Brainstem angiocentric glioma: report of 2 cases

Angiocentric glioma is a rare tumor that was recognized by the WHO Classification of Tumours of the Central Nervous System as a distinct clinicopathological entity in 2007. Since this initial description, the vast majority of cases of angiocentric glioma reported in the literature have involved tumors of the cerebral hemispheres. To date, only 1 case of angiocentric glioma arising from the posterior midbrain has been reported. The authors present the cases of 2 pediatric patients who were found to have brainstem angiocentric gliomas. The clinical course, radiological and pathological features, treatment, and follow-up are described. The first case is one of a 5-year-old girl who presented with double vision, headache, and nausea and was found to have a midbrain lesion with pathological features consistent with angiocentric glioma. She was treated with resection and endoscopic third ventriculostomy (ETV), followed by close observation and serial neuroimaging. The second case is one of a 6-year-old boy who presented with progressive mouth drooping and problems with balance. He was found to have a pontine lesion with pathological features consistent with angiocentric glioma. This patient was treated with ETV, followed by close observation and serial neuroimaging. This report includes 6 and 1.5 years of follow-up of the patients, respectively. While there are limited data regarding the prognosis or long-term management of patients with brainstem angiocentric gliomas, the cases described in this report suggest an indolent course for this tumor, similar to the course of angiocentric gliomas located in the cerebral hemispheres.

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Inflammatory Myofibroblastic Tumor of the Bladder: 2 Rare Cases Managed with Laparoscopic Partial Cystectomy

Case Reports in Urology ◽

10.1155/2016/4976150 ◽

2016 ◽

Vol 2016 ◽

pp. 1-3 ◽

Cited By ~ 1

Author(s):

Sofia Santos Lopes ◽

Andrea Furtado ◽

Rita Oliveira ◽

Ana Cebola ◽

Bruno Graça ◽

...

Keyword(s):

Inflammatory Myofibroblastic Tumor ◽

Clinical Presentation ◽

Treatment Approach ◽

Pathological Condition ◽

Partial Cystectomy ◽

Pathological Features ◽

Macroscopic Hematuria ◽

Voiding Symptoms ◽

First Case

Two cases of inflammatory myofibroblastic tumor (IMT) of the bladder are reported here. Both patients were male and presented with macroscopic hematuria; in the first case terminal hematuria was associated with irritative voiding symptoms. The second case was a smoker with hematuria unresponsive to medical treatment and anemia. Clinical presentation, pathological features, treatment, and prognosis are discussed. Due to rarity of this pathological condition, there are no guidelines concerning treatment and follow-up. We present our follow-up scheme and highlight the use of laparoscopic partial cystectomy as a successful treatment approach.

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Transventricular, transaqueductal scope-in-scope endoscopic excision of fourth ventricular neurocysticercosis: a series of 13 cases and a review

Journal of Neurosurgery Pediatrics ◽

10.3171/ped-08/01/035 ◽

2008 ◽

Vol 1 (1) ◽

pp. 35-39 ◽

Cited By ~ 27

Author(s):

Ashish Suri ◽

Rohit Kumar Goel ◽

Faiz Uddin Ahmad ◽

Ananth Kesav Vellimana ◽

Bhawani Shankar Sharma ◽

...

Keyword(s):

English Language ◽

Third Ventriculostomy ◽

Cyst Excision ◽

Shunt Placement ◽

Cerebrospinal Fluid Diversion ◽

The Central Nervous System ◽

The Mean ◽

Clinical Records ◽

Ventricle Size

Object Neurocysticercosis (NCC) is the most common parasitic infestation of the central nervous system worldwide. In patients presenting with acute hydrocephalus due to intraventricular NCC, surgery is the only option. Still, there is no consensus regarding the optimal surgical strategy, although neuroendoscopic excision is a promising method. However, the literature regarding the use of this modality in fourth ventricular NCC is scarce. The authors describe a series of patients with fourth ventricular NCC treated endoscopically. Methods The clinical records of 13 patients with fourth ventricular NCC who had presented with hydrocephalus were retrospectively analyzed. A fourth ventricular cyst was completely excised in all patients by using a transventricular, transaqueductal “scope-in-scope” endoscopic technique. Twelve endoscopic third ventriculostomies and 1 septostomy had been performed. Results Shunt placement was avoided in all patients. There were minimal peri- and postoperative complications. The mean duration of follow-up was 22.3 months (range 3–41 months). All patients had an improved clinical outcome. Follow-up neuroimaging revealed no residual lesion and a decreased ventricle size in all patients. Conclusions The present series of patients with fourth ventricular NCC is the largest in the existing English-language medical literature. Endoscopic fourth ventricular cysticercal cyst excision along with internal cerebrospinal fluid diversion via endoscopic third ventriculostomy is an effective alternative to open microneurosurgical procedures and avoids shunt placement and its related complications.

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Intracerebral Whipple disease: unusual location and bone destruction

Journal of Neurosurgery ◽

10.3171/jns.2002.97.4.0988 ◽

2002 ◽

Vol 97 (4) ◽

pp. 988-991 ◽

Cited By ~ 9

Author(s):

Ziya Akar ◽

Necmettin Tanriover ◽

Saffet Tüzgen ◽

Bülent Canbaz ◽

Haldun Erman ◽

...

Keyword(s):

Chronic Diarrhea ◽

Bone Destruction ◽

Cns Involvement ◽

Content Type ◽

First Case ◽

Whipple Disease ◽

The Central Nervous System ◽

Mass Lesions ◽

Systemic Bacterial Infection

✓ Whipple disease is a rare systemic bacterial infection characterized by migratory polyarthralgia and chronic diarrhea. In 5 to 20% of patients with Whipple disease, the infection may present initially with or eventually develop symptoms related to the central nervous system (CNS). Although CNS involvement is a known feature of systemic Whipple disease, intracerebral mass lesions are uncommon. Mass lesions in these cases are typically deep seated and multifocal. Corticosubcortical regions are unusual sites of CNS involvement in cases of Whipple disease. In the present paper, the authors describe the first case of Whipple disease to feature a single corticosubcortical solid frontoparietal mass lesion that displayed homogeneous contrast enhancement on neuroimaging and was associated with bone destruction of the calvaria. Although CNS involvement has been observed in the form of deep-seated mass lesions in cases of systemic Whipple disease, unusual manifestations should be kept in mind during diagnosis and follow-up review in these patients.

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Clinicopathological Characteristics and Immunohistochemistry of Intracranial Hemangiopericytoma: Case Report and Literature Review

10.21203/rs.3.rs-864612/v1 ◽

2021 ◽

Author(s):

Shikun Yang ◽

Junbo Lian ◽

Wenxuan Huang ◽

Yang Liu ◽

Shuangjie Huo ◽

...

Keyword(s):

Clinicopathological Characteristics ◽

The Body ◽

Lower Limbs ◽

Pathological Examination ◽

Immunohistochemical Markers ◽

First Case ◽

Multiple Metastases ◽

Long Term Follow Up ◽

The Central Nervous System

Abstract BackgroundHemangiopericytoma was first named as a soft tissue tumor in 1942. It is a group of tumors composed of short spindle cells with pericyte growth. It is rare in clinical practice and accounts for 0.4 of all tumors originating in the central nervous system 0.4%, with a high degree of recurrence and the potential for metastasis outside the central nervous system.Case presentationWe report 4 patients, including 1 male and 3 females. All patients had headache, dizziness, and fatigue. The first and fourth patients showed acute exacerbation, paroxysmal limb twitching, flexion of both upper limbs, straightening of both lower limbs, unconsciousness, unresponsiveness, and upper eyeballs. Turning and closing of the teeth, 1 out of 2 patients was accompanied by a tongue bite. All 4 patients underwent imaging examinations. Considering the possibility of meningiomas and gliomas, all 4 patients underwent surgical resection and were followed up many times after the operation. The first case was followed up for 68 months and passed away due to recurrence without treatment. The second case was followed up for 50 months and relapsed at 42 months after the operation. It relapsed again 18 months after the operation and passed away with multiple metastases throughout the body; the third patient died in time The 4 patients were followed up for 32 months and 9 months respectively, and there is no recurrence at present.ConclusionsMeningeal HPC is a rare clinical tumor. 4 cases were followed up for 9-68 months, 2 cases recurred after surgery, and 1 case had multiple metastases throughout the body. It is not easy to distinguish HPC from meningioma on imaging. The diagnosis still depends on pathological examination, combined with the combined diagnosis of STAT6, CD34 and ALDHIA1 immunohistochemical markers, which can effectively improve the diagnosis and differential diagnosis of the disease. Because HPC is prone to recurrence and metastasis, Long-term follow-up and timely follow-up are still needed after operation.

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Papillary glioneural tumor presenting with multiple ischemic strokes: an aggressive presentation of a “benign” entity

International Surgery Journal ◽

10.18203/2349-2902.isj20212286 ◽

2021 ◽

Vol 8 (6) ◽

pp. 1892

Author(s):

Alejandro Vargas-Moreno ◽

Viviana Cruz-Ramírez ◽

Eugenio Meek-Benigni ◽

Oscar Feo-Lee

Keyword(s):

Literature Review ◽

Clinical Course ◽

Current Knowledge ◽

Histopathological Analysis ◽

Rare Entity ◽

First Case ◽

The Central Nervous System ◽

Treatment Alternatives ◽

Benign Course

Papillary glioneural tumors are infrequent neoplasms of the central nervous system, classically presenting with an indolent clinical course, rarely being related to an aggressive presentation, and not being associated with ischemic or another type of paraneoplastic phenomena. We describe the first case of this type of presentation with a literature review of the current knowledge of this entity. A 16-year-old female presented with a hemorrhagic intra-axial lesion, confirmed to be a papillary glioneural tumor in the histopathological analysis, being associated with multiple ischemic cerebral and posterior fossa strokes without another discernable cause than the presence of a paraneoplastic syndrome, not previously reported with this type of neoplasms. A literature review is presented detailing the current knowledge about this entity and emphasizing the need for greater knowledge about its natural history, immunobiology and treatment alternatives, opening a new window for the study of this pathology and establishing the need for a strict follow-up of patients who have this kind of tumors in order to learn more about their evolution. The papillary glioneural tumor, a rare entity having generally with a benign course, can have different presentations. Greater knowledge is needed to understand this behavior in order to optimize patient’s outcomes.

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Coccidioidomycosis Masquerading as Eosinophilic Ascites

Case Reports in Gastrointestinal Medicine ◽

10.1155/2015/891910 ◽

2015 ◽

Vol 2015 ◽

pp. 1-4 ◽

Cited By ~ 1

Author(s):

Kourosh Alavi ◽

Pradeep R. Atla ◽

Tahmina Haq ◽

Muhammad Y. Sheikh

Keyword(s):

Small Bowel ◽

Acute Abdominal Pain ◽

The United States ◽

Valley Fever ◽

Oral Fluconazole ◽

Bacterial Peritonitis ◽

First Case ◽

Eosinophilic Ascites ◽

The Central Nervous System

Endemic to the southwestern parts of the United States, coccidioidomycosis, also known as “Valley Fever,” is a common fungal infection that primarily affects the lungs in both acute and chronic forms. Disseminated coccidioidomycosis is the most severe but very uncommon and usually occurs in immunocompromised individuals. It can affect the central nervous system, bones, joints, skin, and, very rarely, the abdomen. This is the first case report of a patient with coccidioidal dissemination to the peritoneum presenting as eosinophilic ascites (EA). A 27-year-old male presented with acute abdominal pain and distention from ascites. He had eosinophilia of 11.1% with negative testing for stool studies, HIV, and tuberculosis infection. Ascitic fluid exam was remarkable for low serum-ascites albumin gradient (SAAG), PMN count >250/mm3, and eosinophils of 62%. Abdominal imaging showed thickened small bowel and endoscopic testing negative for gastric and small bowel biopsies. He was treated empirically for spontaneous bacterial peritonitis, but no definitive diagnosis could be made until coccidioidal serology returned positive. We noted complete resolution of symptoms with oral fluconazole during outpatient follow-up. Disseminated coccidioidomycosis can present in an atypical fashion and may manifest as peritonitis with low SAAG EA. The finding of EA in an endemic area should raise the suspicion of coccidioidal dissemination.

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When fever is more than infection: two cases of vancomycin-induced drug reaction with eosinophilia and systemic symptoms (DRESS)

BMJ Case Reports ◽

10.1136/bcr-2020-238006 ◽

2021 ◽

Vol 14 (1) ◽

pp. e238006

Author(s):

Mitchell Cox ◽

Sophie Paviour ◽

Sophie Gregory ◽

Rusheng Chew

Keyword(s):

Drug Reaction ◽

Cytomegalovirus Reactivation ◽

First Case ◽

Metropolitan Hospital ◽

Orthopaedic Ward ◽

Systemic Hypersensitivity ◽

Systemic Symptoms ◽

Inflammatory Syndrome ◽

Intravenous Glucocorticoids

Drug reaction with eosinophilia and systemic symptoms (DRESS) is a rare, but serious systemic hypersensitivity reaction associated with a range of medications. We present two cases of vancomycin-induced DRESS, which occurred simultaneously in the orthopaedic ward in an outer metropolitan hospital. These cases demonstrate the complexity in the diagnosis and management of this inflammatory syndrome on the background of known infection as well as evidence for linezolid as an alternative to vancomycin. The first case was managed conservatively, but developed progressive renal and liver injury along with demonstrated cytomegalovirus reactivation and recurrent colitis, and was eventually palliated. The second was commenced on intravenous glucocorticoids and achieved remission, although had ongoing renal dysfunction at the time of discharge from outpatient follow-up.

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Complete resolution of acute pancreatitis-induced chylous ascites following transhepatic portal vein stenting

BMJ Case Reports ◽

10.1136/bcr-2020-235986 ◽

2020 ◽

Vol 13 (12) ◽

pp. e235986

Author(s):

Alexander Tindale ◽

James Jackson ◽

Darina Kohoutova ◽

Panagiotis Vlavianos

Keyword(s):

Portal Vein ◽

Complete Resolution ◽

Chylous Ascites ◽

Biliary Pancreatitis ◽

Acute Biliary Pancreatitis ◽

Portal Vein Stenosis ◽

First Case ◽

Vein Stenosis ◽

Inflammatory Changes

We introduce a case of a 73-year-old man who developed intractable chylous ascites due to portal vein compression as a result of peripancreatic inflammatory changes after acute biliary pancreatitis. After stenting the portal vein stenosis, the chylous ascites improved from requiring weekly paracentesis to requiring no drainage within 4 months of the procedure and at the 15-month follow-up. To our knowledge, it is the first case reported in the literature where portal vein stenting has successfully been used to treat pancreatitis-induced chylous ascites.

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Extremely Elevated Cerebrospinal Fluid Protein and Glucose Level in a Neonate with Hypernatremic Dehydration

Journal of Pediatric Neurology ◽

10.1055/s-0040-1708496 ◽

2020 ◽

Author(s):

Arti Maria ◽

Tapas Bandyopadhyay

Keyword(s):

Cerebrospinal Fluid ◽

Neurodevelopmental Outcome ◽

Neurological Sequelae ◽

Glucose Levels ◽

Csf Analysis ◽

First Case ◽

Time Of Admission ◽

Cerebrospinal Fluid Protein ◽

Hypernatremic Dehydration

AbstractWe describe the case of a term newborn who presented with hypernatremic dehydration on day 19 of life. The baby was otherwise hemodynamically stable with no evidence of focal or asymmetric neurological signs. The laboratory tests at the time of admission were negative except for hypernatremia and the extremely elevated levels of cerebrospinal fluid (CSF) protein (717 mg/dL) and glucose levels (97 mg/dL). The hypernatremic dehydration was corrected as per the unit protocol over 48 hours. Repeat CSF analysis done after 5 days showed normalization of the protein and glucose levels. Serial follow-up and neuroimaging showed no evidence of neurological sequelae. Unique feature of our case is this is the first case reporting such an extreme elevation of CSF protein and glucose levels that have had no bearing on neurodevelopmental outcome at 1 month and 3 months of follow-up.

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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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