scholarly journals Chondrosarcoma of Cranial Vault: Case Report and Review of Literature

2021 ◽  
Vol 7 (2) ◽  
pp. 119-124
Author(s):  
Keshav Mishra ◽  
◽  
Somnath Sharma ◽  
Devendra K. Purohit ◽  
Arpita Jindal ◽  
...  
Keyword(s):  
Final Diagnosis ◽  
Primary Treatment ◽  
Cranial Vault ◽  
World Health ◽  
Unusual Site ◽  
Who Grade ◽  
Skull Vault ◽  
Well Differentiated ◽  
Health Organization ◽  
The Right

Background and Importance: Chondrosarcoma is a rare malignant cartilage forming tumor, usually arising from long bones and rarely observed in the cranium. In the cranium, it commonly arises from the skull base with the skull vault being a highly unusual site. Case Presentation: We present the case of a 30-year female presenting with complaints of headache for 6 months. The patient was found to have large chondrosarcoma in the right frontoparietal region, which is an extremely rare location. The final diagnosis was based on histological examination, suggestive of well-differentiated chondrosarcoma [the World Health Organization (WHO); grade I]. Conclusion: Cranial vault chondrosarcoma is an uncommon histological diagnosis with surgery as the primary treatment option; however, adjuvant radiotherapy plays a definitive role, especially in aggressive or incomplete removed cases.

scholarly journals Imaging and Histopathologic Nuances of Epithelioid Glioblastoma

2018 ◽  
Vol 2018 ◽  
pp. 1-5 ◽  
Author(s):  
Brian H. Le ◽  
Richard A. Close
Keyword(s):  
Mass Effect ◽  
Clonic Seizure ◽  
Cystic Mass ◽  
Braf V600e ◽  
World Health ◽  
Significant Past Medical History ◽  
Who Grade ◽  
Epithelioid Glioblastoma ◽  
Health Organization ◽  
The Right

A 27-year-old male without significant past medical history presented following collapse resulting from a syncopal episode at work. There was an episode of vomiting, and one of tonic-clonic seizure activity, which was spontaneously resolved after approximately one minute. His neurologic exam was nonfocal, with full strength in the bilateral upper and lower extremities, and no sensory deficits were elicited. MRI studies demonstrated a 4.7 cm rim-enhancing cystic mass in the right temporal-parietal region, with resultant mass effect and edema. At surgery, intraoperative pathologic consultation favoured a primary glial neoplasm. Subsequent complete histologic examination on permanent sections confirmed the presence of glioblastoma, with a morphologic pattern and immunohistochemical profile most consistent with epithelioid glioblastoma (WHO grade IV). Epithelioid glioblastoma is a rare, especially aggressive variant of IDH-wildtype glioblastoma, recognized in the 2016 World Health Organization classification. Approximately 50% of such tumors harbour the BRAF V600E mutation, which has also been observed in some melanomas where selective inhibitors have demonstrated a therapeutic role. The especially aggressive behaviour and poor clinical outcome typically observed for this variant of glioblastoma demonstrate the importance of emerging areas relevant to neurooncology, specifically those of proteomic characterization and therapeutic nanomedicine.

scholarly journals Transcavernous Resection of an Upper Clival Chondrosarcoma: “Cavernous Sinus as a Route”: 2-Dimensional Operative Video

2021 ◽  
Author(s):  
Walid Ibn Essayed ◽  
Michael A Mooney ◽  
Ossama Al-Mefty
Keyword(s):  
Skull Base ◽  
Cavernous Sinus ◽  
World Health ◽  
Petrous Apex ◽  
Who Grade ◽  
Interpeduncular Cistern ◽  
Health Organization ◽  
Multimodality Image ◽  
The Right ◽  
Total Tumor Removal

Abstract Complete resection of skull base chondrosarcomas offers the potential for a durable, or even lifelong, cure and is best achieved at the first surgery.1,2 When a skull base chondrosarcoma is located at the upper clivus and in the interpeduncular cistern and invading laterally toward the petrous apex and cavernous sinus, the traditional approaches, ie, endonasal endoscopic or middle fossa approaches, are not adequate for the exposure and resection. The transcavernous sinus approach has been utilized to remove tumor from the cavernous sinus and as a corridor to the interpeduncular cistern and upper clivus, originally described for the clipping of basilar apex aneurysms.  We present a case of a chondrosarcoma centered in the upper clivus and eroding the right posterior clinoid, analogous to the location of a giant basilar apex aneurysm. Detailed study of the tumor extension, bony invasion, and relationship with neuroanatomy dictated the most effective surgical approach.3,4  Neuronavigation and intraoperative magnetic resonance imaging (MRI) facilitated the gross total resection of the tumor in the Advanced Multimodality Image-Guided Operating (AMIGO) suite. Achieving a gross total tumor removal of this World Health Organization (WHO) grade I chondrosarcoma, adjuvant irradiation can be withheld1 and the patient monitored with serial imaging. The patient did well after the surgery. The patient consented for surgery and the use of photography.

scholarly journals Extracerebral Pterional Metastasis from Malignant Meningioma: A Case Report

2021 ◽  
Author(s):  
Edmundo Luís Rodrigues Pereira ◽  
Diego Arthur Castro Cabral ◽  
Fernanda Myllena Sousa Campos
Keyword(s):  
Distant Metastases ◽  
World Health ◽  
Malignant Meningioma ◽  
Benign Meningioma ◽  
Who Grade ◽  
History Of ◽  
Health Organization ◽  
The Right ◽  
Who Grade Iii ◽  
Grade Iii

AbstractAnaplastic or malignant meningiomas that are classified as World Health Organization (WHO) grade III account for less than 1% of all meningiomas diagnosed. Despite the aggressive course, distant metastases are a rarity, occurring in only 0.1% to 0.2% of cases. We report the case of a 56-year-old woman who presented with parasagittal benign meningioma that underwent malignant transformation along with metastasis into the right orbitosphenoid region. The clinical, radiological, and histopathological aspects are highlighted, with an emphasis on the natural history of meningiomas.

An approach to the understanding of the clinical-etiopathological aspect of COVID-19 (SARS-CoV-2)

2020 ◽  
Vol 11 (SPL1) ◽  
pp. 862-869
Author(s):  
Meena Kumari ◽  
Monika Agrawal ◽  
Rakesh Kumar Singh ◽  
Parameswarappa S Byadgi
Keyword(s):  
World Health ◽  
Apical Surface ◽  
Therapy Assessment ◽  
Differentiated Cells ◽  
The World ◽  
Polarized Epithelia ◽  
Well Differentiated ◽  
Novel Coronavirus ◽  
Health Organization ◽  
Epidemiological Characteristics

Currently, the world is facing a health and socioeconomic crisis caused by the novel coronavirus disease COVID-19. On 11 March 2020, the World Health Organization (WHO) has declared this disease as a pandemic. The condition (COVID-19) is an infectious disorder triggered by a newly discovered severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2. Most of the COVID-19 infected patients will experience mild to moderate respiratory symptoms and recover without any unique therapy. Assessment of the clinical and epidemiological characteristics of SARS-CoV-2 cases suggests the infected patients will not be contagious until the onset of severe symptoms and affects the other organs. Well-differentiated cells of apical airway epithelia communicating with ACE2 were promptly infected to SARS-CoV-2 virus. But the expression of ACE 2 in poorly differentiated epithelia facilitated SARS spike (S) protein-pseudo typed virus entry and it is replicated in polarized epithelia and especially exited via the apical surface. Limiting the transmission of COVID-19 infection & its prevention can be regarded as a hierarchy of controls. In this article, we briefly discuss the most recent advances in respect to aetiology, pathogenesis and clinical progression of the disease COVID-19.

scholarly journals Mosaic Pattern of H3 K27M-Mutant Protein Expression in a Diffuse Midline Glioma—A Diagnostic Dilemma for the Pathologist

2021 ◽  
Author(s):  
Deepti Narasimhaiah ◽  
Bejoy Thomas ◽  
Mathew Abraham ◽  
Rajalakshmi Poyuran
Keyword(s):  
Tumor Tissue ◽  
World Health ◽  
Mutant Protein ◽  
Histone Genes ◽  
Mosaic Pattern ◽  
Diagnostic Dilemma ◽  
Who Grade ◽  
Therapeutic Implications ◽  
Health Organization ◽  
Diffuse Midline Glioma

AbstractDiffuse midline glioma, H3 K27M-mutant, is a World Health Organization (WHO) grade IV glioma arising in pons, thalamus, and spinal cord. They show mutations resulting in replacement of lysine at position 27 by methionine (K27M) of histone genes, H3F3A, HIST1H3B, and HIST1H3C. The H3 K27M mutant protein is identified in tumor tissue by immunohistochemistry. As these mutations are clonal and homogeneous, the mutant protein is normally identified in all tumor cells. Here we report a case of diffuse midline glioma with mosaic pattern of expression of H3 K27M mutant protein and discuss the diagnostic and therapeutic implications of this unusual pattern.

scholarly journals Role of Extradural Clinoidectomy and Optic Unroofing in Resection of an Anterior Clinoidal Meningioma with Encasement of the Internal Carotid Artery and Its Branches

2021 ◽  
Author(s):  
Sima Sayyahmelli ◽  
Zhaoliang Sun ◽  
Emel Avci ◽  
Mustafa K. Başkaya
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Skull Base ◽  
Vision Loss ◽  
Internal Carotid ◽  
Extent Of Resection ◽  
World Health ◽  
Who Grade ◽  
The Right ◽  
Supraclinoid Internal Carotid Artery

AbstractAnterior clinoidal meningiomas (ACMs) remain a major neurosurgical challenge. The skull base techniques, including extradural clinoidectomy and optic unroofing performed at the early stage of surgery, provide advantages for improving the extent of resection, and thereby enhancing overall outcome, and particularly visual function. Additionally, when the anterior clinoidal meningiomas encase neurovascular structures, particularly the supraclinoid internal carotid artery and its branches, this further increases morbidity and decreases the extent of resection. Although it might be possible to remove the tumor from the artery wall despite complete encasement or narrowing, the decision of whether the tumor can be safely separated from the arterial wall ultimately must be made intraoperatively.The patient is a 75-year-old woman with right-sided progressive vision loss. In the neurological examination, she only had light perception in the right eye without any visual acuity or peripheral loss in the left eye. MRI showed a homogeneously enhancing right-sided anterior clinoidal mass with encasing and narrowing of the supraclinoid internal carotid artery (ICA). Computed tomography (CT) angiography showed a mild narrowing of the right supraclinoid ICA with associated a 360-degree encasement. The decision was made to proceed using a pterional approach with extradural anterior clinoidectomy and optic unroofing. The surgery and postoperative course were uneventful. MRI confirmed gross total resection (Figs. 1 and 2). The histopathology was a meningothelial meningioma, World Health Organization (WHO) grade I. The patient continues to do well without any recurrence and has shown improved vision at 15-month follow-up.This video demonstrates important steps of the microsurgical skull base techniques for resection of these challenging tumors.The link to the video can be found at https://youtu.be/vt3o1c2o8Z0

scholarly journals Recurrent Sphenocavernous Meningioma

2021 ◽  
Author(s):  
Mizuho Inoue ◽  
Mohamed Labib ◽  
Alexander Yang ◽  
A. Samy Youssef
Keyword(s):  
Tumor Resection ◽  
Intensity Modulated Radiotherapy ◽  
Residual Tumor ◽  
World Health ◽  
Neurological Deficits ◽  
Falciform Ligament ◽  
Total Resection ◽  
Anterior Clinoid Process ◽  
Who Grade ◽  
Health Organization

AbstractA case of a recurrent sphenocavernous meningioma is presented. The patient is a 42-year-old male who presented with an episode of transient right-sided numbness. A magnetic resonance imaging (MRI) revealed a large left sphenocavernous meningioma. The patient underwent a frontotemporal craniotomy for tumor resection. Near total resection was achieved with minimal residual in the left cavernous sinus (CS) and orbital apex. The pathology was consistent with meningioma, World Health Organization (WHO) grade I. A follow-up MRI was done 9 months after surgery and showed a growth of the residual tumor, which was treated with intensity modulated radiotherapy. Tumor growth was detected on serial imaging over a 4-year period. Surgical resection was offered. A left frontotemporal craniotomy with pretemporal transcavernous approach was performed. The bone flap was reopened and the dura was opened in a Y-shaped fashion. The roof of the optic canal was drilled off, and the falciform ligament was opened to decompress the optic nerve. The tumor was disconnected from the anterior clinoid region (the anterior clinoid process was eroded by the tumor) and reflected off the wall of the lateral CS. Tumor was adherent to the V2 fascicles (the lateral CS wall was resected in the first surgery) and was sharply dissected off. Gross total resection was achieved. The pathology was consistent with meningioma, WHO grade I. The patient had an unremarkable postoperative course without any new neurological deficits.The link to the video can be found at: https://youtu.be/KVBVw_86JqM.

scholarly journals Extracranial metastases in secondary glioblastoma multiforme: a case report

BMC Neurology ◽  
2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Jessica Rossi ◽  
Lucia Giaccherini ◽  
Francesco Cavallieri ◽  
Manuela Napoli ◽  
Claudio Moratti ◽  
...  
Keyword(s):  
Brain Lesion ◽  
Rare Event ◽  
Subsequent Development ◽  
World Health ◽  
Who Grade ◽  
Systemic Involvement ◽  
Grade Ii ◽  
The Stability ◽  
Health Organization ◽  
Extracranial Metastases

Abstract Background Glioblastoma (GBM) is known for its devastating intracranial infiltration and its unfavorable prognosis, while extracranial involvement is a very rare event, more commonly attributed to IDH wild-type (primary) GBM evolution. Case presentation We present a case of a young woman with a World Health Organization (WHO) grade II Astrocytoma evolved to WHO grade IV IDH mutant glioblastoma, with subsequent development of lymphatic and bone metastases, despite the favorable biomolecular pattern and the stability of the primary brain lesion. Conclusions Our case highlights that grade II Astrocytoma may evolve to a GBM and rarely lead to a secondary metastatic diffusion, which can progress quite rapidly; any symptoms referable to a possible systemic involvement should be carefully investigated.

Implementing the Sphere Project’s standards for patient’s healthcare rights in the disaster zone: The experience of the Israeli field hospital in post-quake Nepal

2021 ◽  
Vol 16 (1) ◽  
pp. 59-66
Author(s):  
Deganit Kobliner-Friedman, RN, MPH ◽  
Ofer Merin, MD ◽  
Eran Mashiach, MD ◽  
Reuven Kedar, MD ◽  
Shai Schul, MHA ◽  
...  
Keyword(s):  
Disaster Response ◽  
Sexual Exploitation ◽  
World Health ◽  
Field Hospital ◽  
Medical Teams ◽  
Health Organization ◽  
The Individual ◽  
The Right ◽  
Israel Defense Forces ◽  
Privacy And Confidentiality

Emergency medical teams (EMTs) encounter chaos upon arriving at the scene of a disaster. Rescue efforts are utilitarian and focus on providing the technical aspects of medical care in order to save the most lives at the expense of the individual. This often neglects the basic healthcare rights of the patient. The Sphere Project was initiated to develop universal humanitarian standards for disaster response.The increase in the number of EMTs led the World Health Organization (WHO) to organize standards for disaster response. In 2016, the WHO certified the Israel Defense Forces Field Hospital (IDF-FH) as the first to be awarded the highest level of accreditation (EMT-3). This paper presents the IDF-FH’s efforts to protect the patient’s healthcare rights in a disaster zone based on the Sphere Principles.These core Sphere Principles include the right to professional medical treatment; the right to dignity, privacy, and confidentiality; the right for information in an understandable language; the right to informed consent; the obligation to maintain private medical records; the obligation to adhere to universal ethical standards, to respect culture and custom and to care for vulnerable populations; the right to protection from sexual exploitation and violence; and the right to continued treatment.

scholarly journals Lebanon Cities’ Public Spaces

2018 ◽  
Vol 3 (1) ◽  
pp. 119-152 ◽  
Author(s):  
Maryam Nazzal ◽  
Samer Chinder
Keyword(s):  
Green Space ◽  
Public Spaces ◽  
World Health ◽  
Right To The City ◽  
Social Connections ◽  
Land Prices ◽  
The Social ◽  
Health Organization ◽  
The Right ◽  
The City

In Lebanon, the social connections are undeniable and crucial. However, meeting places remain private such as houses, restaurants, malls, and beach resorts. This is mainly due to the shortage of public spaces in Lebanon resulting from lack of planning, regulations and awareness around the right to the city and the importance of public spaces. In main cities where land prices are so expensive, common practice has prioritized the use of land in real estate development, thus trumping other uses such as public and communal spaces.In the late 1990s, Lebanon saw the emergence of malls, which have arguably acted as alternatives to public spaces. Malls, with their wealth of food courts, restaurants, cinemas, and play areas, have become the new downtown for a portion of the Lebanese population. They are also considered safe, which is another important factor.In 2015, the percentage of green spaces in Lebanon has decreased to less than 13%. While the World Health Organization (WHO) recommends a minimum of 9m2 of green space per capita (UN-HABITAT, 2016), Beirut has only 0.8m2.

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