Malignant squamous degeneration of a cerebellopontine angle epidermoid tumor

2002 ◽  
Vol 97 (5) ◽  
pp. 1237-1243 ◽  
Author(s):  
Michael J. Link ◽  
Paul L. Cohen ◽  
John C. Breneman ◽  
John M. Tew
Keyword(s):  
Squamous Cell Carcinoma ◽  
Neurological Deficit ◽  
Epidermoid Cyst ◽  
Cerebellopontine Angle ◽  
External Beam Radiotherapy ◽  
Subtotal Resection ◽  
External Beam ◽  
Content Type ◽  
Progressive Neurological Deficit ◽  
Fine Print

✓ The authors present the case of a woman with a cerebellopontine angle (CPA) epidermoid cyst that degenerated into a squamous cell carcinoma. Malignant degeneration of an epidermoid cyst is an extremely rare occurrence. Malignant transformation must be considered in the differential diagnosis when new contrast enhancement on imaging studies and progressive neurological deficit are seen in a patient harboring an epidermoid cyst. The patient initially presented with a 10-year history of left trigeminal neuralgia, subacute left-sided hearing loss, and with facial weakness of 3 weeks' duration. Initial magnetic resonance (MR) imaging revealed a left CPA mass, consistent with an epidermoid. There was faint contrast enhancement where the tumor was in contact with the lateral brainstem. A subtotal resection was performed. Histopathological findings were consistent with an epidermoid tumor. One year after initial presentation, the patient's neurological deficit had increased, and follow-up MR imaging demonstrated a large contrast-enhancing tumor filling the left CPA and compressing the brainstem. At repeated surgery a squamous cell carcinoma arising from the previous epidermoid was found. The patient was subsequently treated with external-beam radiotherapy and stereotactic radiosurgery. Her tumor stabilized. Three years and 8 months after the patient's initial presentation, a new area of tumor developed at the torcular Herophili. The patient died shortly thereafter. Malignant squamous degeneration is a rare cause of enhancement on MR images, as is progressive neurological deficit in a patient with an epidermoid. The combination of subtotal resection, external-beam radiotherapy, and stereotactic radiosurgery may be useful for local tumor control but the long-term prognosis is guarded.

Progressive neurological dysfunction secondary to postoperative cervical pseudomeningocele in a C-4 quadriplegic

1978 ◽  
Vol 48 (2) ◽  
pp. 289-291 ◽  
Author(s):  
Kenneth P. Burres ◽  
Frances K. Conley
Keyword(s):  
Neurological Deficit ◽  
Neurological Symptoms ◽  
Diagnostic Evaluation ◽  
Neurological Dysfunction ◽  
Previous Surgery ◽  
Content Type ◽  
Progressive Neurological Deficit ◽  
Operative Closure ◽  
Fine Print

✓ A case is detailed of a patient who developed progressive neurological deficit above a fixed quadriplegic level at C-4 18 years after posterior cervical decompression for trauma. Diagnostic evaluation revealed a pseudomeningocele at the site of his previous surgery. Subsequent operative closure resulted in reversal of his neurological symptoms.

Radiation-induced intracranial malignant gliomas

1989 ◽  
Vol 71 (1) ◽  
pp. 77-82 ◽  
Author(s):  
Scott Shapiro ◽  
John Mealey ◽  
Carl Sartorius
Keyword(s):  
Central Nervous System ◽  
Radiation Necrosis ◽  
External Beam Radiotherapy ◽  
Malignant Gliomas ◽  
Interstitial Brachytherapy ◽  
External Beam ◽  
Glial Tumor ◽  
Content Type ◽  
Radiation Induced ◽  
Fine Print

✓ The authors present seven cases of malignant gliomas that occurred after radiation therapy administered for diseases different from the subsequent glial tumor. Included among these seven are three patients who were treated with interstitial brachytherapy. Previously reported cases of radiation-induced glioma are reviewed and analyzed for common characteristics. Children receiving central nervous system irradiation appear particularly susceptible to induction of malignant gliomas by radiation. Interstitial brachytherapy may be used successfully instead of external beam radiotherapy in previously irradiated, tumor-free brain, and thus may reduce the risk of radiation necrosis.

Odontoid compression of the brain stem in a patient with rheumatoid arthritis

1980 ◽  
Vol 53 (6) ◽  
pp. 841-845 ◽  
Author(s):  
Harold P. Smith ◽  
Venkata R. Challa ◽  
Eben Alexander
Keyword(s):  
Rheumatoid Arthritis ◽  
Brain Stem ◽  
Neurological Deficit ◽  
Neurological Symptoms ◽  
Direct Compression ◽  
Content Type ◽  
Vertical Subluxation ◽  
Progressive Neurological Deficit ◽  
The Brain ◽  
Fine Print

✓ Cervical spine involvement by rheumatoid arthritis is common; brain-stem compression secondary to vertical subluxation of the odontoid in patients with rheumatoid arthritis is rare. Vertical subluxation results from 1) destruction of the transverse atlantal, apical, and alar ligaments of the atlas and odontoid, and 2) bone resorption in the occipital condyles, lateral masses of the atlas, and basilar processes of the skull. Neurological symptoms result from direct compression of the brain stem or from ischemia secondary to compression of vertebral arteries, anterior spinal arteries, or small perforating arteries of the brain stem and spinal cord. A case is reported in which a slowly progressive neurological deficit developed in a woman with rheumatoid arthritis following a fall from a stretcher. Neurological symptoms represented direct compression of the medulla by the dens, a mechanism confirmed at operation and autopsy. Recognition of progressive neurological deficit is often difficult in patients with rheumatoid arthritis because of their inactivity and their atrophic and immobile joints, but is essential if appropriate decompressive or stabilizing procedures are to be done. In patients with vertical subluxation of the dens, the transoral approach with removal of the odontoid is recommended. Decompression should be extensive, including the fibrous capsule around the odontoid and overlying synovial tissue as well as the odontoid itself.

Squamous cell carcinoma as a late complication of intracerebroventricular epidermoid cyst

1987 ◽  
Vol 66 (4) ◽  
pp. 618-620 ◽  
Author(s):  
Steven A. Goldman ◽  
Samuel E. Gandy
Keyword(s):  
Squamous Cell Carcinoma ◽  
Natural History ◽  
Cell Carcinoma ◽  
Surgical Resection ◽  
Squamous Cell ◽  
Epidermoid Cyst ◽  
Late Complication ◽  
Content Type ◽  
History Of ◽  
Fine Print

✓ Primary intracerebral squamous cell carcinoma is a rare sequela of benign cerebral epidermoid cysts. A case of presumed malignant transformation in a lateral ventricular epidermoid cyst is described, in which squamous cell carcinoma arose 33 years after the surgical resection of a benign epidermoid cyst. Three years after diagnosis of malignancy, the patient remains functional with a slowly invasive tumor. This case provides a rare description of the natural history of forebrain squamous cell carcinoma, which would appear to be a more indolent tumor than previously realized.

Successful treatment of spindle cell sarcoma of the sella turcica

2002 ◽  
Vol 97 ◽  
pp. 438-440
Author(s):  
Tracy E. Alpert ◽  
Seung S. Hahn ◽  
Chung T. Chung ◽  
Jeffrey A Bogart ◽  
Charles J. Hodge ◽  
...  
Keyword(s):  
Spindle Cell ◽  
Radiation Treatment ◽  
External Beam Radiotherapy ◽  
Gamma Knife Radiosurgery ◽  
Sella Turcica ◽  
Subtotal Resection ◽  
Spindle Cell Sarcoma ◽  
Content Type ◽  
Cell Sarcoma ◽  
Fine Print

✓ A primary spindle cell sarcoma of the sella turcica in a patient without a history of radiation treatment is a very rare occurrence. Only one other case has been reported to date, with local recurrence 7 months after the patient underwent subtotal resection and stereotactic radiosurgery of the tumor. The authors present a case of spindle cell sarcoma of the sella turcica successfully treated by surgery, external-beam radiotherapy, and gamma knife radiosurgery. After 24 months of follow up, the patient continues to show no evidence of disease.

Vertebral metastatic chemodectoma: imaging and therapeutic octreotide

2002 ◽  
Vol 97 (1) ◽  
pp. 106-109 ◽  
Author(s):  
Jean Marie U-King-Im ◽  
Thomas A. Carroll ◽  
Kevin Morris
Keyword(s):  
Magnetic Resonance Imaging ◽  
External Beam Radiotherapy ◽  
Somatostatin Receptors ◽  
Cord Compression ◽  
External Beam ◽  
Spinal Angiography ◽  
Current Investigation ◽  
Resonance Imaging ◽  
Content Type ◽  
Fine Print

✓ The authors report on the use of external-beam radiotherapy and octreotide in a 32-year-old woman who presented with spinal cord compression secondary to metastatic chemodectoma. Scintigraphy studies were used to confirm the presence of somatostatin receptors. Magnetic resonance imaging, and in particular spinal angiography, were performed to define the extent of spinal metastatic disease. The literature on current investigation and management of vertebral metastatic chemodectoma is reviewed.

An unusual middle fossa interdural epidermoid tumor

2001 ◽  
Vol 95 (5) ◽  
pp. 902-904 ◽  
Author(s):  
Yuichi Inoue ◽  
Kenji Ohata ◽  
Keiko Nakayama ◽  
Tomoko Haba ◽  
Miyuki Shakudo
Keyword(s):  
Magnetic Resonance ◽  
Computerized Tomography ◽  
Epidermoid Cyst ◽  
Unusual Case ◽  
Subtotal Resection ◽  
Middle Fossa ◽  
Content Type ◽  
Epidermoid Tumor ◽  
Fine Print

✓ The authors report an unusual case of an intracranial, interdural epidermoid tumor and cyst in a 72-year-old woman who presented with longstanding, mild numbness over her right cheek. She was initially treated conservatively, but on follow-up review the mass was found to have grown and evidence of hemorrhage was present, and therefore a subtotal resection was performed. This case should probably be classified as a paratrigeminal, interdural epidermoid cyst; this is the first known report in which magnetic resonance and computerized tomography images of such an entity are presented and discussed.

Penetrating gunshot wounds of the cervical spine in civilians

1975 ◽  
Vol 42 (5) ◽  
pp. 575-579 ◽  
Author(s):  
James S. Heiden ◽  
Martin H. Weiss ◽  
Alan W. Rosenberg ◽  
Theodore Kurze ◽  
Michael L. J. Apuzzo
Keyword(s):  
Cervical Spine ◽  
Neurological Deficit ◽  
Surgical Intervention ◽  
Gunshot Wounds ◽  
Neurological Recovery ◽  
Content Type ◽  
Initial Injury ◽  
Progressive Neurological Deficit ◽  
Nonsurgical Therapy ◽  
Fine Print

✓ The authors present a series of 38 civilian patients with cervical gunshot injuries, and compare neurological recovery in patients with complete lesions and patients with incomplete lesions according to whether therapy was surgical or nonsurgical. In patients with incomplete injury, ultimate recovery was a function of the initial injury more than surgical or nonsurgical therapy; nor did patients with complete lesions show significant change in outcome with either mode of therapy. Cord pathology at laminectomy rarely provided a clue about neurological recovery, and dural decompression did not alter neurological outcome. The authors conclude that the sole indication for routine surgical intervention appears to be progressive neurological deficit.

Primary intracranial squamous cell carcinoma of the right cerebellopontine angle

1981 ◽  
Vol 54 (6) ◽  
pp. 824-828 ◽  
Author(s):  
Carlos A. Garcia ◽  
Paul A. McGarry ◽  
Fred Rodriguez
Keyword(s):  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Cerebellopontine Angle ◽  
Middle Aged ◽  
Content Type ◽  
The Right ◽  
Fine Print

✓ A case of primary solid squamous cell carcinoma of the right cerebellopontine angle is described, and the literature is reviewed. Thirteen cases selected by strict criteria are analyzed, and the behavior of the lesion is described. This lesion seems to be found predominantly in middle-aged males in the cerebellopontine angle or parapontine region, and grows slowly.

Malignant transformation of a dysembryoplastic neuroepithelial tumor

2000 ◽  
Vol 92 (4) ◽  
pp. 722-725 ◽  
Author(s):  
Robert R. Hammond ◽  
Neil Duggal ◽  
John M. J. Woulfe ◽  
John P. Girvin
Keyword(s):  
Malignant Transformation ◽  
Complex Form ◽  
Ct Scanning ◽  
Subtotal Resection ◽  
Dysembryoplastic Neuroepithelial Tumor ◽  
Content Type ◽  
Recent Onset ◽  
Fibrillary Astrocytoma ◽  
Fine Print ◽  
Glial Nodules

✓ A 29-year-old man presented in 1984 with a recent onset of partial seizures marked by speech arrest. Electroencephalography identified a left frontotemporal dysrhythmia. Computerized tomography (CT) scanning revealed a superficial hypodense nonenhancing lesion in the midleft frontal convexity, with some remodeling of the overlying skull. The patient was transferred to the London Health Sciences Centre for subtotal resection of what was diagnosed as a “fibrillary astrocytoma (microcystic).” He received no chemotherapy or radiation therapy and remained well for 11 years.The patient presented again in late 1995 with progressive seizure activity. Both CT and magnetic resonance imaging demonstrated a recurrent enhancing partly cystic lesion. A Grade IV astrocytoma was resected, and within the malignant tumor was a superficial area reminiscent of a dysembryoplastic neuroepithelial tumor (DNT). Data on the lesion that had been resected in 1984 were reviewed, and in retrospect the lesion was identified as a DNT of the complex form. It was bordered by cortical dysplasia and contained glial nodules, in addition to the specific glioneuronal element. The glial nodules were significant for moderate pleomorphism and rare mitotic figures. The Ki67 labeling index averaged 0.3% in the glial nodules and up to 4% focally. Cells were rarely Ki67 positive within the glioneuronal component. This case is the first documented example of malignant transformation of a DNT. It serves as a warning of the potential for malignant transformation in this entity, which has been traditionally accepted as benign. This warning may be especially warranted when confronted with complex forms of DNT. The completeness of resection in the benign state is of paramount importance.

Sign in / Sign up

Export Citation Format

Share Document