scholarly journals Radiation-associated Pituitary Sarcoma

2018 ◽  
Vol 25 (2) ◽  
pp. 161-165
Author(s):  
Felipe Andres Constanzo ◽  
Jaime Mauricio Pinto ◽  
Thomas Wilhem Schmidt ◽  
Maria Loreto Spencer
Keyword(s):  
Short Term Memory ◽  
Background Radiation ◽  
Histopathological Examination ◽  
Rare Complication ◽  
Memory Loss ◽  
Whole Brain Radiotherapy ◽  
Residual Tumor ◽  
Optic Chiasm ◽  
Low Grade ◽  
Brain Radiotherapy

Background: Radiation therapy is commonly used as primary or adjuvant treatment for pituitary adenomas. Frequent side effects of this modality include hypopituitarism, visual disturbances, short-term memory loss and secondary tumors, sarcomas being among the rarest of the sellar region, with only 55 reported cases to date. Clinical Presentation: A 57-year old man with hypopituitarism and a 20-year history of a non-functioning pituitary macroadenoma subtotally resected four times and undergoing whole brain radiotherapy and bromocriptine, who developed acute visual deterioration due to compression of the optic chiasm by rapid growth of the residual tumor. An endoscopic transplanum approach was performed achieving gross total resection. Histopathological examination was consistent with an undifferentiated low-grade pituitary sarcoma. The patient’s vision improved after surgery, but healthcare-associated complications compromised his clinical outcome, succumbing to a pulmonary embolism a month after surgery. Conclusion: Radiation-induced pituitary sarcoma is a very rare complication of radiotherapy. There is no distinctive feature on imaging that can predict its occurrence. Prognosis is grim, without effective management and a mean survival of 6.5 months after diagnosis.

scholarly journals Extra and intradural spinal Hemangioblastoma

2012 ◽  
Vol 11 (3) ◽  
pp. 242-244
Author(s):  
Marcelo Campos Moraes Amato ◽  
Caio César Marconato Simões Matias ◽  
João Alberto Assirati Junior ◽  
Aline Paixão Becker ◽  
Carlos Gilberto Carlotti Junior ◽  
...  
Keyword(s):  
Histopathological Examination ◽  
Correct Diagnosis ◽  
White Male ◽  
Residual Tumor ◽  
Illustrative Case ◽  
Low Grade ◽  
Von Hippel Lindau ◽  
Von Hippel Lindau Disease ◽  
The Central Nervous System ◽  
Spinal Hemangioblastoma

Hemangioblastomas of the central nervous system (CNS) are low-grade highly vascularized tumors that may be sporadic or associated with Von Hippel-Lindau disease. Extradural hemangioblastomas are uncommon and those located extra and intradurally are even rarer. This study uses an illustrative case and literature review to discuss the difficulties to consider the correct diagnosis and to select the best surgical approach. A 57 years-old white male patient presented with myelopathy and right C5 radiculopathy. The images showed a lobulated, hourglass shaped, highly enhanced extra/intradural lesion that occupied the spinal canal and widened the C4-C5 right intervertebral foramen. Total resection of the intradural lesion was achieved through a posterior approach, but the extradural part could only be partially removed. Complete improvement was observed after four months of follow-up and the residual tumor has been followed up clinically and radiologically. Even though the preoperative impression was of a spinal schwannoma, the histopathological examination revealed grade I hemangioblastoma as per WHO. Despite their rarity, current complementary exams allow considering the diagnosis of hemangioblastoma preoperatively. That is essential to a better surgical planning in view of the particular surgical features of this lesion.

Delayed Radiation Toxicity after Focal or Whole Brain Radiotherapy for Low-Grade Glioma

2004 ◽  
Vol 66 (3) ◽  
pp. 333-339 ◽  
Author(s):  
M.H.J. Swennen ◽  
J.E.C. Bromberg ◽  
Th.D. Witkamp ◽  
C.H.J. Terhaard ◽  
T.J. Postma ◽  
...  
Keyword(s):  
Whole Brain Radiotherapy ◽  
Low Grade Glioma ◽  
Low Grade ◽  
Radiation Toxicity ◽  
Whole Brain ◽  
Brain Radiotherapy

MUCINOUS LOW-GRADE ADENOCARCINOMA ARISING IN AN INTRACRANIAL ENTEROGENOUS CYST

Neurosurgery ◽  
2008 ◽  
Vol 62 (4) ◽  
pp. E972-E973 ◽  
Author(s):  
Marco Gessi ◽  
Federico G. Legnani ◽  
Emanuela Maderna ◽  
Cecilia Casali ◽  
Carlo L. Solero ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Malignant Transformation ◽  
Histopathological Examination ◽  
Present Report ◽  
Cranial Nerves ◽  
Residual Tumor ◽  
Magnetic Resonance Imaging Scan ◽  
Low Grade ◽  
Resonance Imaging

Abstract OBJECTIVE Enterogenous cysts (ECs) of the central nervous system are developmental malformations that occur in the spinal canal, posterior fossa, or cerebral hemispheres. They are usually benign lesions, and malignant transformation is rare. To date, only three cases of malignant transformation have been reported in the literature. We present a case of a cerebellopontine EC showing foci of epithelial dysplasia and malignant transformation into a low-grade papillary mucinous adenocarcinoma. CLINICAL PRESENTATION A 25 year-old man with a 6-year history of hypoacusia presented to our department with facial nerve deficit, visual disturbances, and gait instability. A magnetic resonance imaging scan demonstrated a multiloculated cerebellopontine angle cyst with supratentorial hydrocephalus. INTERVENTION A retrosigmoidal approach was used to achieve cyst removal. This was followed several months later by ventriculoperitoneal shunt placement. The cyst was adherent to the brainstem, cranial nerves, and vessels, and it resembled a thin encapsulated structure filled with mucinous-like substance. No solid component was identified. Histopathological examination revealed an EC with foci of malignant transformation in a mucinous papillary adenocarcinoma. Magnetic resonance imaging was performed 5 months postoperatively due to progressive clinical worsening; this scan revealed lesion recurrence with severe brainstem compression. Emergency surgery was performed, and a large decompression was achieved. Subsequent follow-up computed tomographic scans showed progression of the residual tumor. The patient's neurological condition rapidly worsened, ultimately resulting in death. CONCLUSION The present report suggests that a careful histological examination of all ECs after surgery should be made to exclude dysplastic foci or carcinomatous transformation. Although the clinical behavior of ECs with malignant trasformation is unpredictable, surgery remains the treatment of choice. The use of possible adjuvant chemo- or radiotherapy has not been established.

scholarly journals Ganglioglioma of optic chiasma: A case report and review of literature

2020 ◽  
Vol 11 ◽  
pp. 392
Author(s):  
Bashar Abuzayed ◽  
Khaled Alawneh ◽  
Majdi Al-Qawasmeh ◽  
Sohaib Al-Khatib ◽  
Marwa Barukba ◽  
...  
Keyword(s):  
Histopathological Examination ◽  
Brain Magnetic Resonance Imaging ◽  
Optic Chiasm ◽  
Subtotal Resection ◽  
Low Grade ◽  
Who Grade ◽  
Optic Chiasma ◽  
Radiologic Findings ◽  
Pilocytic Astrocytomas ◽  
The Right

Background: Gangliogliomas are neoplasms containing both astrocytic and neuronal components. We present a case of gangliogliomas of the optic chiasm, which are extremely rare pathologies. Case Description: A 16-year-old female patient referred to our clinic with gradual deterioration of vision for the age of 1 year mostly in the right eye. Ophthalmic examination confirmed reduced visual acuity with only perception of light in the left eye. Brain magnetic resonance imaging showed a solid mass lesion involving the hypothalamus and the optic chiasm, which was hypointense on T1-weighted images, hyperintense on T2-WI, and marked homogenous contrast enhancement. The patient was operated and bulging of the optic chiasm and the site of lamina terminalis was seen. Subtotal resection of the tumor was achieved. Histopathological examination revealed ganglioglioma (WHO Grade I). Follow-up of the patient was for 3 years and 8 months with stable neurologic and radiologic findings. Conclusion: To the best of our knowledge, 20 cases, including ours, have been reported in the literature and a presurgical diagnosis of ganglioglioma is very infrequent with confused radiologically with low-grade pilocytic astrocytomas.

scholarly journals Treatment of Recurrent Primary Cutaneous Mucinous Carcinoma of the Eyelid with Modified Wide Local Excision

2020 ◽  
Vol 2020 ◽  
pp. 1-5
Author(s):  
Stephanie M. Tillit ◽  
Siva S. R. Iyer ◽  
Eric J. Grieser ◽  
John T. LiVecchi
Keyword(s):  
Case Report ◽  
Histopathological Examination ◽  
Malignant Neoplasm ◽  
Surgical Excision ◽  
Residual Tumor ◽  
Excisional Biopsy ◽  
Mucinous Carcinoma ◽  
Low Grade ◽  
Upper Eyelid ◽  
First Case

Primary cutaneous mucinous carcinoma (PCMC) is a rare, low-grade malignant neoplasm of the sweat gland, whose history has been controversial regarding eccrine versus apocrine origin. This case report describes a 53-year-old male who presented to the University of Florida, Gainesville, ophthalmology clinic and was referred to the oculoplastics service with a painless, subcentimeter mass on the lateral right upper eyelid including the canthus, consistent with recurrent primary cutaneous mucinous carcinoma of the eyelid. Four years prior, the patient had undergone excisional biopsy of the lesion in a clinic, which revealed residual tumor, but the patient deferred further surgery at the time. The patient underwent surgical excision of the mass with reconstruction without operative complications and with negative surgical margins. PCMC is difficult to diagnose clinically due to its rarity and requires a histopathological examination for confirmation of the diagnosis. This report presents the first case in the literature of primary cutaneous mucinous carcinoma in a patient with human immunodeficiency virus (HIV). With this case report, we aim to raise awareness of primary cutaneous mucinous carcinoma as a potential part of the differential diagnosis for malignant eyelid lesions, including those present in patients with HIV.

Radiosurgery alone or in combination with whole-brain radiotherapy for brain metastases.

1998 ◽  
Vol 16 (11) ◽  
pp. 3563-3569 ◽  
Author(s):  
A Pirzkall ◽  
J Debus ◽  
F Lohr ◽  
M Fuss ◽  
B Rhein ◽  
...  
Keyword(s):  
Brain Metastases ◽  
Median Survival ◽  
Local Control ◽  
Radiation Necrosis ◽  
Whole Brain Radiotherapy ◽  
Low Grade ◽  
Median Dose ◽  
Whole Brain ◽  
Brain Radiotherapy ◽  
Extracranial Disease

PURPOSE Evaluation of the treatment outcome after radiosurgery (RS) alone or in combination with whole-brain radiotherapy (WBRT) with special attention to prescribed dose and its influence on local control and survival. PATIENTS AND METHODS Between September 1984 and January 1997, 236 patients with 311 brain metastases treated with radiosurgery met the following inclusion criteria: one to three brain metastases per patient; no previous WBRT; and Kamofsky performance status (KPS) > or = 50%. One hundred fifty-eight patients treated only with RS received a median dose of 20 Gy prescribed to the 80% isodose line; 78 patients received RS with a median dose of 15 Gy/80% and an additional course of WBRT. RESULTS For the entire series, overall median survival was 5.5 months, with control of CNS disease achieved in 92% of the treated brain metastases; the results were not significantly different between patients treated by RS with or without WBRT. However, in patients without evidence of extracranial disease, median survival was increased for patients who received WBRT (15.4 vs 8.3 months; P=.08). Additionally, there was a suggestion that increased doses for patients treated with RS only resulted in improved outcome. Four lesions were suspicious for radiation necrosis by magnetic resonance imaging (MRI); in one of the four lesions, radiation necrosis was confirmed histologically. The incidence of transient low-grade toxicity was 18%; symptoms could be treated by the temporary administration of steroids. CONCLUSION RS is an effective, noninvasive means of controlling brain metastases when used alone or in combination with WBRT. There is a trend for superior local control and especially in patients without extracranial disease for superior survival when RS is used in conjunction with WBRT. Randomized trials would seem to be warranted, comparing the benefit of RS with or without additional WBRT.

scholarly journals Functional role of brain-engrafted macrophages against brain injuries

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Xi Feng ◽  
Elma S. Frias ◽  
Maria S. Paladini ◽  
David Chen ◽  
Zoe Boosalis ◽  
...  
Keyword(s):  
Cognitive Deficits ◽  
Brain Injuries ◽  
Memory Loss ◽  
Whole Brain Radiotherapy ◽  
Intermediate Phenotype ◽  
Protective Effects ◽  
Whole Brain ◽  
Brain Radiotherapy ◽  
Bone Marrow Chimeras

Abstract Background Brain-resident microglia have a distinct origin compared to macrophages in other organs. Under physiological conditions, microglia are maintained by self-renewal from the local pool, independent of hematopoietic progenitors. Pharmacological depletion of microglia during whole-brain radiotherapy prevents synaptic loss and long-term recognition memory deficits. However, the origin or repopulated cells and the mechanisms behind these protective effects are unknown. Methods CD45low/int/CD11b+ cells from naïve brains, irradiated brains, PLX5622-treated brains and PLX5622 + whole-brain radiotherapy-treated brains were FACS sorted and sequenced for transcriptomic comparisons. Bone marrow chimeras were used to trace the origin and long-term morphology of repopulated cells after PLX5622 and whole-brain radiotherapy. FACS analyses of intrinsic and exotic synaptic compartments were used to measure phagocytic activities of microglia and repopulated cells. In addition, concussive brain injuries were given to PLX5622 and brain-irradiated mice to study the potential protective functions of repopulated cells after PLX5622 + whole-brain radiotherapy. Results After a combination of whole-brain radiotherapy and microglia depletion, repopulated cells are brain-engrafted macrophages that originate from circulating monocytes. Comparisons of transcriptomes reveal that brain-engrafted macrophages have an intermediate phenotype that resembles both monocytes and embryonic microglia. In addition, brain-engrafted macrophages display reduced phagocytic activity for synaptic compartments compared to microglia from normal brains in response to a secondary concussive brain injury. Importantly, replacement of microglia by brain-engrafted macrophages spare mice from whole-brain radiotherapy-induced long-term cognitive deficits, and prevent concussive injury-induced memory loss. Conclusions Brain-engrafted macrophages prevent radiation- and concussion-induced brain injuries and cognitive deficits.

scholarly journals LONG-LASTING CONTROL OF HER-2 POSITIVE DISSEMINATED BREAST CANCER IN A REPRODUCTIVE AGED PATIENT

2021 ◽  
Vol 20 (3) ◽  
pp. 158-164
Author(s):  
A. V. Vazhenin ◽  
N. V. Voroshina ◽  
O. S. Tereshin ◽  
N. S. Dubrovskaya
Keyword(s):  
Breast Cancer ◽  
Social Activity ◽  
Whole Brain Radiotherapy ◽  
First Year ◽  
Low Grade ◽  
Significant Prognostic Factor ◽  
Brain Radiotherapy ◽  
Multiple Metastases ◽  
Her 2

Background. Breast cancer ranks as the second most common cancer (14.9 %) and the most common female cancer (20.9 %) in Russia. at the time of diagnosis, 11.0 % of patients have already developed metastases, and 10.3 % of patients die within the first year of diagnosis from disease progression. distant metastasis is the leading cause of death from breast cancer, and brain metastasis is a significant prognostic factor for poor survival.Case description. We report the case of a long-lasting control of advanced breast cancer with brain metastases in a 32-year-old woman. low grade tubular breast carcinoma was histologically confirmed. immunohistochemical study: eR-ts-4 points, PR-ts – 3 points, Her-2 positive, Ki67 – 35.0 %. BRCa1 5382ins C mutation was not detected. the long-term use of therapy with lapatinib and capecitabine was described.Conclusion. this case demonstrates the feasibility of long-term (31 months) control over Her-2 positive disseminated breast cancer with multiple metastases to the brain and bones, while maintaining the quality of life and social activity of a young patient. despite the risks associated with whole brain radiotherapy, no cognitive impairment was observed. therapy with lapatinib and capecitabine was effective for 28 months with good tolerance.

Combination of microsurgery and Gamma Knife surgery for the treatment of intracranial chondrosarcomas

2006 ◽  
Vol 105 (Supplement) ◽  
pp. 18-25 ◽  
Author(s):  
Petter Förander ◽  
Tiit Rähn ◽  
Lars Kihlström ◽  
Elfar Ulfarsson ◽  
Tiit Mathiesen
Keyword(s):  
Gamma Knife ◽  
Cranial Nerve ◽  
Residual Tumor ◽  
Local Tumor Control ◽  
Gamma Knife Surgery ◽  
Long Term Results ◽  
Tumor Control ◽  
Low Grade ◽  
Cranial Nerve Palsies ◽  
Tumor Volume Reduction

ObjectIntracranial chondrosarcomas have a high risk of recurrence after surgery. This retrospective study of patients with intracranial chondrosarcoma was conducted to determine the long-term results of microsurgery followed by Gamma Knife surgery (GKS) for residual tumor or recurrence.MethodsThe authors treated nine patients whose median age was 36 years. Seven patients had low-grade chondrosarcomas (LGCSs), whereas mesenchymal chondrosarcomas (MCSs) were diagnosed in two. Radiosurgery was performed in eight patients, whereas one patient declined further surgical intervention and tumor-volume reduction necessary for the GKS.The patients were followed up for 15 to 173 months (median 108 months) after diagnosis and 3 to 166 months (median 88 months) after GKS. Seven patients had residual tumor tissue after microsurgery, and two operations appeared radical. In the two latter cases, tumors recurred after 25 and 45 months. Thus, definite tumor control was not achieved after surgery alone in any patient, whereas the addition of radiosurgery allowed tumor control in all six patients with LGCSs. Two of these patients experienced an initial tumor regrowth after GKS; in both cases the recurrences were outside the prescribed radiation field. The patients underwent repeated GKS, and subsequent tumor control was observed. An MCS was diagnosed in the remaining two patients. Complications after microsurgery included diplopia, facial numbness, and paresis. After GKS, one patient had radiation necrosis, which required microsurgery, and two patients had new cranial nerve palsies.Conclusions Tumor control after microsurgery alone was not achieved in any patient, whereas adjuvant radiosurgery provided local tumor control in six of eight GKS-treated patients. Tumor control was not achieved in the two patients with MCS. Similar to other treatments for intracranial chondrosarcoma, morbidity after micro- and radiosurgical combination therapy was high and included severe cranial nerve palsies.

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