Right temporal lobe glioblastoma presenting in the left orbit

2000 ◽  
Vol 92 (4) ◽  
pp. 702-705 ◽  
Author(s):  
Johan M. Kros ◽  
Herbert van den Berge ◽  
Hervé L. J. Tanghe ◽  
Stef L. M. Bakker
Keyword(s):  
Tumor Invasion ◽  
Initial Presentation ◽  
Bone Lesions ◽  
Primary Tumors ◽  
Content Type ◽  
Left Orbit ◽  
The Central Nervous System ◽  
The Brain ◽  
Dose Radiation ◽  
Fine Print

✓ Dissemination of gliomas outside the central nervous system without preceding neurosurgery is a rare phenomenon. Glial neoplasms presenting as bone lesions are even more rare. A case of glioblastoma multiforme (GBM) with initial presentation in the orbit following a single generalized seizure is described. Signs of intracranial hypertension resulted from subarachnoid tumor invasion. The patient was treated with whole-dose radiation therapy but survived for only 6 months following the initial presentation. An autopsy revealed a right temporal GBM with extensive subarachnoid spread and invasion in the left orbit and skull base. The literature on dissemination of primary tumors of the brain is reviewed.

Multiple primary tumors of the brain and bowel

1972 ◽  
Vol 36 (1) ◽  
pp. 93-96 ◽  
Author(s):  
Bruce F. Sorenson
Keyword(s):  
Central Nervous System ◽  
Malignant Neoplasm ◽  
Primary Tumors ◽  
Content Type ◽  
Multiple Primary ◽  
The Central Nervous System ◽  
Primary Neoplasms ◽  
Similarities And Differences ◽  
The Brain ◽  
Fine Print

✓ A 69-year-old man had two different primary neoplasms of the central nervous system and a third primary malignant neoplasm of the large bowel. Similarities and differences between this case and cases previously reported are discussed.

Capillary hemangioma of the central nervous system

2004 ◽  
Vol 101 (1) ◽  
pp. 73-81 ◽  
Author(s):  
Masamitsu Abe ◽  
Kazuo Tabuchi ◽  
Shin Tanaka ◽  
Akira Hodozuka ◽  
Katsuzo Kunishio ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Central Nervous System ◽  
Nervous System ◽  
Capillary Hemangioma ◽  
Benign Tumors ◽  
Content Type ◽  
Perifocal Edema ◽  
The Central Nervous System ◽  
The Brain ◽  
Fine Print

Object. Capillary hemangiomas are benign tumors or tumorlike lesions that originate from blood vessels and have rarely been reported to develop in the brain or spinal cord. The authors summarize the clinical and histological features of capillary hemangiomas of the central nervous system (CNS). Methods. The clinical features, imaging characteristics, and outcomes in 10 patients with CNS capillary hemangiomas were reviewed. Histological studies included immunostaining with CD31, α-smooth muscle actin, vascular endothelial growth factor, and Ki-67 antigen. Three patients with lesions in the brain presented with symptoms of increased intracranial pressure or seizures. Seven patients with lesions in the spinal cord presented with progressive sensorimotor disturbances of the lower limbs. Computerized tomography and magnetic resonance imaging demonstrated well-defined, enhancing lesions associated with marked perifocal edema. Angiography demonstrated hypervascular lesions, which have not recurred after resection. In two cases, multiple satellite lesions resolved after the systemic administration of steroid drugs or interferon-α. Histologically, all lesions were consistent with findings of capillary hemangioma of the skin or soft tissues. The CNS lesions differed significantly from other vascular neoplasms, such as hemangioendotheliomas, hemangiopericytomas, and hemangioblastomas. Conclusions. Capillary hemangiomas of the CNS are benign lesions that can be surgically removed and cured without adjuvant therapy.

Primary demyelinating disease simulating glioma of the corpus callosum

1981 ◽  
Vol 55 (4) ◽  
pp. 620-624 ◽  
Author(s):  
Kenneth G. Rieth ◽  
Giovanni Di Chiro ◽  
Laurence D. Cromwell ◽  
Paul E. McKeever ◽  
Paul L. Kornblith ◽  
...  
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Corpus Callosum ◽  
Demyelinating Disease ◽  
Mass Effect ◽  
Periventricular White Matter ◽  
Content Type ◽  
The Central Nervous System ◽  
The Brain ◽  
Fine Print

✓ Computerized tomography (CT) has made it easier to distinguish tumoral from nontumoral diseases of the central nervous system. In the presence of mass effect, however, this distinction may be difficult or impossible to make. Primary demyelinating disease may occasionally present as a focal cerebral mass. The authors report three cases of primary demyelinating disease of the brain involving the corpus callosum and periventricular white matter and associated with mass effect, which proved difficult to differentiate from infiltrating “butterfly” gliomas.

Actinomycosis of the brain

1985 ◽  
Vol 63 (1) ◽  
pp. 131-133 ◽  
Author(s):  
He Chen-wei
Keyword(s):  
Central Nervous System ◽  
Rare Case ◽  
Surgical Excision ◽  
Content Type ◽  
Different Types ◽  
Excellent Health ◽  
The Central Nervous System ◽  
The Brain ◽  
Fine Print

✓ A rare case of actinomycosis of the brain is reported. The patient recovered after surgical excision of the lesion and a prolonged course of antibiotic therapy. At follow-up examination 25 months later, the patient was in excellent health. Different types of actinomycotic infections of the central nervous system are reviewed and the diagnosis and treatment of this disease are discussed.

Surface properties, more than size, limiting convective distribution of virus-sized particles and viruses in the central nervous system

2005 ◽  
Vol 103 (2) ◽  
pp. 311-319 ◽  
Author(s):  
Michael Y. Chen ◽  
Alan Hoffer ◽  
Paul F. Morrison ◽  
John F. Hamilton ◽  
Jeffrey Hughes ◽  
...  
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Gray Matter ◽  
Extracellular Space ◽  
Invasive Technique ◽  
Major Barrier ◽  
Content Type ◽  
The Central Nervous System ◽  
The Brain ◽  
Fine Print

Object. Achieving distribution of gene-carrying vectors is a major barrier to the clinical application of gene therapy. Because of the blood—brain barrier, the distribution of genetic vectors to the central nervous system (CNS) is even more challenging than delivery to other tissues. Direct intraparenchymal microinfusion, a minimally invasive technique, uses bulk flow (convection) to distribute suspensions of macromolecules widely through the extracellular space (convection-enhanced delivery [CED]). Although acute injection into solid tissue is often used for delivery of oligonucleotides, viruses, and liposomes, and there is preliminary evidence that certain of these large particles can spread through the interstitial space of the brain by the use of convection, the use of CED for distribution of viruses in the brain has not been systematically examined. That is the goal of this study. Methods. Investigators used a rodent model to examine the influence of size, osmolarity of buffering solutions, and surface coating on the volumetric distribution of virus-sized nanoparticles and viruses (adeno-associated viruses and adenoviruses) in the gray matter of the brain. The results demonstrate that channels in the extracellular space of gray matter in the brain are large enough to accommodate virus-sized particles and that the surface characteristics are critical determinants for distribution of viruses in the brain by convection. Conclusions. These results indicate that convective distribution can be used to distribute therapeutic viral vectors in the CNS.

Plasma globulin determinations in patients with microglioma

1971 ◽  
Vol 35 (4) ◽  
pp. 406-415 ◽  
Author(s):  
Carl H. Gunderson ◽  
James Henry ◽  
Nathan Malamud
Keyword(s):  
The Other ◽  
Reticulum Cell ◽  
Reticulum Cell Sarcoma ◽  
Content Type ◽  
Cell Sarcoma ◽  
Brain Scan ◽  
The Central Nervous System ◽  
The Relationship ◽  
The Brain ◽  
Fine Print

✓ Five patients are described with cerebral microglioma or reticulum cell sarcoma. The tumors varied from local neoplasms to multicentric or miliary foci. One of these patients is the second case reported of a microglioma associated with Waldenström's macroglobulinemia. Serum electrophoresis on the other four patients did not reveal any consistent abnormality or pattern. Immunoglobulin studies performed on three of the five patients confirmed Waldenström's syndrome in one, revealed an elevated IgA globulin in a second, and was normal in a third. Cerebrospinal fluid findings included elevated spinal fluid protein in all five patients. The brain scan was abnormal in all four cases so tested. Arteriograms in four patients demonstrated tumor blushes indicative of increased numbers of enlarged vessels. The relationship between reticulum cell sarcomas originating in the central nervous system and those originating elsewhere is discussed.

Nasal glioma and encephalocele: two separate entities

1986 ◽  
Vol 64 (3) ◽  
pp. 516-519 ◽  
Author(s):  
Mohammod Younus ◽  
Peter E. Coode
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Malignant Tumor ◽  
Malignant Potential ◽  
Developmental Abnormality ◽  
Content Type ◽  
Nasal Glioma ◽  
The Central Nervous System ◽  
The Brain ◽  
Fine Print

✓ The term “nasal glioma” is a confusing misnomer as it implies a neoplastic condition with malignant potential, which it is not. Nasal glioma is a rare developmental abnormality and should be differentiated from glioma, which is a malignant tumor of the brain, and from a primary encephalocele, which is herniation of the cranial contents through a bone defect in the skull, through which it retains an intact connection with the central nervous system. Two cases of nasal glioma, one with and one without intracranial connections, are described and the literature is reviewed.

Primary cerebellar nocardiosis

1979 ◽  
Vol 51 (3) ◽  
pp. 408-414 ◽  
Author(s):  
George W. Tyson ◽  
Joseph E. Welsh ◽  
Albert B. Butler ◽  
John A. Jane ◽  
H. Richard Winn
Keyword(s):  
Antibiotic Therapy ◽  
Fatal Disease ◽  
Content Type ◽  
Brain Scans ◽  
Focus Of Infection ◽  
Surgical Cure ◽  
The Central Nervous System ◽  
The Brain ◽  
Space Occupying Lesion ◽  
Fine Print

✓ The authors describe two cases of primary cerebellar nocardiosis. Confinement of Nocardia abscesses to a localized, accessible portion of the central nervous system should favor surgical cure of this aggressive and often fatal disease. In our two cases multilocularity, tenuous encapsulation, and proximity to the brain stem prevented complete primary excision. Nevertheless, the infections were effectively treated by intensive postoperative antibiotic therapy and, in one case, a second operation to excise the residual abscess. The need for the latter was suggested by the results of sequential computerized tomographic brain scans that were used to monitor the response to antibiotic therapy. In the absence of any apparent extracranial focus of infection and any overt condition that might impair immunological competence, nocardiosis is likely to be omitted from the preoperative differential diagnosis of a posterior fossa space-occupying lesion.

Safety and efficacy of stereotactic radiosurgery for tumors of the spine

2004 ◽  
pp. 413-418 ◽  
Author(s):  
Deborah L. Benzil ◽  
Mehran Saboori ◽  
Alon Y. Mogilner ◽  
Ronald Rocchio ◽  
Chitti R. Moorthy
Keyword(s):  
Spinal Cord ◽  
Single Dose ◽  
Pain Relief ◽  
Total Dose ◽  
Stereotactic Radiosurgery ◽  
Medical Center ◽  
Primary Tumors ◽  
Content Type ◽  
Increased Risk ◽  
Fine Print

Object. The extension of stereotactic radiosurgery treatment of tumors of the spine has the potential to benefit many patients. As in the early days of cranial stereotactic radiosurgery, however, dose-related efficacy and toxicity are not well understood. The authors report their initial experience with stereotactic radiosurgery of the spine with attention to dose, efficacy, and toxicity. Methods. All patients who underwent stereotactic radiosurgery of the spine were treated using the Novalis unit at Westchester Medical Center between December 2001 and January 2004 are included in a database consisting of demographics on disease, dose, outcome, and complications. A total of 31 patients (12 men, 19 women; mean age 61 years, median age 63 years) received treatment for 35 tumors. Tumor types included 26 metastases (12 lung, nine breast, five other) and nine primary tumors (four intradural, five extradural). Thoracic tumors were most common (17 metastases and four primary) followed by lumbar tumors (four metastases and four primary). Lesions were treated to the 85 to 90% isodose line with spinal cord doses being less than 50%. The dose per fraction and total dose were selected on the basis of previous treatment (particularly radiation exposure), size of lesion, and proximity to critical structures. Conclusions. Rapid and significant pain relief was achieved after stereotactic radiosurgery in 32 of 34 treated tumors. In patients treated for metastases, pain was relieved within 72 hours and remained reduced 3 months later. Pain relief was achieved with a single dose as low as 500 cGy. Spinal cord isodoses were less than 50% in all patients except those with intradural tumors (mean single dose to spinal cord 268 cGy and mean total dose to spinal cord 689 cGy). Two patients experienced transient radiculitis (both with a biological equivalent dose (BED) > 60 Gy). One patient who suffered multiple recurrences of a conus ependymoma had permanent neurological deterioration after initial improvement. Pathological evaluation of this lesion at surgery revealed radiation necrosis with some residual/recurrent tumor. No patient experienced other organ toxicity. Stereotactic radiosurgery of the spine is safe at the doses used and provides effective pain relief. In this study, BEDs greater than 60 Gy were associated with an increased risk of radiculitis.

Radiosurgery for patients with recurrent small cell lung carcinoma metastatic to the brain: outcomes and prognostic factors

2005 ◽  
Vol 102 (Special_Supplement) ◽  
pp. 247-254 ◽  
Author(s):  
Jason Sheehan ◽  
Douglas Kondziolka ◽  
John Flickinger ◽  
L. Dade Lunsford
Keyword(s):  
Lung Cancer ◽  
Brain Metastases ◽  
Lung Carcinoma ◽  
Small Cell Lung Carcinoma ◽  
Small Cell ◽  
Small Cell Lung ◽  
Cell Lung Carcinoma ◽  
Content Type ◽  
The Brain ◽  
Fine Print

Object. Lung carcinoma is the leading cause of death from cancer. More than 50% of those with small cell lung cancer develop a brain metastasis. Corticosteroid agents, radiotherapy, and resection have been the mainstays of treatment. Nonetheless, median survival for patients with small cell lung carcinoma metastasis is approximately 4 to 5 months after cranial irradiation. In this study the authors examine the efficacy of gamma knife surgery for treating recurrent small cell lung carcinoma metastases to the brain following tumor growth in patients who have previously undergone radiation therapy, and they evaluate factors affecting survival. Methods. A retrospective review of 27 patients (47 recurrent small cell lung cancer brain metastases) undergoing radiosurgery was performed. Clinical and radiographic data obtained during a 14-year treatment period were collected. Multivariate analysis was utilized to determine significant prognostic factors influencing survival. The overall median survival was 18 months after the diagnosis of brain metastases. In multivariate analysis, factors significantly affecting survival included: 1) tumor volume (p = 0.0042); 2) preoperative Karnofsky Performance Scale score (p = 0.0035); and 3) time between initial lung cancer diagnosis and development of brain metastasis (p = 0.0127). Postradiosurgical imaging of the brain metastases revealed that 62% decreased, 19% remained stable, and 19% eventually increased in size. One patient later underwent a craniotomy and tumor resection for a tumor refractory to radiosurgery and radiation therapy. In three patients new brain metastases were demonstrating on follow-up imaging. Conclusions. Stereotactic radiosurgery for recurrent small cell lung carcinoma metastases provided effective local tumor control in the majority of patients. Early detection of brain metastases, aggressive treatment of systemic disease, and a therapeutic strategy including radiosurgery can extend survival.

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