scholarly journals Rare Case of Young Patient with Intraventricular Angiomatous Meningioma

2021 ◽  
pp. 19-25
Author(s):  
Gabriel Carvalho Heemann ◽  
Vinicius Rosa de Castro ◽  
Normando Guedes Pereira Neto ◽  
Camila Bocchi ◽  
Otavio Garcia Martins ◽  
...  
Keyword(s):  
Surgical Resection ◽  
Lateral Ventricle ◽  
The Body ◽  
Neurological Sequela ◽  
Transcallosal Approach ◽  
Frontal Horn ◽  
Intraventricular Tumors ◽  
The Right ◽  
Clinical Stability

Pediatric meningiomas are rare and account for only 2.2% of CNS tumors. In this age group, they are more frequently located in atypical sites, such as, mainly, the ventricular system, with a frequency of 8.8 to 13.6%. Adding this to the fact that the angiomatous subtype constitutes only 2.1% of all meningiomas, the rarity of the case reported here i s corroborated. We report a 17-year-old female patient diagnosed with intraventricular angiomatous meningioma; she underwent surgical resection of the tumor in the body and frontal horn of the right lateral ventricle, and there was no neurological sequela. With a follow-up of 4 years, there was no recurrence and the patient had clinical stability. Intraventricular tumors usually have slow growth and reach considerable size until they cause symptoms and then are diagnosed. In addition, the tumor’s deep location and proximity to eloquent areas make such tumors an neurosurgical challenge. The angiomatous subtype, due to the presence of hypervascularization (consisting of more than 50% of vascular components), may, in some cases, hinder surgical resection as well as be erroneously diagnosed. However, surgical treatment aimed at total resection of the lesion remains the conduct of choice in the case reported here, especially in patients in the first two decades of life, in which the use of radiation is avoided. Specifically when it comes to the surgery, we chose a transcallosal approach that allows a good transoperative visualization of the lesion when located in the body and frontal horn of the lateral ventricle.

“Craniotomy Within Craniotomy” Technique for Safe Resection of an Intracranial Arteriovenous Malformation With Frontal Bony Erosion: 2-Dimensional Operative Video

2021 ◽  
Author(s):  
MirHojjat Khorasanizadeh ◽  
Kristine Ravina ◽  
Aristotelis Filippidis ◽  
Christopher S Ogilvy
Keyword(s):  
Surgical Resection ◽  
Endovascular Embolization ◽  
Acute Onset ◽  
Bone Flap ◽  
Intracranial Arteriovenous Malformation ◽  
Excessive Bleeding ◽  
Left Hand ◽  
The Right ◽  
Venous Varix

Abstract Surgical resection is one option in the treatment of large high-grade brain arteriovenous malformations (AVMs). Resection of AVMs with skull-eroding components can be challenging due to the risk of excessive bleeding from these components during craniotomy and bone flap removal. We present a case of a 25-yr-old woman who presented with an acute onset right-sided frontal headache. She was found to have a large, frontal Spetzler-Martin grade IV AVM with an associated dural AVM. The AVM had caused focal erosions of the right frontal bone by a venous varix traversing the region of the calvarial defect. An elective staged endovascular embolization followed by surgical resection was recommended considering the patient's young age and the large size of the AVM located in a noneloquent area. Given the high risk of intraoperative hemorrhage during the craniotomy portion of the procedure, a “craniotomy within craniotomy” approach was planned. During this approach, a small rectangle of bone, including the portion eroded by the venous varix, was left in place, while the larger bone flap surrounding it was removed for an initial approach to the AVM. The small bony piece was safely removed at later stages of resection once the arterial feeders had been reasonably obliterated. Immediate postoperative catheter angiogram demonstrated good filling of the intracranial vascular territories with no residual AVM. The patient developed mild left facial and left hand weakness postoperatively, which resolved after 2 wk of follow-up. The patient remained neurologically intact on further follow-up.

Intrathecal treatment trial of rituximab in progressive MS

Neurology ◽  
2018 ◽  
Vol 91 (20) ◽  
pp. e1893-e1901 ◽  
Author(s):  
Joakim Bergman ◽  
Joachim Burman ◽  
Jonathan D. Gilthorpe ◽  
Henrik Zetterberg ◽  
Elena Jiltsova ◽  
...  
Keyword(s):  
Progressive Multiple Sclerosis ◽  
Intrathecal Administration ◽  
Control Group ◽  
Csf Biomarkers ◽  
Ventricular Catheter ◽  
Frontal Horn ◽  
Severe Infections ◽  
Phase 1B ◽  
The Right

ObjectivesTo perform a phase 1b assessment of the safety and feasibility of intrathecally delivered rituximab as a treatment for progressive multiple sclerosis (PMS) and to evaluate the effect of treatment on disability and CSF biomarkers during a 1-year follow-up period.MethodsThree doses of rituximab (25 mg with a 1-week interval) were administered in 23 patients with PMS via a ventricular catheter inserted into the right frontal horn and connected to a subcutaneous Ommaya reservoir. Follow-ups were performed at 1, 3, 6, 9, and 12 months.ResultsMild to moderate vertigo and nausea were common but temporary adverse events associated with intrathecal rituximab infusion, which was otherwise well tolerated. The only severe adverse event was a case of low-virulent bacterial meningitis that was treated effectively. Of 7 clinical assessments, only 1 showed statistically significant improvement 1 year after treatment. No treatment effect was observed during the follow-up period among 6 CSF biomarkers.ConclusionsIntrathecal administration of rituximab was well tolerated. However, it may involve a risk for injection-related infections. The lack of a control group precludes conclusions being drawn regarding treatment efficacy.ClinicalTrials.gov identifierNCT01719159.Classification of evidenceThis study provides Class IV evidence that intrathecal rituximab treatment is well tolerated and feasible in PMS but involves a risk of severe infections.

scholarly journals Case of primary hepatic leiomyosarcoma successfully treated with laparoscopic right hepatectomy

2020 ◽  
Vol 13 (2) ◽  
pp. e233567 ◽  
Author(s):  
Stephanie Vella ◽  
Kelvin Cortis ◽  
David Pisani ◽  
James Pocock ◽  
Luca Aldrighetti
Keyword(s):  
Physical Examination ◽  
Surgical Resection ◽  
Epigastric Pain ◽  
Large Mass ◽  
Disease Recurrence ◽  
Right Hepatectomy ◽  
Liver Lobe ◽  
Laparoscopic Right Hepatectomy ◽  
The Right

We describe the case of a 77-year-old woman, presenting with non-specific epigastric pain. Physical examination and subsequent imaging revealed the presence of a large mass in the right liver lobe. This was shown to be a leiomyosarcoma on biopsy histology. Further investigation confirmed this to be a primary hepatic leiomyosarcoma with no evidence of metastases. The patient underwent successful surgical resection. She is currently under imaging follow-up, with no evidence of disease recurrence.

scholarly journals The first case of gland inclusion in an intrapulmonary lymph node: a mimic of metastasis

2019 ◽  
Vol 17 (1) ◽  
Author(s):  
Chenglong Wang ◽  
Yijia Cao ◽  
Min Zeng ◽  
Lijuan Wang ◽  
Xiaojing Cao ◽  
...  
Keyword(s):  
Lymph Node ◽  
Mediastinal Lymph Node ◽  
Needle Aspiration ◽  
The Body ◽  
Case Presentation ◽  
Ectopic Tissue ◽  
First Case ◽  
Primary Lung Adenocarcinoma ◽  
The Right

Abstract Background Lymph node inclusions are foci of ectopic tissue in lymph nodes, which were reported in different areas of the body. However, inclusions in the mediastinal lymph node are rare. Here, we report the first case of glandular inclusion within the parenchyma of the intrapulmonary lymph node in a patient with primary lung adenocarcinoma. Case presentation A computed tomography (CT) scan showed a solid pulmonary nodule in the right upper lobe in a 44-year-old man. After a fine needle aspiration biopsy diagnosis of adenocarcinoma, lobectomy and lymph dissection were performed. Histological sections of the lung demonstrated a papillary predominant adenocarcinoma and one intrapulmonary lymph node, which displayed glandular inclusion occupying the node parenchyma. The gland inclusion was very similar to metastasis, but was formed by two layers of epithelial cells, and the abluminal cells were positive for P63, P40, and CK5/6. The patient has remained alive without recurrence and metastasis at the last follow-up before publication. Conclusions It is very important to correctly diagnose a lymph node inclusion for proper clinical management.

Convexity Meningioma Presenting as Postpartum Eclampsia

2003 ◽  
Vol 33 (1) ◽  
pp. 53-54 ◽  
Author(s):  
Bello B Shehu ◽  
Nasiru J Ismail
Keyword(s):  
Early Diagnosis ◽  
The Body ◽  
History Of ◽  
Neurological Features ◽  
The Right ◽  
The Brain ◽  
Tomography Scan ◽  
Progressive Weakness ◽  
In Pregnancy

A 37-year-old woman, Para 5+0 presented with a 1 year history of recurrent convulsions and progressive weakness of the right side of the body. She had been treated for postpartum eclampsia in her last delivery but symptoms recurred 3 months later. Evaluation including computerized tomography scan of the brain suggested a parieto-temporal meningioma, which was completely excised at craniotomy. Histology confirmed this to be a meningioma. The patient was well at 8 months of follow up. The growth of meningiomas may increase during pregnancy due to presence of receptors for progestational hormones in the tumour and the meningioma may become symptomatic in pregnancy, presenting as eclampsia. Close follow up of patients with eclampsia is necessary to identify neurological features that may lead to a diagnosis of meningioma. Early diagnosis is essential if a good outcome is to be ensured.

scholarly journals Clinical Characteristics of Nodular Fasciitis of Ear in Children

2021 ◽  
Author(s):  
Xiaoxu Wang ◽  
Wei Liu ◽  
Lejian He ◽  
Min Chen ◽  
Jianbo Shao ◽  
...  
Keyword(s):  
Surgical Resection ◽  
Clinical Characteristics ◽  
Clinical Manifestations ◽  
Neck Surgery ◽  
Final Diagnosis ◽  
Diagnosis And Treatment ◽  
Nodular Fasciitis ◽  
Gene Test ◽  
The Right

Abstract Purpose Summarized the clinical characteristics and diagnosis and treatment process of three cases of nodular fasciitis of ear, to provide a basis for clinical diagnosis and treatment. Methods Reviewed the clinical manifestations, images, pathology, treatment and postoperative follow up results of three cases of pediatric nodular fasciitis in the Department of Otorhinolaryngology, Head and Neck Surgery, Beijing Children's Hospital, Capital Medical University from 2018 to 2020. Results The average age at diagnosis were 24 months, with two girls and a boy. Two lesions were found in the left ear and one in the right ear. All cases had a history of biopsy before surgery. Two of three cases showed a sign of rapid growth after biopsy and three of which were ineffective in anti-inflammatory treatment. FISH test for USP6 were performed in two of the three cases with positive results. Three lesions show a hypointensity or isointensity on T1-weighted MRI and a heterogeneous hyperintensity on T2-weighted MRI. ‘‘Fascial tail’’ sign was found on image of all three cases. All lesions underwent surgical resection. Follow-up showed no recurrence and had an intact ear appearance. Conclusion The early misdiagnosis rate of nodular fasciitis of the ear is high. Combine clinical features with imaging findings may improve the accuracy of preoperative diagnosis. Besides the appearance of pathology, USP6 gene test is also an important tool in the diagnosis. The final diagnosis should be based on comprehensive assessment. Complete surgical resection can prevent recurrence.

Aneurysm of the distal anterior cerebral artery radiologically mimicking a ventricular mass

2011 ◽  
Vol 114 (4) ◽  
pp. 1061-1064 ◽  
Author(s):  
A. Metin Şanlι ◽  
Saruhan Çekirge ◽  
Zeki Şekerci
Keyword(s):  
Cerebral Artery ◽  
Lateral Ventricle ◽  
Anterior Cerebral Artery ◽  
Artery Aneurysm ◽  
Ventricular Mass ◽  
Frontal Horn ◽  
Major Branch ◽  
The Right ◽  
Distal Anterior Cerebral Artery ◽  
Cerebral Artery Aneurysm

The ventricular system is a rare localization for intracranial aneurysms. Most ventricular aneurysms arise from a distal branch of the choroidal arteries and a major branch point of the circle of Willis. A 41-year-old-man suffering from dizziness of 2 weeks' duration was admitted to the clinic. On radiological examination, he had a well-circumscribed mass involving the frontal horn of the right lateral ventricle without radiological evidence of a prior or recent hemorrhage. Localization and radiological appearance were not typical of a ventricular mass and did not allow diagnosis. After cerebral angiography, an aneurysm arising from the distal anterior cerebral artery was incidentally found in an intraventricular location. This unruptured aneurysm was successfully treated via the endovascular route. The authors describe the unusual case of a distal anterior cerebral artery aneurysm with a dome extending into the right lateral ventricle, which appears to be the first such case in the literature. Angiography may be helpful to neurosurgeons in avoiding the disastrous complications of a biopsy procedure in such unusual cases.

Ectopic Recurrence of Craniopharyngioma after an Interhemispheric Transcallosal Approach: Case Report

Neurosurgery ◽  
2002 ◽  
Vol 50 (3) ◽  
pp. 639-645 ◽  
Author(s):  
Jeannette M. Liu ◽  
Ira M. Garonzik ◽  
Charles G. Eberhart ◽  
Prakash Sampath ◽  
Henry Brem
Keyword(s):  
Vasogenic Edema ◽  
Case Reports ◽  
Postoperative Radiotherapy ◽  
Transcallosal Approach ◽  
Ectopic Recurrence ◽  
Microsurgical Resection ◽  
Surgical Field ◽  
The Right

Abstract OBJECTIVE AND IMPORTANCE: Ectopic recurrence of a craniopharyngioma is a rare postoperative complication. We present a case of a craniopharyngioma that ectopically recurred along the tract of a previous surgical route. CLINICAL PRESENTATION: A 73-year-old female patient presented 8 years earlier with a suprasellar craniopharyngioma. She underwent a right frontal craniotomy, with an interhemispheric transcallosal approach, for total microsurgical resection of the tumor. No postoperative radiotherapy was administered. Four years after surgery, magnetic resonance imaging studies revealed a well-circumscribed, heterogeneously enhancing, parasagittal mass with significant vasogenic edema in the right frontal lobe. Enlargement of the lesion was noted in subsequent radiological evaluations until 8 years after surgery, when the patient experienced a significant decline in neurocognitive status and the mass was surgically resected. INTERVENTION: Gross total resection of a histologically confirmed craniopharyngioma was achieved. CONCLUSION: To our knowledge, only eight previous case reports described the ectopic recurrence of a craniopharyngioma. Transplantation of tumor cells along the tract of a previous surgical route in six cases and dissemination in cerebrospinal fluid in two cases are presumed to be the primary mechanisms by which these ectopic recurrences occurred. The results of our literature review led us to conclude that total surgical resection, combined with careful inspection and irrigation of the surgical field, is the optimal treatment for preventing ectopic recurrences. Furthermore, it is recommended that, after primary craniopharyngioma resection, patients undergo long-term clinical and radiological follow-up monitoring for the rare development of an ectopically recurring tumor.

Calcifying fibrous tumour originating from the right cardiac ventricle in a child

2013 ◽  
Vol 24 (1) ◽  
pp. 161-163 ◽  
Author(s):  
Ben Zhang ◽  
Weida Zhang ◽  
Xiaowu Wang
Keyword(s):  
Right Ventricle ◽  
Soft Tissues ◽  
The Body ◽  
Dystrophic Calcification ◽  
Cardiac Ventricle ◽  
The Right

AbstractCalcifying fibrous tumour is a rare benign fibrous lesion. It is paucicellular, with fibroblasts, dense collagenisation, psammomatous and dystrophic calcification, and patchy lymphoplasmacytic infiltrates. Calcifying fibrous tumour was first described in subcutaneous and deep soft tissues, and has been reported all over the body. However, calcifying fibrous tumour originating from the heart is extremely rare. This article describes the case of a giant calcifying fibrous tumour arising from the right ventricle in a child, where the tumour was totally resected and no recurrence was observed during a 4-year follow-up period.

scholarly journals MORPHOMETRIC CHARACTERISTICS OF THE VENTRICULAR BRAIN SYSTEMS IN THE ELDERLY AGE

2020 ◽  
Vol 19 (4) ◽  
pp. 15-19
Author(s):  
O. Slobodian ◽  
V. Kryvetskyi ◽  
T. Khmara
Keyword(s):  
Magnetic Resonance ◽  
Human Brain ◽  
Lateral Ventricle ◽  
Hemispheric Asymmetry ◽  
Ventricular System ◽  
The Body ◽  
Elderly Persons ◽  
The Right ◽  
The Brain ◽  
Anterior Posterior

The introduction into medical practice of new methods of neuroimaging - computed and magnetic resonance imaging, has changed the principles of diagnosing morphological changes in the brain and opened up new horizons in the study of its structure. The literature sources provide conflicting and fragmentary data on the anatomical features and morphometric parameters of the parts of the brain, and especially its ventricular system, at different age periods of a person's life. The human brain is characterized by significant age-sex anatomical variability. It differs in men and women in different races, ethnic groups. Signs of difference persist from generation to generation and can be an important characteristic of the variability of the human brain as a species. However, the sex and age features of the structure of the cerebral ventricles, taking into account their individual anatomical variability, have not been sufficiently studied. During morphometric study of magnetic resonance tomograms a comprehensive in vivo characteristic of the cerebral ventricular system in elderly persons is presented. Gender peculiarities and inter-hemispheric asymmetry of relevant indicators are studied. The examinations were conducted in standard anatomical planes (sagittal, frontal and axial) in people with no visual signs of organic lesions of the brain and skull. 38 tomograms of elderly patients were analyzed 38 (14 men and 24 women). 13 indicators of the liquor system of the brain were studied and a significant increase of the following parameters were found in males: the length of the anterior horn of the right lateral ventricle, the length and width of the central part of the lateral ventricle both on the right and left, the length of the lower horn of the lateral ventricle on the left and right, and anterior-posterior size of the lateral ventricle on the right and left. Some of the parameters studied possessed reliable inter-hemispheric asymmetry, namely, in men on the left: the body width of the lateral ventricle, the length and width of the posterior horn of the lateral ventricle, anterior-posterior size of the lateral ventricle; in women – the length of the lower horn of the lateral ventricle on the right.

Sign in / Sign up

Export Citation Format

Share Document