Primary ectopic parasellar craniopharyngioma: a case report

Abstract Background Craniopharyngioma (CP) is a slow-growing, benign tumor of the central nervous system located within the sellar and suprasellar regions. The tumor may extend from the suprasellar region to other areas. CPs are generally believed to originate from squamous remnants of an incompletely involuted craniopharyngeal duct that also develops from Rathke’s pouch. Primary parasellar craniopharyngioma is a relatively rare tumor, and nasal endoscopy, computed tomography, and enhanced magnetic resonance imaging can be applied to better evaluate the invasiveness and characteristics of these tumors. Case presentation We report a case of right parasellar craniopharyngioma in a 49-year-old female patient with a 10-day history of dizziness and blurred vision. Preoperative imaging examination revealed right parasellar space-occupying lesions, and the patient underwent transnasal neuroendoscopic resection of the right parasellar space-occupying lesion. The postoperative pathological result confirmed craniopharyngioma. Conclusions Primary ectopic parasellar craniopharyngioma is a relatively rare tumor, and preoperative imaging examination can assist in the evaluation of tumor characteristics. However, the final diagnosis continues to depend on the histopathological results.

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Giant hyperostosis after sphenoid ridge en plaque meningioma removal

Romanian Neurosurgery ◽

10.2478/romneu-2014-0063 ◽

2014 ◽

Vol 21 (4) ◽

pp. 471-476

Author(s):

Danil Adam ◽

Toma Papacocea ◽

Ioana Hornea ◽

Cristiana Moisescu

Keyword(s):

Brain Mri ◽

Growth Patterns ◽

Neurological Deficits ◽

X Rays ◽

Blurred Vision ◽

Orbital Cavity ◽

Orbital Wall ◽

The Central Nervous System ◽

The Right ◽

Sphenoid Ridge

Abstract Meningioma is in most cases a benign tumor of the central nervous system with two growth patterns: en masse and en plaque. Hyperostosis is associated in 13 - 49 % of the cases with en plaque meningioma. We describe the case of a 47 years old woman with meningotelial sphenoid ridge meningioma which was totally removed. At the first admission she presented with no neurological deficits, seizures and a mild right exophthalmos. This had an indolent growth. After 10 years, the patient was readmitted for headache, blurred vision and right exophthalmos. Skull X-rays and brain MRI revealed an important thickening of the right superior orbit wall and sphenoid ridge. She underwent a new surgery. There was no intradural tumor found. Instead, bones of the superior and lateral right orbit walls were very hiperostotic. A hole of 3/2 cm in the right superior orbital wall was drilled and the orbital cavity was decompressed. In the postoperative period, the symptoms were remitted and the exophthalmos reduced. We discuss the causes and management of hyperostosis associated with meningiomas.

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Skull Base Chondrosarcoma Presenting with Hemorrhage

Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques ◽

10.1017/s0317167100008428 ◽

2009 ◽

Vol 36 (6) ◽

pp. 774-775 ◽

Cited By ~ 5

Author(s):

Gary L. Gallia ◽

Zev A. Binder ◽

Jacob Schwarz ◽

John L. Moriarity ◽

Jon D. Weingart

Keyword(s):

Temporal Lobe ◽

Intraventricular Hemorrhage ◽

Histopathological Examination ◽

Acute Onset ◽

Low Grade ◽

Blurred Vision ◽

Proton Beam Radiotherapy ◽

Suprasellar Region ◽

Third Cranial Nerve Palsy ◽

The Right

A 34-year-old white man with a six month history of a feeling of déjà vu presented with an acute onset of headache and blurred vision associated with nausea and vomiting. Neurological examination was significant for a right third cranial nerve palsy. Computerized tomography (CT) demonstrated a 2.0 cm rim calcified right paracavernous mass with intratumoral hemorrhage and an adjacent 2.6 cm by 2.0 cm right temporal lobe hematoma. Intraventricular hemorrhage (IVH) was present in both lateral ventricles, right more than left (Figure 1). Diagnostic cerebral angiography demonstrated no evidence of aneurysm. Brain magnetic resonance (MR) imaging revealed a 2 cm mass in the right paracavernous region extending into the suprasellar region with heterogeneous signal intensity on T1- and T2-weighted images and heterogeneous enhancement after gadolinium administration. Adjacent to the lesion was a right temporal lobe hematoma; intraventricular hemorrhage was also observed in the right lateral ventricle (Figure 2). The patient underwent a right pterional craniotomy for gross total resection of the tumour. Histopathological examination of the tumour demonstrated a low grade hyaline chondrosarcoma. The patient subsequently underwent proton beam radiotherapy and is currently 82 months out from surgery with no evidence of recurrence.

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COT-05 A CASE OF NEPALESE IN JAPAN SUSPECTED OF NEUROCYSTICERCOSIS

Neuro-Oncology Advances ◽

10.1093/noajnl/vdz039.188 ◽

2019 ◽

Vol 1 (Supplement_2) ◽

pp. ii41-ii41

Author(s):

Masataka Mikai ◽

Ryo Matsuzaki ◽

Chie Matsuura ◽

Sayaka Terazono ◽

Shumpei Ando ◽

...

Keyword(s):

Tissue Reaction ◽

Whole Body ◽

High Signal ◽

Enhancement Effect ◽

Pathological Findings ◽

Whole Body Ct ◽

Pathological Result ◽

The Central Nervous System ◽

Magnetic Resonance Imaging Mri ◽

The Right

Abstract INTRODUCTION Cystosis is the most common parasitic disease of the central nervous system. Especially in developing countries, it is one of the differential diagnosis of diseases that cause seizures. We report a case of a foreigner suspected of having neurocysticercosis. CASE A 36-year-old Nepalese visiting Japan for 2 years. Two days ago, she lost consciousness for a few seconds and was transferred to our hospital complaint of convulsions for about 1 minute. Head Computed Tomography (CT) revealed a mass lesion with a ring enhancement effect of about 10 mm in the right frontal lobe, with edema around it. Magnetic Resonance Imaging (MRI) shows T1WI low signal, T2WI high signal, and diffusion-weighted image with a light high signal. The ring-shaped enhancement effect was exhibited. Whole body CT showed no obvious lesions and blood tumor markers were negative. Various infections were negative, and cerebrospinal fluid cytology and culture were negative. POSTOPERATIVE COURSE From the surgical findings, brain abscesses such as cerebral tuberculoma were suspected, but various tests were negative. As a pathological result, the tumor had a capsule, and the inside showed necrotic tissue and fibrous granulation tissue reaction. There were no insects, and no obvious cells were identified by special staining. From the origin area, symptoms, and pathological findings, neurocysticercosis was most suspected. CONCLUSION We experienced a case of suspected neurocysticercosis that was difficult to diagnose from images and pathological findings. In neurocysticercosis, when the worm body dies, contrast-enhanced MRI shows a ring-like enhancement effect, and it is accompanied by surrounding edema, which may require differentiation from brain tumors.

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New recognition of hepatic perivascular epithelioid cell tumours (PEComa): a retrospective analysis of 35 cases

10.21203/rs.2.22805/v1 ◽

2020 ◽

Author(s):

Xiao Yang ◽

Qing Yuan Wang ◽

Xiao Zhou ◽

Haoming Zhou ◽

Wen Bo Jia ◽

...

Keyword(s):

Smooth Muscle Actin ◽

Clinical Manifestations ◽

Epithelioid Cell ◽

Tumour Recurrence ◽

Preoperative Imaging ◽

Perivascular Epithelioid Cell ◽

Imaging Examination ◽

Right Lobe ◽

The Right

Abstract Purpose Our primary objective was to investigate the clinical features, diagnosis, treatment and prognosis of hepatic perivascular epithelioid cell tumours (PEComa).Patients and Methods Thirty-five cases of pathologically proven hepatic PEComa that were treated in the Department of Hepatobiliary Center of the First Affiliated Hospital of Nanjing Medical University from January 2008 to February 2019 were retrospectively analysed, and the literature was reviewed.Results Twenty-nine females and 6 males were included in this study. The mean age of these patients was 48.0 years (range, 21-75 years). Thirteen patients complained of upper abdominal pain and discomfort, but the tumours in the other patients were identified by performing an imaging examination. Hepatic PEComas tended to occur in the right lobe of the liver (20 cases in the right lobe, 13 in the left lobe and 2 in the caudate lobe). Two cases were characterized by multiple tumours, and the remaining cases were single lesions (range, 1.2-12 cm). Only 8 cases were correctly diagnosed by the preoperative imaging examination, and the correct diagnosis rate was only 22.9%. The postoperative immunohistochemistry analysis showed that hepatic PEComas are positive for human melanoma black 45 (HMB-45), Melan-A and smooth muscle actin (SMA), with the exception of 1 case that was negative for Melan-A. All patients undergoing an operation accepted regular follow-up, and the average time was 66.5 months (range, 3-132 months). Two patients who experienced tumour recurrence and 1 patient who died due to cardiovascular disease, but the remaining patients showed no evidence of tumour recurrence or metastasis during the follow-up period.Conclusions Hepatic PEComa is a rare type of tumour that mainly occurs in young and middle-aged women. The lack of clinical manifestations and imaging findings increases the difficulty of determining a preoperative diagnosis, which mainly depends on the pathological examinations. Surgery is currently the only effective treatment, and long-term clinical follow-up is necessary due to the aggressive behaviour and relapse of hepatic PEComa in some cases.

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Recurrence of Primary Breast Lymphoma Presenting as Bilateral Vitreoretinal Lymphoma

Ocular Oncology and Pathology ◽

10.1159/000515560 ◽

2021 ◽

pp. 1-5

Author(s):

Karishma Habbu ◽

Roshan George ◽

Miguel Materin

Keyword(s):

Brain Mri ◽

B Cell Lymphoma ◽

Intrathecal Chemotherapy ◽

Primary Breast Lymphoma ◽

Blurred Vision ◽

Breast Lymphoma ◽

Central Nervous System Penetration ◽

Vitreoretinal Lymphoma ◽

The Right ◽

Vitreous Biopsy

Purpose: This report describes a case of relapsed primary breast lymphoma (PBL) presenting as vitreoretinal lymphoma (VRL). Methods: We describe the clinical and hematopathologic findings in a patient with relapsed PBL involving the vitreous of both eyes. Results: A 59-year-old woman was treated for PBL with systemic and intrathecal chemotherapy 5 years prior to presentation. Three years later, she presented to an outside clinic with blurred vision in both eyes and bilateral vitritis. She was referred to our clinic with concern for ocular lymphoma. On presentation, the patient’s best-corrected visual acuity was 20/40 in the right eye and 20/25 in the left eye with 3+ vitreous cells in the right eye and 2+ vitreous cells in the left eye. Vitreous biopsy of the right eye revealed CD5-negative/CD10-negative B-cell lymphoma cells on flow cytometry. She had no evidence of disease on brain MRI, lumbar puncture, bone marrow biopsy, or full-body CT scans. She was treated with a regimen of rituximab, methotrexate, procarbazine, and vincristine for central nervous system penetration as well as multiple intraocular injections of methotrexate and rituximab with improvement in vision and ocular inflammation bilaterally. Conclusion: Relapsed PBL can present as bilateral VRL.

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A First Case Report of Orbital Extra-Adrenal Paraganglioma in Cat

Veterinary Sciences ◽

10.3390/vetsci8050086 ◽

2021 ◽

Vol 8 (5) ◽

pp. 86

Author(s):

Leonardo Leonardi ◽

Raluca Ioana Rizac ◽

Ilaria Pettinari ◽

Luca Mechelli ◽

Carlo De Feo

Keyword(s):

Parasympathetic Nervous System ◽

Neuron Specific Enolase ◽

Final Diagnosis ◽

Neuroendocrine Cells ◽

Neuroendocrine Neoplasm ◽

Glial Fibrillary Acid Protein ◽

Veterinary Clinic ◽

First Case ◽

The Right ◽

Extra Adrenal Paraganglioma

Paraganglioma is a rare neuroendocrine neoplasm originating from paraganglia and consisting of neuroendocrine cells of the sympathetic and parasympathetic nervous system. Extra-adrenal paraganglioma occurs with a low incidence in both humans and animals. This report presents the first case of paraganglioma in a cat with orbital primary location. An 18-year-old spayed female European domestic shorthair cat of 3.60 kg body weight was evaluated in a private veterinary clinic in Perugia, Italy, for a pronounced exophthalmos of the right eye. The cat underwent surgery for the enucleation of the right eye and of the mass. The biopsy samples of the removed tissue were fixed in 10% buffered neutral formalin for histological and immunohistochemical evaluations. Therefore, specific markers were used for immunohistochemical investigations, such as anti-neuron specific enolase (NSE), anti-synaptophysin, anti-glial fibrillary acid protein, anti-cytokeratin and anti-chromogranin. The results of these investigations allowed establishing the final diagnosis of ocular extra-adrenal paraganglioma of the cat.

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Bilateral angle-closure during hospitalization for coronavirus disease-19 (COVID-19): A case report

European Journal of Ophthalmology ◽

10.1177/11206721211012197 ◽

2021 ◽

pp. 112067212110121

Author(s):

Guido Barosco ◽

Roberta Morbio ◽

Francesca Chemello ◽

Roberto Tosi ◽

Giorgio Marchini

Keyword(s):

Visual Impairment ◽

Cataract Extraction ◽

Ultrasound Biomicroscopy ◽

Angle Closure ◽

Blurred Vision ◽

Primary Angle Closure ◽

Primary Angle Closure Glaucoma ◽

Increased Risk ◽

The Right ◽

End Stage

Purpose: This report describes a case of bilateral primary angle closure (PAC) progressing to unilateral end-stage primary angle closure glaucoma (PACG) associated with treatment for coronavirus disease-19 (COVID-19) infection. Methods: A 64-year-old man came to our attention because of blurred vision after a 2-month hospital stay for treatment of COVID-19 infection. Examination findings revealed PACG, with severe visual impairment in the right eye and PAC in the left eye due to plateau iris syndrome. The patient’s severe clinical condition and prolonged systemic therapy masked the symptoms and delayed the diagnosis. Medical chart review disclosed the multifactorial causes of the visual impairment. Ultrasound biomicroscopy (UBM) aided in diagnosis and subsequent therapy. Results: The cause behind the primary angle closure and the iridotrabecular contact was eliminated by bilateral cataract extraction, goniosynechialysis, and myotic therapy. Conclusions: COVID-19 treatment may pose an increased risk for PAC. Accurate recording of patient and family ophthalmic history is essential to prevent its onset. Recognition of early signs of PAC is key to averting its progression to PACG.

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Ex Vivo Repair of a Renal Artery Saccular Aneurysm in a Living-Nonrelated Donor and Subsequent Successful Kidney Transplantation

Vascular and Endovascular Surgery ◽

10.1177/1538574418770104 ◽

2018 ◽

Vol 52 (6) ◽

pp. 455-458

Author(s):

Rogerio A. Muñoz-Vigna ◽

Javier E. Anaya-Ayala ◽

Juan N. Ramirez-Robles ◽

Daniel Nuño-Diaz ◽

Sandra Olivares-Cruz

Keyword(s):

Kidney Transplantation ◽

Renal Artery ◽

Ex Vivo ◽

Incidental Finding ◽

Left Kidney ◽

Renal Arteries ◽

Saccular Aneurysm ◽

Preoperative Imaging ◽

The Right ◽

Stage Renal Disease

The use of kidney grafts with aneurysmal disease involving the renal arteries for transplantation is very uncommon and relatively controversial. We herein present the case of a 52-year-old woman who volunteered to become a living-nonrelated donor; during the preoperative imaging workup, a computed tomography angiography revealed a 1.5-cm saccular aneurysm in the left kidney, while the contralateral renal artery was normal. We decided to utilize the left kidney for a 25-year-old male patient with end-stage renal disease, and following the ex vivo repair using the recipient epigastric vessels and saphenous veins, we completed the transplantation in the right pelvic fossa. The postoperative period was uneventful, and at 8 months from the surgery, the graft remains functional. The surgical repair of renal artery aneurysms followed by immediate kidney transplantation is a safe technique and an effective replacement therapy for recipients. The incidental finding of isolated aneurysmal disease in renal arteries should not exclude graft potential availability for transplantation following repair.

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Are we Ready for a “Microbiome-Guided Behaviour” Approach?

Cambridge Quarterly of Healthcare Ethics ◽

10.1017/s0963180119000653 ◽

2019 ◽

Vol 28 (04) ◽

pp. 708-724

Author(s):

ANDREA LAVAZZA ◽

VITTORIO A. SIRONI

Keyword(s):

Fecal Microbiota Transplantation ◽

Negative Attitude ◽

Well Being ◽

Fecal Microbiota ◽

Point Of View ◽

Brain Functioning ◽

The Central Nervous System ◽

The Individual ◽

The Right ◽

The Mind

Abstract:The microbiome is proving to be increasingly important for human brain functioning. A series of recent studies have shown that the microbiome influences the central nervous system in various ways, and consequently acts on the psychological well-being of the individual by mediating, among others, the reactions of stress and anxiety. From a specifically neuroethical point of view, according to some scholars, the particular composition of the microbiome—qua microbial community—can have consequences on the traditional idea of human individuality. Another neuroethical aspect concerns the reception of this new knowledge in relation to clinical applications. In fact, attention to the balance of the microbiome—which includes eating behavior, the use of psychobiotics and, in the treatment of certain diseases, the use of fecal microbiota transplantation—may be limited or even prevented by a biased negative attitude. This attitude derives from a prejudice related to everything that has to do with the organic processing of food and, in general, with the human stomach and intestine: the latter have traditionally been regarded as low, dirty, contaminated and opposed to what belongs to the mind and the brain. This biased attitude can lead one to fail to adequately consider the new anthropological conceptions related to the microbiome, resulting in a state of health, both physical and psychological, inferior to what one might have by paying the right attention to the knowledge available today. Shifting from the ubiquitous high-low metaphor (which is synonymous with superior-inferior) to an inside-outside metaphor can thus be a neuroethical strategy to achieve a new and unbiased reception of the discoveries related to the microbiome.

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Malignant astrocytoma following radiotherapy of a craniopharyngioma

Journal of Neurosurgery ◽

10.3171/jns.1978.48.4.0622 ◽

1978 ◽

Vol 48 (4) ◽

pp. 622-627 ◽

Cited By ~ 76

Author(s):

Richard L. Sogg ◽

Sarah S. Donaldson ◽

Craig H. Yorke

Keyword(s):

Experimental Evidence ◽

Temporal Lobe ◽

Malignant Astrocytoma ◽

Content Type ◽

Suprasellar Region ◽

The Right ◽

Fine Print

✓ A 9-year-old schoolgirl received 6007 rads to the suprasellar region for craniopharyngioma. Five years later, a malignant astrocytoma developed in the right temporal lobe. We cite clinical and experimental evidence to support our suspicion that the glioma may have been induced by radiation.

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