or tenderness. The skin biopsy implied skin metastatic adenocarcinoma. After an endoscopic duodenal biopsy, the patient was finally diagnosed with DA with skin metastasis. The patient received two courses of oral treatment of Tegafur (40 mg, bid d1–d14). However, the patient stopped taking Tegafur because of its poor effect and received Chinese medicine as a replacement treatment. Unfortunately, he was lost to follow-up. Conclusions Early diagnosis of DA metastasis is of significant importance as prognosis of these patients is poor.

scholarly journals Perforation of the atrial wall and aortic sinus after closure of an atrial septal defect with an Atriasept occluder: a case report

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Zai-Qiang Zhang ◽  
Jia-Wang Ding
Keyword(s):  
Case Report ◽  
Atrial Septal Defect ◽  
Septal Defect ◽  
Emergency Operation ◽  
Atrial Wall ◽  
Aortic Sinus ◽  
Case Presentation ◽  
Lethal Complications ◽  
Life Threatening

Abstract Background While the perforation of the atrial wall and aortic sinus after closure of an atrial septal defect (ASD) is rare, it’s life-threatening, with rapid progress and high mortality. To the best of our knowledge, 21 similar cases have been reported since 1976. Case presentation We report a 16-year-old male whose atrial septal defect (ASD) was closed using a 12-mm Amplatzer septal occluder (ASO). Atrial wall and aortic sinus perforation occurred 3 months after transcatheter closure, and the patient was discharged after emergency operation. He was discharged on the 12th postoperative day in good overall condition. Conclusions With this case report, we want to illustrate that although percutaneous closure of ASD is regarded as a routine procedure, we should not forget the potentially lethal complications, especially cardiac erosion. Therefore, we should carefully evaluate the risk of erosion before surgery, and careful lifelong follow-up is needed.

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