Glioblastoma multiforme of the pineal region: case report

PURPOSE: pineal region tumors are uncommon, and comprise more frequently three categories: germ cell, parenchymal cell and glial tumors. Most pineal gliomas are low-grade astrocytomas. Glioblastoma multiforme, the most aggressive and common brain tumor, is extremely rare at this location with only few cases reported. CASE DESCRIPTION: a 29-year-old woman with a two month history of headache, nuchal pain, fever, nausea and seizures and physical examination showing nuchal rigidity, generalized hypotony, hypotrophy and hyper-reflexia, Babinski sign and left VI cranial par palsy. CT scan examination revealed a ill-defined hypodense lesion at the pineal region with heterogeneous contrast enhancement. MRI showed a lesion at the pineal region infiltrating the right thalamic region. The patient underwent a right craniotomy with partial resection of the mass. The histological examination of paraffin-embedded material defined the diagnosis of glioblastoma multiforme. Post-operative radiotherapy was indicated but the patient refused the treatment and died two months afterwards. CONCLUSION: in spite of its rarity at this location, glioblastoma multiforme should be considered in the differential diagnosis of aggressive lesions at the pineal region.

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Interhemispheric transcallosal intervenous approach to a pineal region tumor

Neurosurgical Focus: Video ◽

10.3171/2021.4.focvid2120 ◽

2021 ◽

Vol 5 (1) ◽

pp. V11

Author(s):

Daniel A. Donoho ◽

Guillermo Aldave

Keyword(s):

Extent Of Resection ◽

Pineal Region ◽

Cerebral Veins ◽

Surgical Morbidity ◽

Pineal Tumors ◽

Pineal Region Tumor ◽

Pineal Region Tumors ◽

Transcallosal Approach ◽

Formidable Challenge ◽

The Right

Pineal region tumors represent a formidable challenge to the neurosurgeon. Choosing the right approach is key to optimizing the extent of resection and minimizing surgical morbidity. In this video, the authors show an interhemispheric transcallosal approach to a pineal region tumor in a 15-year-old boy. The advantage of this corridor over posterior approaches is that it provides a nice view of the tumor plane with the venous complex, especially while dissecting tumor from the anterior aspect of the internal cerebral veins on their vertical path. Thus, this approach represents a safe and effective alternative for selected pineal tumors. The video can be found here: https://stream.cadmore.media/r10.3171/2021.4.FOCVID2120.

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Pleomorphic xanthoastrocytoma at the pineal region: rare case report with successful surgical management

Egyptian Journal of Neurosurgery ◽

10.1186/s41984-021-00107-z ◽

2021 ◽

Vol 36 (1) ◽

Author(s):

Saraj Kumar Singh ◽

Krishan Kumar Sharma ◽

Tarun Kumar

Keyword(s):

Surgical Management ◽

Rare Case ◽

Case Reports ◽

Internal Capsule ◽

Pleomorphic Xanthoastrocytoma ◽

Pineal Region ◽

Low Grade ◽

Pineal Region Tumors ◽

Pediatric Age Group ◽

Rare Case Report

Abstract Background Pineal region tumors are commonly present in the pediatric age group. However, pleomorphic xanthoastrocytoma (PXA) is very rare at this region, and only few case reports have been reported till now in literature. Case presentation Here, we report a rare case of pineal region, juxta-thalamic, pleomorphic xanthoastrocytoma (PXA) in an 11-year-old male child. The child presented with severe headache after which MRI was done. It was suggestive of pineal region low-grade tumor. The patient was operated in Parkbench position with SCIT (supracerebellar approach) in a retractor-free manner. Gross total resection was done. However, the patient developed postoperative left-sided hemiparesis. It got improved in 1 month, and the patient became ambulatory. Histopathology came out as pleomorphic xanthoastrocytoma. Conclusion Surgical management should include careful resection near the internal capsule to avoid postoperative hemiparesis. Also, shunt should be delayed in the cystic cavity created by resection of tumor.

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Infrared Thermography in Surgery of Newly Diagnosed Glioblastoma Multiforme: A Technical Case Report

Case Reports in Oncology ◽

10.1159/000470832 ◽

2017 ◽

Vol 10 (1) ◽

pp. 350-355 ◽

Cited By ~ 4

Author(s):

Emanuil Naydenov ◽

Krasimir Minkin ◽

Marin Penkov ◽

Sevdalin Nachev ◽

Walter Stummer

Keyword(s):

Glioblastoma Multiforme ◽

Infrared Thermography ◽

Aminolevulinic Acid ◽

Newly Diagnosed ◽

Number Of Patients ◽

Newly Diagnosed Glioblastoma ◽

History Of ◽

The Right ◽

Insular Region ◽

Histological Result

Infrared thermography (IRT) is a real-time non-contact diagnostic tool with a broad potential for neurosurgical applications. Here we describe the intraoperative use of this technique in a single patient with newly diagnosed glioblastoma multiforme (GBM). An 86-year-old female was admitted in the clinic with a 2-month history of slowly progressing left-sided paresis. Neuroimaging studies demonstrated an irregular space-occupying process consistent with a malignant glioma in the right fronto-temporo-insular region. An elective surgical intervention was performed by using 5-aminolevulinic acid fluorescence (BLUE 400, OPMI) and intraoperative IRT brain mapping (LWIR, 1.25 mRad IFOV, 0.05°C NETD). After dura opening, the cerebral surface appeared inconspicuous. However, IRT revealed a significantly colder area (Δt° 1.01°C), well corresponding to the cortical epicenter of the lesion. The underlying tumor was partially excised and the histological result was GBM. Intraoperative IRT seems to be a useful technique for subcortical convexity brain tumor localization. Further studies with a large number of patients are needed to prove the reliability of this method in GBM surgery.

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Combined microsurgical-endoscopic paramedian supracerebellar-infratentorial approach for resection of a pineal low-grade glioma

Neurosurgical Focus: Video ◽

10.3171/2021.4.focvid2119 ◽

2021 ◽

Vol 5 (1) ◽

pp. V9

Author(s):

Juan M. Revuelta Barbero ◽

Roberto M. Soriano ◽

Rima S. Rindler ◽

David P. Bray ◽

Oswaldo Henriquez ◽

...

Keyword(s):

Endoscopic Third Ventriculostomy ◽

Third Ventricle ◽

Pineal Region ◽

Third Ventriculostomy ◽

Low Grade ◽

Total Resection ◽

Blurred Vision ◽

History Of ◽

Supracerebellar Infratentorial Approach

The authors present the case of a 20-year-old male with a history of headaches and blurred vision found to have a pineal mass and chronic hydrocephalus. The patient initially underwent an endoscopic third ventriculostomy and pineal mass biopsy that revealed a low-grade neuroepithelial neoplasm. A microsurgery-endoscope–assisted paramedian supracerebellar-infratentorial approach was chosen and a gross-total resection was achieved. The patient’s postoperative and follow-up course has been unremarkable, with early postoperative imaging demonstrating no residual tumoral mass. The operative video highlights the advantages of endoscopic visualization for deep lesions in the pineal region and posterior third ventricle. The video can be found here: https://stream.cadmore.media/r10.3171/2021.4.FOCVID2119.

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Clinicopathologic characteristics of primary pleural epithelioid hemangioendothelioma

Oncology Reviews ◽

10.4081/oncol.2010.219 ◽

2011 ◽

Vol 4 (4) ◽

pp. 219

Author(s):

Chad A. Reade ◽

Apar Kishor Ganti ◽

Anne Kessinger

Keyword(s):

Spontaneous Remission ◽

Epithelioid Hemangioendothelioma ◽

Low Grade ◽

Clinicopathologic Characteristics ◽

Short Survival ◽

History Of ◽

Therapeutic Measures ◽

Long Life ◽

Grade Malignancy ◽

The Right

Epithelioid hemangioendothelioma (EHE) is a rare vascular-derived malignancy. Within the thorax, EHE originating in the pleura is less often reported than EHE originating in the lung. Pulmonary EHE has been referred to as a borderline or low-grade malignancy that exhibits an unpredictable course. It often is associated with a long life expectancy and occasional spontaneous remission. Because the natural history of pleural EHE is less well understood, a literature review was conducted to investigate the characteristics of the disease. Twenty-two cases of pleural EHE were identified. The disease occurred more often in men than women, appeared in the right thorax more often than the left, exhibited a virulent course, was usually refractory to systemic therapy, and was often associated with a short survival. These characteristics differ substantially from those of pulmonary EHE and suggest that the clinician should approach pleural EHE anticipating an especially aggressive malignancy which likely will not respond to current therapeutic measures.

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Aseptic Meningitis in the Decennium of Borrelia burgdorferi Infection (Lyme Disease)

PEDIATRICS ◽

10.1542/peds.87.2.268a ◽

1991 ◽

Vol 87 (2) ◽

pp. 268-269

Author(s):

CHRISTOPH AUFRICHT ◽

WILLI TENNER ◽

GEROLD STANEK

Keyword(s):

Lyme Disease ◽

Borrelia Burgdorferi ◽

Physical Examination ◽

Lymph Nodes ◽

Sore Throat ◽

Aseptic Meningitis ◽

Cervical Lymph Nodes ◽

Nuchal Rigidity ◽

History Of ◽

The Right

To the Editor.— A 7-year-old boy with a 2-week history of fatigue, sore throat, and swelling of the right cheek was admitted to our hospital in May 1989. He had no history of intoxication, trauma, fever, or bite. He lived in Vienna and did not travel outside Austria.1 His mother was concerned about his irritability and emotional liability. Physical examination revealed mild hyperemia of his pharynx and ear drums. There were enlarged cervical lymph nodes and mild nuchal rigidity.

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Biodegradable Antibiotic Delivery Systems in the treatment chronic osteomyelitis

American Journal of BioMedicine ◽

10.18081/2333-5106/014-01/19-25 ◽

2014 ◽

Vol 2 (2) ◽

pp. 73-77

Keyword(s):

Chronic Osteomyelitis ◽

Past History ◽

Delivery Systems ◽

Subsequent Treatment ◽

Passive Movement ◽

Residential Home ◽

Low Grade ◽

History Of ◽

The Right ◽

Antibiotic Delivery

An 82-year-old woman was referred to the orthopedic department with a three-month history of low-grade fever. She had a known past history of type 2 diabetes. She had been unwell for last 5-days, complaining of feeling hot and 'shivery' with general aches, particularly in her right shoulder. The staff in the residential home where she lived had called the general practitioner who had prescribed a three-day course of trimethoprim for a suspected urinary tract infection. On examination, she was pyrexia with a temperature of 39.5°C. She was drowsy but reusable. Pulse was 125 beats per minute and regular. Blood pressure was 90/55 mmHg. Heart sounds were normal with no added sounds or murmurs. The chest was clear. Her abdomen was soft and non-tender with no palpable masses or organs. The skin overlying the right shoulder was warm to touch and erythematous. She was unable to tolerate any passive movement of the joint. A plain x ray of her shoulder shows lucent defects in the head of the humerus with loss of the normally well-corticated surface. This is consistent with osteomyelitis. Two of 2-blood cultures and numerous operative cultures grew MRSA. His subsequent treatment consisted of intravenous vancomycin, achieving plasma drug levels approximating 24 μg/mL. This treatment was extended for 8 weeks, given the clinical concern for possible osteomyelitis in an area. Treatment was complicated by significant a decline in hearing. Biodegradable drug delivery systems provide a method for local delivery of drugs in deeper tissues, obviating parenteral or enteral usage; in some situations, a significant advantage is that much higher doses and/or strengths of the drug can be delivered locally than can be tolerated if the drug is delivered systemically. In this case report, we discussed the use of Biodegradable Antibiotic Delivery Systems in treatment chronic osteomyelitis.

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Parasitic Myoma: A Very Rare Case Report aAnd Review of Literature

Journal of Surgical Sciences ◽

10.3329/jss.v17i1.43711 ◽

2019 ◽

Vol 17 (1) ◽

pp. 50-53

Author(s):

Md Manir Hossain Khan ◽

Jobaida Sultana

Keyword(s):

Abdominal Wall ◽

Blood Supply ◽

Iliac Fossa ◽

Abdominal Cavity ◽

Low Grade ◽

Review Of Literature ◽

Rare Case Report ◽

History Of ◽

The Right ◽

Further Development

A 32 years old unmarried women presented with periumbilical colickey abdominal pain which shiftted to the right iliac fossa with anorexia, vomiting and low grade fever. She had history of open myomectomy 4 years back for menorrhagia with multiple fibroids (myomas). On examination, the pointing sign, Rovsing's sign, McBurney's sign &Blumberg's sign were positive. Then she was diagnosed as a case of acute appendicitis. Ultrasonography revealed nothing significant. Appendicectomy was done through right Grid Iron incision. Appendix was found inflammed, swollen and there was collection of fluid in the peritoneal cavity. During closure, incidentally a solid mass about 5 ><4 ><2.5 cm was found exterior to the peritoneum near the incision at the abdominal wall. The mass was excised. Subsequently histopathotology confirmed a leiomyoma (Myoma or parasitic fibroid). The parasitic myoma may develop spontaneously as pedanculatedsubcerousmyomaloose their uterine blood supply or iatrogenically from retained fragment of myoma from previous myomectomy or hysterectomy and get blood supply from abdominal wall. Even small bits displaced into the abdominal cavity can result in parasitic fibroids. This case is reported here to give emphasis on the surveilence of parasitic myoma during myomectomy or hysterectomy for fibroid uterus and all tissue pieces that are morcellated should be delligently removed for the prevention of further development of parasitic myoma. Journal of Surgical Sciences (2013) Vol. 17 (1) : 50-53

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AIDS presenting as radial bone tuberculosis and pyogenic methicillin-sensitive Staphylococcus aureus osteomyelitis

BMJ Case Reports ◽

10.1136/bcr-2020-236802 ◽

2020 ◽

Vol 13 (10) ◽

pp. e236802

Author(s):

Nigel Jeronimo Cortez Santos ◽

Isabelle Dominique Villegas Tomacruz ◽

Frances Lina Lantion-Ang ◽

Paula Veronica San Juan Reyes

Keyword(s):

Staphylococcus Aureus ◽

Purulent Discharge ◽

Team Approach ◽

Low Grade ◽

Successful Infection ◽

History Of ◽

Bone Tuberculosis ◽

The Right ◽

Pyogenic Osteomyelitis ◽

Radial Bone

Osteomyelitis is a rare initial presentation of HIV. We report a case of a 25-year-old, apparently well man presenting with a traumatic, pathological fracture of the right radius. He had a 2-week history of low-grade fever, swelling and purulent discharge of the radial aspect of his right forearm. Osteomyelitis, secondary bacteraemia and pneumonia were clues that led physicians to test for HIV. Multiple debridement, sequestrectomy and vacuum-assisted closure were done. Tissue cultures revealed Mycobacterium tuberculosis (TB) and methicillin-sensitive Staphylococcus aureus. He was treated successfully with 6 weeks of culture-guided intravenous oxacillin, staphylococcal decontamination and first-line anti-TB regimen (rifampicin, isoniazid, ethambutol, pyrazinamide). Antiretroviral agents were started thereafter. Successful infection control and preservation of limb functionality was achieved with a multidisciplinary team approach. To our knowledge this is the first reported case of an adult patient with HIV presenting with tuberculous and pyogenic osteomyelitis of the radial bone.

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Primary angiosarcoma of the breast presenting with a benign vascular skin-like lesion and expanding hematoma: a case report of an extremely rare tumor

Journal of Surgical Case Reports ◽

10.1093/jscr/rjz223 ◽

2019 ◽

Vol 2019 (7) ◽

Author(s):

Chairat Burusapat ◽

Nutthadon wongprakob ◽

Rapeepat Sapruangthong ◽

Chatchai Pruksapong ◽

Viriya Kaewkangsadan ◽

...

Keyword(s):

Low Grade ◽

Tumor Type ◽

Rare Tumor ◽

Breast Cancers ◽

Breast Parenchyma ◽

Primary Angiosarcoma ◽

Cystic Changes ◽

Angiosarcoma Of The Breast ◽

History Of ◽

The Right

AbstractPrimary breast angiosarcoma is an extremely rare tumor type (0.05% of primary breast cancers) for which diagnosis can be difficult. They arise within the breast parenchyma and typically present as a breast mass. Here, we present the case of a 30-year-old female with spontaneous hypervascular skin on her right breast with progressive enlargement presenting as an expanding hematoma. A chest computed tomography revealed a hypervascular mass in the right breast abutting the pectoralis muscle and cystic changes within the mass. A core needle biopsy revealed an angiosarcoma. In this case study, we report a patient who, with no history of any known risk factors, presented with a benign vascular skin lesion as the first sign of angiosarcoma followed by an expanding hematoma, which is an extremely rare manifestation of the disease. Microscopic examination demonstrated a low-grade angiosarcoma on the skin, while a high-grade angiosarcoma was found in the breast parenchyma.

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