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Journal articles on the topic 'Cerebellar Neoplasms'
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1
Steinberg, Gary K., Lawrence M. Shuer, Frances K. Conley, and John W. Hanbery. "Evolution and outcome in malignant astroglial neoplasms of the cerebellum." Journal of Neurosurgery 62, no. 1 (January 1985): 9–17. http://dx.doi.org/10.3171/jns.1985.62.1.0009.
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✓ Malignant astroglial neoplasms of the cerebellum are rare and the clinical behavior of these tumors is unpredictable. The authors describe the histological characteristics and clinical outcome in 10 patients; eight had malignant cerebellar astrocytomas, and one each had an astroblastoma and a true polar spongioblastoma. Malignant glial tumors involving the cerebellum usually behave very aggressively. Cerebellar astroblastomas and polar spongioblastomas are too rare to predict their natural history. Some hypotheses are proposed concerning the evolution and interrelationship of malignant glial tumors of the cerebellum.
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Gusnard, Debra A. "Cerebellar neoplasms in children." Seminars in Roentgenology 25, no. 3 (July 1990): 263–78. http://dx.doi.org/10.1016/0037-198x(90)90055-9.
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Jackson, Thad R., William F. Regine, Dianne Wilson, and Daron G. Davis. "Cerebellar liponeurocytoma." Journal of Neurosurgery 95, no. 4 (October 2001): 700–703. http://dx.doi.org/10.3171/jns.2001.95.4.0700.
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✓ Cerebellar liponeurocytoma is a rare tumor of the posterior fossa that has many morphological similarities to medulloblastoma and neurocytoma. Recently the World Health Organization working group for classification of central nervous system neoplasms adopted the term “cerebellar liponeurocytoma” to provide a unified nomenclature for a tumor variously labeled in the literature as lipomatous medulloblastoma, lipidized medulloblastoma, medullocytoma, neurolipocytoma, lipomatous glioneurocytoma, and lipidized mature neuroectodermal tumor of the cerebellum. The rarity of this tumor and paucity of pertinent information regarding its biological potential and natural history have resulted in the application of various treatment modalities. It is suggested in the available literature that these lesions have a much more favorable prognosis than typical medulloblastomas, and that adjuvant therapy for liponeurocytoma need not be as extensive as that administered for medulloblastomas.
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Kostadinov, Stefan, and Suzanne de la Monte. "A Case of Congenital Brainstem Oligodendroglioma: Pathology Findings and Review of the Literature." Case Reports in Neurological Medicine 2017 (2017): 1–4. http://dx.doi.org/10.1155/2017/2465681.
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Congenital and perinatal primary brain neoplasms are extremely rare. Brainstem neoplasms in the perinatal and neonatal period are typically of high-grade nature and have poor prognoses with survival rates of less than 2 years from diagnosis. Herein, we report an unusual case of congenital anaplastic oligodendroglioma that arose in the pons and was detected as diffuse pontine glioma on in utero imaging studies during prenatal evaluation at 26 weeks’ gestation. A male infant was delivered at 36.4 weeks of gestation via Cesarean section who developed progressive dyspnea shortly after birth. Magnetic resonance imaging (MRI) studies of his head showed the expansile, poorly demarcated mass in the pons with minimal heterogeneous enhancement and severe communicating hydrocephalus. Despite aggressive management, including dexamethasone treatment, the infant expired on the third day of postnatal life. On postmortem examination cut sections through the brainstem and cerebellum disclosed the neoplasm that infiltrated the entire pons, extended into the midbrain, medulla, cerebellar peduncles, and caudal diencephalon. Histological sections demonstrated an anaplastic oligodendroglioma infiltrating the pons, 4th ventricle, midbrain, medulla, cerebellar white matter, posterior thalamus, and occipital white matter. The pathological features of the lesion distinguish it from previous reports in which spontaneous regression of pontine gliomas occurred and argue in favor of establishing a tissue diagnosis to plan for aggressive versus conservative management.
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Elias, W. Jeffrey, M. Beatriz S. Lopes, Wendy L. Golden, John A. Jane, and Federico Gonzalez-Fernandez. "Trilateral retinoblastoma variant indicative of the relevance of the retinoblastoma tumor-suppressor pathway to medulloblastomas in humans." Journal of Neurosurgery 95, no. 5 (November 2001): 871–78. http://dx.doi.org/10.3171/jns.2001.95.5.0871.
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✓ Results of recent studies have led investigators to suggest that the retinoblastoma tumor-suppressor (rb) gene plays an underappreciated role in the genesis of brain tumors. Such tumors cause significant rates of mortality in children suffering from hereditary retinoblastoma. It has been assumed that the pineal gland, which is ontogenetically related to the retina, accounts for the intracranial origin of these trilateral neoplasms. To address this issue, the authors describe an unusual trilateral retinoblastoma variant. The authors provide a detailed clinicopathological correlation by describing the case of a child with bilateral retinoblastoma who died of a medulloblastoma. The intraocular and intracranial neoplasms were characterized by performing detailed imaging, histopathological, and postmortem studies. Karyotype analysis and fluorescence in situ hybridization were used to define the chromosomal defect carried by the patient and members of her family. An insertion of the q12.3q21.3 segment of chromosome 13 into chromosome 18 at band q23 was identified in members of the patient's family. This translocation was unbalanced in the proband. The intraocular and cerebellar neoplasms were found to be separate primary neoplasms. Furthermore, the pineal gland was normal and the cerebellar neoplasm arose within the vermis as a medulloblastoma. Finally, the two neoplasms had different and characteristically identifiable cytolological and immunohistochemical profiles. The findings of the present study, taken together with those of recent molecular and transgenic studies, support the emerging concept that rb inactivation is not restricted to central nervous system regions of photoreceptor lineage and that inactivation of this tumor suppressor pathway may be relevant to the determination of etiological factors leading to medulloblastoma in humans.
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Forbes, Jonathan A., Bret C. Mobley, Thomas M. O'Lynnger, Calvin M. Cooper, Mahan Ghiassi, Rimal Hanif, and Matthew M. Pearson. "Pediatric cerebellar pilomyxoid-spectrum astrocytomas." Journal of Neurosurgery: Pediatrics 8, no. 1 (July 2011): 90–96. http://dx.doi.org/10.3171/2011.4.peds1115.
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Object Pediatric cerebellar astrocytomas with pilomyxoid features include classic pilomyxoid astrocytomas (PMAs) and intermediate pilomyxoid tumors (IPTs). Since the original description of PMA in 1999, most reports in the literature have described PMAs arising from the hypothalamic/chiasmatic region. To the authors' knowledge, PMAs arising from the posterior fossa have not been discussed in the neurosurgical literature. Intermediate pilomyxoid tumors, or tumors with pathological features of both pilocytic astrocytoma (PA) and PMA, have only recently been described. In this article, the authors present 2 cases that fall within the spectrum of pediatric cerebellar PMA—including a classic PMA and an intermediate pilomyxoid tumor. The authors compare the radiological presentation, surgical results, and postoperative course to findings in a cohort of 15 patients with cerebellar PAs. Methods Between 2003 and 2010, 2 patients with pilomyxoid-spectrum astrocytomas underwent treatment at Vanderbilt Children's Hospital. One was a 22-month-old girl who presented with progressive gait disturbance and falls. The other was a 4-year-old girl who presented with ataxia and generalized weakness. In a retrospective review of pediatric cerebellar neoplasms resected by the senior author during this period, these tumors comprised 4% of cerebellar neoplasms and approximately 10% of cerebellar glial neoplasms. Results Both patients were treated with midline suboccipital craniotomy for resection. In both cases, tumor invasion anteriorly into the brainstem prevented gross-total resection. the patient in Case 1 was placed on chemotherapy following pathological diagnosis and later developed definitive evidence of leptomeningeal dissemination (LD) 3 years after the operation. The patient in Case 2 was placed on chemotherapy after exhibiting progressive evidence of local recurrence (findings were negative for LD) 12 months following resection. Conclusions Pediatric patients with cerebellar pilomyxoid-spectrum astrocytomas appear to suffer higher rates of local recurrence and LD than pediatric patients with cerebellar PAs.
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Forbes, Jonathan A., Lola B. Chambless, Jason G. Smith, Curtis A. Wushensky, Richard L. Lebow, JoAnn Alvarez, and Matthew M. Pearson. "Use of T2 signal intensity of cerebellar neoplasms in pediatric patients to guide preoperative staging of the neuraxis." Journal of Neurosurgery: Pediatrics 7, no. 2 (February 2011): 165–74. http://dx.doi.org/10.3171/2010.11.peds10312.
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Object The question of whether to obtain routine or selective preoperative imaging of the neuraxis in pediatric patients with cerebellar neoplasms remains a controversial topic. Staging of the neuraxis is generally considered beneficial in patients with neoplasms associated with an elevated risk of leptomeningeal dissemination (LD). When these studies are obtained preoperatively, there is a decrease in the number of false-positive images related to debris in the immediate postoperative period. Additionally, knowledge of the extent of spread has the potential to affect the risk/benefit analysis of aggressive resection. Although the majority of pediatric neurosurgeons surveyed choose to obtain selective preoperative imaging of the neuraxis in cases of cerebellar neoplasms “with findings suggestive of high-grade pathology,” an evidence-based protocol in the literature is lacking. The goal of this study was to assess radiological characteristics of tumors with an elevated risk of LD and identify a method to help guide preoperative imaging of the neuraxis. Methods The authors first reviewed the literature to gain an appreciation of the risk of LD of pediatric cerebellar neoplasms based on underlying histopathology and/or grade. Available evidence indicates preoperative imaging of the neuraxis in patients with Grade I tumors to be of questionable utility. In contrast, evidence suggested that preoperative imaging of the neuraxis in patients with Grades II–IV neoplasms was clinically warranted. The authors then evaluated an extensive base of neuroradiological literature to identify possible MR imaging and/or CT findings with the potential to differentiate Grade I from higher-grade neoplasms in pediatric patients. They analyzed the preoperative radiological findings in 50 pediatric patients who had undergone craniotomy for resection of cerebellar neoplasms at Vanderbilt Children's Hospital since 2003 with reference to 7 chosen radiological criteria. Logistic regression models were fit using radiological features to determine the best predictors of Grades II–IV tumors. Receiver operating characteristic methods were used to identify diagnostic properties of the best predictors. Results The relative T2 signal intensity (RT2SI), an indirect measure of the water content of the solid component of the tumor, was best able to identify neoplasms with an elevated risk of LD. An RT2SI value of 0.71 was selected by the authors as the best operating point on the curve. Of the 31 neoplasms retrospectively designated as hypointense T2-weighted lesions (RT2SI ≤ 0.71), 30 (97%) were Grade II or higher. All medulloblastomas, ependymomas, and high-grade (Grades III and IV) neoplasms were hypointense T2-weighted lesions. Of the 19 T2-weighted hyperintense neoplasms (RT2SI > 0.71), 16 (84%) were Grade I and 3 were Grade II. Conclusions Measurement of the RT2SI can help predict Grade II–IV tumors at an elevated risk of leptomeningeal spread and guide staging of the neuraxis. Pediatric patients with cerebellar neoplasms found to have an RT2SI of less than or equal to 0.71 are recommended for neuraxis imaging prior to surgery.
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Kepes, John J., Keith C. Whittaker, Kenneth Watson, Robert A. Morantz, Ruth Millett, Charles A. Clough, and Dwight K. Oxley. "Cerebellar Astrocytomas in Elderly Patients with Very Long Preoperative Histories: Report of Three Cases." Neurosurgery 25, no. 2 (August 1, 1989): 258–64. http://dx.doi.org/10.1227/00006123-198908000-00016.
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Abstract Three patients, ages 69, 67, and 74 years, respectively, underwent surgical removal of cystic cerebellar astrocytomas. All three had past histories pointing to the existence of a cerebellar lesion for many decades prior to surgery: Patient 1 had had nystagmus on lateral gaze on the side of the tumor since early childhood; Patient 2 had had sensorineural hearing loss on the side of her neoplasm for 38 years preceding the operation; and Patient 3 was diagnosed as having a brain tumor 51 years before the operation. (He has been blind because of pressure hydrocephalus for half a century, but otherwise managed to live a productive farming and family life until he sustained a head injury in a car accident, which forced him to undergo removal of his cerebellar tumor.) The neoplasms in all three instances were found by histological examination to be low-grade astrocytomas. These cases indicate that low-grade cerebellar astrocytomas, which are well known for their characteristically long postoperative courses, may at times manifest a slow growth potential with an exceptionally long preoperative course.
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Salcman, Michael, Robert W. Nudelman, and Edwin H. Bellis. "Arteriovenous Malformations of the Superior Cerebellar Artery: Excision via an Occipital Transtentorial Approach." Neurosurgery 17, no. 5 (November 1, 1985): 749–56. http://dx.doi.org/10.1227/00006123-198511000-00004.
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Abstract Arteriovenous malformations (AVMs) of the superior cerebellar artery (SCA) are unusual and difficult lesions to treat, representing less than half of all AVMs located in the posterior fossa. Traditional approaches for surgical extirpation include the subtemporal transtentorial and suboccipital supracerebellar routes. On the basis of our recent experience with three SCA-supplied AVMs, we advocate an occipital transtentorial approach similar to that used for neoplasms of the pineal gland. Exposure of the AVM from above and in the midline provides superior visualization of the deep veins, the SCA arborization in the retrocollicular space, and the rostral cerebellum, without exposing the temporal lobe and the 4th nerve to surgical trauma in a narrow, confined space. Superior cerebellar AVMs that arise from the caudal branch of the SCA on the superolateral aspect of the hemisphere are more easily handled by standard suboccipital methods.
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Harrison, William, Aladine A. Elsamadicy, J. Tanner McMahon, Gustavo Chagoya, Raymond A. Sobel, Roger E. McLendon, and Cory Adamson. "Glioneuronal Tumor With Features of Ganglioglioma and Neurocytoma Arising in the Fourth Ventricle: A Report of 2 Unusual Cases and a Review of Infratentorial Gangliogliomas." Journal of Neuropathology & Experimental Neurology 78, no. 9 (July 30, 2019): 780–87. http://dx.doi.org/10.1093/jnen/nlz060.
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Abstract Infratentorial glioneuronal neoplasms are overall quite rare and are more commonly low-grade with surgical excision usually being curative. Multiple distinct histologic entities have been described including rosette-forming glioneuronal tumor, papillary glioneuronal tumor, neurocytoma, dysplastic gangliocytoma of the cerebellum (Lhermitte-Duclos disease), cerebellar liponeurocytoma, and ganglioglioma. While each of these entities has distinct findings, in some instances a tumor may demonstrate overlapping histologic features with mixed components. Herein, we report 2 unusual adult cases of a fourth ventricular glioneuronal tumor with features of ganglioglioma and neurocytoma, with one coming from a surgical resection and one found incidentally at autopsy. To the best of our knowledge, this specific histologic combination has not previously been described. As such, the clinical significance is unknown although in both cases the neoplasms were circumscribed and appeared to be low grade. The presence of the gangliogliomatous component was of particular interest since these are extremely rare occurrences in the fourth ventricle and we provide a comprehensive review of infratentorial gangliogliomas.
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Gasparetto, Emerson L., Sérgio Rosemberg, Hamilton Matushita, and Claudia da Costa Leite. "Ganglioneuroblastoma of the cerebellum: neuroimaging and pathological features of a case." Arquivos de Neuro-Psiquiatria 65, no. 2A (June 2007): 338–40. http://dx.doi.org/10.1590/s0004-282x2007000200029.
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OBJECTIVE: To report a case of ganglioneuroblastoma of cerebellum, with emphasis to the neuroimaging and pathological findings. CASE REPORT: A one year and eight-month-old girl presented with a two-month history of hypoactivity and tremor in the legs. The MRI showed an enhancing cerebellar mass hypointense on T1 and hyperintense on T2-weighted images. The patient underwent a craniotomy with resection of the lesion. The histological and immunohistochemical studies defined the diagnosis of ganglioneuroblastoma. CONCLUSION: The MRI findings of our case showed no features which could help in the differentiation between ganglioneuroblastoma and the other common types of posterior fossa neoplasms in the pediatric population.
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González, Iván A., Douglas R. Stewart, Kris Ann P. Schultz, Amanda P. Field, D. Ashley Hill, and Louis P. Dehner. "DICER1 tumor predisposition syndrome: an evolving story initiated with the pleuropulmonary blastoma." Modern Pathology 35, no. 1 (October 1, 2021): 4–22. http://dx.doi.org/10.1038/s41379-021-00905-8.
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AbstractDICER1 syndrome (OMIM 606241, 601200) is a rare autosomal dominant familial tumor predisposition disorder with a heterozygous DICER1 germline mutation. The most common tumor seen clinically is the pleuropulmonary blastoma (PPB), a lung neoplasm of early childhood which is classified on its morphologic features into four types (IR, I, II and III) with tumor progression over time within the first 4–5 years of life from the prognostically favorable cystic type I to the unfavorable solid type III. Following the initial report of PPB, its association with other cystic neoplasms was demonstrated in family studies. The detection of the germline mutation in DICER1 provided the opportunity to identify and continue to recognize a number seemingly unrelated extrapulmonary neoplasms: Sertoli-Leydig cell tumor, gynandroblastoma, embryonal rhabdomyosarcomas of the cervix and other sites, multinodular goiter, differentiated and poorly differentiated thyroid carcinoma, cervical-thyroid teratoma, cystic nephroma-anaplastic sarcoma of kidney, nasal chondromesenchymal hamartoma, intestinal juvenile-like hamartomatous polyp, ciliary body medulloepithelioma, pituitary blastoma, pineoblastoma, primary central nervous system sarcoma, embryonal tumor with multilayered rosettes-like cerebellar tumor, PPB-like peritoneal sarcoma, DICER1-associated presacral malignant teratoid neoplasm and other non-neoplastic associations. Each of these neoplasms is characterized by a second somatic mutation in DICER1. In this review, we have summarized the salient clinicopathologic aspects of these tumors whose histopathologic features have several overlapping morphologic attributes particularly the primitive mesenchyme often with rhabdomyoblastic and chondroid differentiation and an uncommitted spindle cell pattern. Several of these tumors have an initial cystic stage from which there is progression to a high grade, complex patterned neoplasm. These pathologic findings in the appropriate clinical setting should serve to alert the pathologist to the possibility of a DICER1-associated neoplasm and initiate appropriate testing on the neoplasm and to alert the clinician about the concern for a DICER1 mutation.
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Kenyon, Anna P., Salman Haider, Keyoumars Ashkan, and Catherine Nelson-Piercy. "Cerebellar haemangioblastoma presenting with dizziness in pregnancy: case report and review of the literature." Obstetric Medicine 2, no. 4 (November 30, 2009): 164–67. http://dx.doi.org/10.1258/om.2009.090018.
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Cerebral neoplasms are uncommon in pregnancy but should be considered in any pregnant woman with new onset neurological symptoms and signs. We report a case of cerebellar haemangioblastoma presenting in pregnancy and discuss the clinical presentation, diagnosis, surgical management and medical literature surrounding the condition.
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Muñoz-Gutiérrez, Juan F., Michael M. Garner, and Matti Kiupel. "Primary central nervous system neoplasms in African hedgehogs." Journal of Veterinary Diagnostic Investigation 30, no. 5 (August 22, 2018): 715–20. http://dx.doi.org/10.1177/1040638718793687.
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In this retrospective study, we describe the clinicopathologic and immunohistochemical findings in a series of primary central nervous system (CNS) neoplasms in African hedgehogs ( Atelerix albiventris). Twelve CNS neoplasms were found among 762 African hedgehog submissions (1.6%) to a private diagnostic laboratory in an 18-y period. The median age of affected hedgehogs was 3.5 y. No sex predilection was found. Hindlimb paresis, weakness, and ataxia were the most commonly reported clinical signs. Gangliogliomas ( n = 6) and astrocytomas ( n = 5) were the most commonly observed neoplasms; one oligodendroglioma was found. Gangliogliomas were found in the cerebellar white matter (2 of 6), brainstem (4 of 6), cervical spinal cord (1 of 6), and frontal lobe (1 of 6); one metastasized to the tongue. Gangliogliomas were immunoreactive for neurofilament protein (NFP), glial fibrillary acidic protein (GFAP), S100, and CD34. All astrocytomas were gemistocytic, located in the cerebrum, and none of these neoplasms metastasized. Astrocytomas were positive for GFAP, S100, and CD34, but negative for NFP. The oligodendroglioma was located in the cerebrum, and was positive for S100, but negative for GFAP and NFP.
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Forbes, Jonathan A., Adam S. Reig, Jason G. Smith, Walter Jermakowicz, Luke Tomycz, Sheila D. Shay, David A. Sun, Curtis A. Wushensky, and Matthew M. Pearson. "Findings on Preoperative Brain MRI Predict Histopathology in Children with Cerebellar Neoplasms." Pediatric Neurosurgery 47, no. 1 (2011): 51–59. http://dx.doi.org/10.1159/000329627.
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Jenkinson, Michael David, Jark Jan Daniel Bosma, Daniel Du Plessis, Hiroko Ohgaki, Paul Kleihues, Peter Warnke, and Nikolai G. Rainov. "Cerebellar Liponeurocytoma with an Unusually Aggressive Clinical Course: Case Report." Neurosurgery 53, no. 6 (December 1, 2003): 1425–28. http://dx.doi.org/10.1227/01.neu.0000093430.61239.7e.
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Abstract OBJECTIVE AND IMPORTANCE Liponeurocytomas are rare cerebellar neoplasms in adults, with benign histological features and a favorable clinical prognosis. Current clinical opinion is based on a total of less than 20 published cases and suggests that gross total resection and long-term follow-up monitoring, with possible additional surgery and radiotherapy for treatment of recurrent tumors, represent the best treatment approach for this relatively benign tumor type. CLINICAL PRESENTATION A 51-year-old Caucasian woman presented with worsening unsteady gait and headaches, suggesting increased intracranial pressure. INTERVENTION The patient underwent subtotal resection of a cerebellar liponeurocytoma, followed by fractionated radiotherapy (total dose of 54 Gy). She experienced a local recurrence of the tumor 12 months later and underwent additional surgery for removal of the cerebellar mass. A second recurrent tumor was diagnosed on magnetic resonance imaging scans 3 months later and was surgically resected. The tumor histological findings were consistently devoid of atypical features, apart from leptomeningeal invasion noted in the first surgical specimen. CONCLUSION This unusual case demonstrated an atypical clinical course of a highly aggressive and radiation-resistant tumor, despite the consistent absence of aggressive histological features. Cerebellar liponeurocytomas may not be as benign as the current literature and typical low-grade cytological and histological features suggest.
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Bontozoglou, N. P., D. W. Chakeres, G. F. Martin, M. A. Brogan, and R. B. McGhee. "Cerebellorubral degeneration after resection of cerebellar dentate nucleus neoplasms: evaluation with MR imaging." Radiology 180, no. 1 (July 1991): 223–28. http://dx.doi.org/10.1148/radiology.180.1.2052699.
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Marino, Silvia, Marc Vooijs, Hanneke van der Gulden, Jos Jonkers, and Anton Berns. "Induction of medulloblastomas in p53-null mutant mice by somatic inactivation of Rb in the external granular layer cells of the cerebellum." Genes & Development 14, no. 8 (April 15, 2000): 994–1004. http://dx.doi.org/10.1101/gad.14.8.994.
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Medulloblastomas are among the most common malignancies in childhood, and they are associated with substantial mortality and morbidity. The molecular pathogenesis as well as the ontogeny of these neoplasms is still poorly understood. We have generated a mouse model for medulloblastoma by Cre–LoxP-mediated inactivation ofRb and p53 tumor suppressor genes in the cerebellar external granular layer (EGL) cells. GFAP–Cre-mediated recombination was found both in astrocytes and in immature precursor cells of the EGL in the developing cerebellum.GFAP–Cre;RbLoxP/LoxP;p53−/−or LoxP/LoxP mice developed highly aggressive embryonal tumors of the cerebellum with typical features of medulloblastoma. These tumors were identified as early as 7 weeks of age on the outer surface of the molecular layer, corresponding to the location of the EGL cells during development. Our results demonstrate that loss of function of RB is essential for medulloblastoma development in the mouse and strongly support the hypothesis that medulloblastomas arise from multipotent precursor cells located in the EGL.
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Chalk, Colin H., Anthony J. Windebank, David W. Kimmel, and Philip G. McManis. "The Distinctive Clinical Features of Paraneoplastic Sensory Neuronopathy." Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques 19, no. 3 (August 1992): 346–51. http://dx.doi.org/10.1017/s0317167100041974.
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ABSTRACT:A 15-year experience with paraneoplastic sensory neuronopathy at the Mayo Clinic is reviewed. Of 26 patients with paraneoplastic sensory neuronopathy, 19 had small cell lung cancer, 4 had breast cancer, and 3 had other neoplasms. There was a striking predominance of females (20:6). Neuropathic symptoms (pain, paresthesia, sensory loss) were asymmetric at onset, with a predilection for the upper limbs; in three patients, symptoms were confined to the arms. Electrophysiologic testing revealed absent sensory responses and normal or minimally altered motor responses. Slightly more than half the patients had associated autonomic, cerebellar, or cerebral abnormalities. In some patients, treatment of the neoplasm seemed to halt progression of the neuronopathy, but none had neurologic improvement and most continued to worsen, even when the oncologic response was good. Distinguishing between paraneoplastic and nonparaneoplastic sensory neuronopathies can be difficult, but prominent neuropathic pain, neurologic dysfunction involving more than the peripheral sensory system, or an increased cerebrospinal fluid protein value should prompt a careful search for a cancer.
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Kozák, Ján, Jozef Šurkala, Martin Novotný, and Marián Švajdler. "Hemorrhagic Epidermoid Cyst in Cerebellar Vermis: Case Report and Review of the Literature." Journal of Neurological Surgery Reports 82, no. 01 (January 2021): e6-e10. http://dx.doi.org/10.1055/s-0041-1726286.
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AbstractIntracranial epidermoid cysts are slow growing congenital avascular neoplasms that spread across the basal surface of the brain. They most commonly occur in the paramedial region in the cerebellopontine angle and the parasellar region. Despite its generally benign nature, sporadically they can be accompanied with hemorrhage or very rarely undergo malignant transformation. The authors present a case report of a patient with a hemorrhagic vermian epidermoid cyst and a review of all published similar cases.
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Dixon, Brandon, Renn Holness, Tasha-Kay Walker, and Franz Pencle. "SURG-28. PRESENTATION OF A POSTERIOR FOSSA TUMOR AT A HOSPITAL IN WESTERN JAMAICA." Neuro-Oncology 22, Supplement_2 (November 2020): ii209. http://dx.doi.org/10.1093/neuonc/noaa215.874.
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Abstract The posterior cranial fossa is part of the cranial cavity, located between the foramen magnum and tentorium cerebelli that houses the cerebellum, pons and medulla oblongata. Commonly, tumors arising from this region in adults are cerebellar metastases or schwannomas of the vestibular nerve – the incidence of primary neoplasms is uncommon and more reserved for the pediatric population. A 28 year old female was in her usual state of health until last year when she started experiencing recurrent headaches with associated vomiting and intermittent loss of consciousness. A CT brain was done upon presentation to the hospital that revealed a 4th ventricle mass with obstructive hydrocephalus. A ventriculoperitoneal (VP) shunt was done thereafter to decompress the ventricular system, in anticipation for further surgical intervention for mass. Occipital craniotomy and resection of tumor was done and patient managed in a multidisciplinary manner in the intensive care unit. Post-operative course was marked by occipital pseudomeningocele with an associated CSF leak; a lumbar drain was placed in situ until complete resolution of leak. Histological analysis showed WHO Grade II Astrocytoma. Adult primary posterior fossa tumors are rare and can present with a constellation of symptoms. Although patient presented with findings in keeping with the diagnosis of an ependymoma, close clinical follow up will be required henceforth due to the refractory nature of such a low grade astrocytoma post-resection. Radiotherapy can also be considered in further management of case.
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Broekman, Marike L. D., Roelof Risselada, JooYeon Engelen-Lee, Wim G. M. Spliet, and Bon H. Verweij. "Glioblastoma Multiforme in the Posterior Cranial Fossa in a Patient with Neurofibromatosis Type I." Case Reports in Medicine 2009 (2009): 1–4. http://dx.doi.org/10.1155/2009/757898.
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Patients with Neurofibromatosis type 1 (NF1) have an increased risk of developing neoplasms. The most common brain tumors, found in 15%–20% of NF1 patients, are hypothalamic-optic gliomas, followed by brainstem and cerebellar pilocytic astrocytomas. These tumors generally have a benign nature. NF1 patients are predisposed to a 5-fold increased incidence of high-grade astrocytomas, which are usually located in supratentorial regions of the brain. We present an NF1 patient who developed a high-grade astrocytoma in the posterior fossa and discuss possible pathophysiological mechanisms.
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Sarnat, Harvey B., Bernadette Curry, N. B. Rewcastle, and Cynthia L. Trevenen. "Cytoplasmic RNA in Nervous System Tumours in Children: A Fluorochromic Histochemical Study using Acridine Orange." Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques 13, no. 1 (February 1986): 31–41. http://dx.doi.org/10.1017/s0317167100035769.
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ABSTRACT:Acridine orange was used as a fluorochromic histochemical stain of nucleic acids, applied to 78 neoplasms of the central and peripheral nervous systems of 60 children. Some cases were compared with 5 adults and 4 other cases of chronic reactive gemistocytic gliosis. Opposite concentration gradients of cytoplasmic ribonucleic acid (RNA) was demonstrated in tumours of the neuronal/neuroectodermal series, and those of the glial/neuroepithelial series. Minimal AO-RNA fluorescence was seen in 8 cerebellar medulloblastomas and in a retinoblastoma; strong AO-RNA fluorescence occurred in one cerebellar medulloblastoma and in 3 primitive neuroectodemal tumours of the cerebral cortex. Intermediate intensity of fluorescence was found in neuroblastomas, and strong fluorescence was shown in well differentiated ganglioneuroma cells and in cells of chromaffin tumours. Among glial tumours, by contrast, the most anaplastic cells displayed the most RNA fluorescence, while better differentiated astrocytoma cells showed much less. Gradients also were found within some astrocytomas, corresponding to zones of relative anaplasia. Minimal or no fluorescence was detected in reactive gemistocytes or in oligodendroglioma cells. Ependymomas were weakly fluorescent and choroid plexus papillomas showed more fluorescence, similar to the findings in normal ependyma and choroid plexus. Several non-neuroepithelial tumours of the nervous system and Schwannomas also were studied. The acridine orange technique applied to either frozen or paraffin sections of nervous system tumours, has value as an adjunct in the diagnosis and grading of these neoplasms and perhaps in distinguishing reactive gliosis from benign astrocytoma.
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Carvalho Neto, Arnolfo de, Emerson L. Gasparetto, Sérgio E. Ono, Guilherme A. Bertoldi, and André F. Gomes. "Adult cerebellar medulloblastoma: CT and MRI findings in eight cases." Arquivos de Neuro-Psiquiatria 61, no. 2A (June 2003): 199–203. http://dx.doi.org/10.1590/s0004-282x2003000200008.
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Medulloblastoma is a brain tumor of neuroepithelial origin, which represents 15 to 30% of all pediatric brain tumors, and less than 1% of CNS adult neoplasms. We report the imaging findings of 8 adult patients with medulloblastoma. The mean age was 35 years, ranging from 20 to 65 years, and the male:female rate was 3:5. The tumors were predominantly lateral (63%), hyperdense on CT scans (83%), and on the MRI, hypointense on T1 (100%) and hyperintense on T2 (80%) weighted images. It was seen intratumoral necrosis and cysts in six cases and calcifications in three. Hydrocephalus was observed in 5 cases and brain stem invasion in four. The imaging findings of medulloblastomas in adults are different of those in child, and also nonspecific. Although these tumors are uncommon in adults, they must be considered in the differential diagnosis of cerebellar masses in the posterior fossa of this age group.
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Wildes, T. J., S. Rentas, E. Carlsen, J. Dennison, and A. Dixon. "Myelodysplastic Syndrome with Monosomy 7 in a Patient with Ataxia-Pancytopenia Syndrome." American Journal of Clinical Pathology 158, Supplement_1 (November 1, 2022): S100. http://dx.doi.org/10.1093/ajcp/aqac126.211.
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Abstract Introduction/Objective Ataxia-pancytopenia syndrome is caused by mutations in SAMD9L, a tumor suppressor gene on chromosome 7 with roles in normal hematopoiesis and cerebellar development. Syndrome manifestations consist of a combination of progressive ataxia, multilineage cytopenias, and increased risk of myeloid neoplasms associated with monosomy 7. Histopathologic and radiologic descriptions of this recently described disorder are scarce and treatment strategies are not standardized. Additionally, features that predict spontaneous hematologic remission of myeloid neoplasms are incompletely understood. Therefore, detailed discussions of this disorder and its possible outcomes are warranted. Methods/Case Report A six-year-old boy was brought to his doctor when his parents noticed head tilting while reading and impaired coordination. Brain MRI revealed extensive T2/FLAIR hyperintensities of white matter, cerebellar hypoplasia, and a thinned corpus callosum. Further evaluation excluded autoimmune etiologies, infectious diseases, and inherited leukodystrophies. Whole exome sequencing demonstrated a previously uncharacterized heterozygous mutation in SAMD9L, c.2062T>A; p.Tyr688Asn. Subsequent testing revealed pancytopenia. A bone marrow biopsy showed small megakaryocytes with abnormal nuclear lobation and erythroid progenitors with nuclear blebbing and binucleation. Blasts were borderline increased (4%). Fluorescence in-situ hybridization and karyotype showed monosomy 7. A myeloid next-generation sequencing panel identified an ETV6 mutation (p.Gln143Ter, VAF=5.4%). A diagnosis of myelodysplastic syndrome with monosomy 7 in the setting of ataxia-pancytopenia syndrome was rendered. The patient underwent allogeneic stem cell transplant and is doing well at last follow-up. Results (if a Case Study enter NA) N/A Conclusion Ataxia pancytopenia syndrome is a recently described and incompletely understood disorder. Some myeloid neoplasms in ataxia-pancytopenia syndrome can undergo somatic revertant mosaicism via uniparental disomy, resulting in spontaneous hematologic remission. Factors that predict spontaneous remission are unclear; however, secondary mutations have been associated with poorer outcomes. This case emphasizes the value of comprehensive genetic testing modalities in challenging cases. Screening for SAMD9L mutations in cases of pediatric myelodysplastic syndrome could be considered.
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Salazar, Miguel Fdo, Paola Andrea Escalante Abril, María Verónica Velasco Vales, Celene Martínez Ruiz, Erick Gómez Apo, and Laura G. Chávez Macías. "Short-Spindled Cell Haemangioblastoma with CD34 Expression: New Histopathological Variant or Just a Stochastic Cytological Singularity?" Case Reports in Pathology 2016 (2016): 1–5. http://dx.doi.org/10.1155/2016/6749590.
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Haemangioblastomas are neoplasms of uncertain histogenesis with cellular and reticular variants advocated in current lore. Herein we describe an intriguing cerebellar specimen with unusual traits including spindle cell morphology and CD34 positivity. A thirty-nine-year old man had an infratentorial tumour discovered incidentally and resected three times. In all the instances, histopathological diagnosis was haemangioblastoma; nonetheless, he had neither physical stigmata nor family history of von Hippel-Lindau disease. By histology, the lesion was composed of areas of conventional stromal cells admixed with territories populated by short-spindled cells packed in lobules, sometimes giving the appearance ofgomitoli. Immunoperoxidase-coupled reactions confirmed the expression of inhibin A, neuron-specific enolase (NSE), PS100, and CD57 but also revealed focal immunolabeling for CD34, CD99, and FXIIIa. This case highlights the potential phenotypical diversity that can be found within these neoplasms. Rather than uncertain histogenesis, it may in fact reflect multiple lines of differentiation—histomimesis—prone to adopt unusual morpho- and immunophenotypes in a subset of haemangioblastomas.
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Tedeschi, E., S. Cirillo, M. L. Del Basso De Caro, E. M. Covelli, and G. Belfiore. "Un caso di Neurofibromatosi di tipo 1 “complicata” da processo espansivo cerebellare maligno con aspetti TC/RM atipici." Rivista di Neuroradiologia 16, no. 3 (June 2003): 445–48. http://dx.doi.org/10.1177/197140090301600319.
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A 13 year-old boy, previously diagnosed as having Neurofibromatosis Type 1 (NF1) but otherwise healthy, was referred to our Department for headache, vomiting, ataxia and VI-VII left cranial nerve palsy. Emergency head CT scan was performed, immediately followed by contrast-enhanced MR scan with Echo-Planar (EPI) water diffusibility study. A large ovalar mass lesion was evident in the left cerebellar hemisphere, hyperdense on CT, hypointense in T2-weighted images, isointense to grey matter in FLAIR and T1-weighted images, with clear mass effect on the surrounding structures, but only mild peripheral contrast-enhancement in the anterior part of the mass, these features resembling those of a desmoplastic medulloblastoma. However, the EPI Diffusion-weighted images (DWI) and corresponding Apparent Diffusion Coefficient (ADC) maps consistently showed increased water diffusivity, a pattern not compatible with the dense cell-packing typical of medulloblastomas. The pathological analysis of the surgical specimen indeed showed focal neoplastic cell clusters interspersed in a diffusely altered cerebellar cortex. Neoplastic cells exhibited large eosinophilic cytoplasma, hyperchromatic and multinucleolated nuclei, and frequent mitoses, a pattern indicative of anaplastic astrocytoma. The case presented supports the evidence that NF1 is associated with increased risk of developing several different neoplasms, beside the well-known pilocytic astrocytomas of the optic pathway. As these neoplasms may exhibit misleading imaging features at CT or “conventional” MRI study, the assessment of water diffusivity may provide useful data for reaching a correct pre-operative diagnosis, since it reflects the histological architecture of the neoplastic tissue.
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Safneck, Janice R., Lee B. Napier, and William C. Halliday. "Malignant Astrocytoma of the Optic Nerve in a Child." Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques 19, no. 4 (November 1992): 498–503. http://dx.doi.org/10.1017/s0317167100041706.
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ABSTRACT:Malignant gliomas of optic nerve and chiasm are rare, rapidly fatal neoplasms of adulthood. This report documents the occurrence of a malignant astrocytoma of the optic nerve in an 11-year-old boy who 9 years previously had a cerebellar medulloblastoma treated with surgery and irradiation. This malignant optic nerve glioma followed the same aggressive clinical course as that seen in adults, with death 9 months after diagnosis despite surgery and chemotherapy: Radiation may have been an important factor in the development of this malignant tumor which is almost never seen in the pediatric age group.
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Prabhu, Vikram C., Mark H. Bilsky, Kedar Jambhekar, Katherine S. Panageas, Patrick J. Boland, Eric Lis, Linda Heier, and P. Kim Nelson. "Results of preoperative embolization for metastatic spinal neoplasms." Journal of Neurosurgery: Spine 98, no. 2 (March 2003): 156–64. http://dx.doi.org/10.3171/spi.2003.98.2.0156.
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Object. Arterial embolization reduces blood loss in patients undergoing surgery for hypervascular spinal tumors. The objectives of this study were twofold: 1) to evaluate the role of magnetic resonance (MR) imaging in predicting tumor vascularity and 2) to assess the effectiveness of preoperative embolization in devascularizing these tumors. Methods. Fifty-one patients with metastatic spinal neoplasms underwent angiography, preoperative embolization, and excision of the lesion between 1995 and 2000. The MR imaging studies were correlated with tumor vascularity on angiograms. Embolization was angiographically graded on a five-point scale ranging from no embolization (Grade A) to total embolization (Grade E). The embolization grade was correlated with intraoperative blood loss. The mean age was 57 years, the male/female ratio was 1.2:1, and back pain was present in all patients. Metastatic renal cell carcinoma (30 cases) and thoracic spine involvement (33 cases) were most frequent. The positive predictive value of MR imaging in determining tumor vascularity was 77%, whereas the negative predictive value was 21%. Total embolization (Grade E) was achieved in 34 patients. A shared vascular pedicle between a radiculomedullary artery (RMA) and a tumor diminished the likelihood of complete embolization (p = 0.02). Small asymptomatic cerebellar infarctions were demonstrated in two cases. The mean intraoperative blood loss was 2586 ml. Following Grade D or E embolization, intraoperative bleeding was largely related to unembolized epidural veins. Conclusions. Tumor histology and MR imaging findings are predictive of hypervascularity; however, hypervascular tumors may not be detected by standard MR imaging sequences. Superselective catheterization permits Grade D or E embolization in 80% of patients. Shared blood supply with an RMA is the most important factor precluding complete embolization.
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Tomita, Tadanori, and Paolo Frassanito. "Tumors of the superior medullary velum in infancy and childhood: report of 6 cases." Journal of Neurosurgery: Pediatrics 11, no. 1 (January 2013): 52–59. http://dx.doi.org/10.3171/2012.9.peds12236.
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Object The superior medullary velum (SMV) is a thin lamina of white matter located between the superior cerebellar peduncles horizontally and between the midbrain and cerebellum vertically. The SMV has not previously been described as the primary location of a posterior fossa tumor, although it can be secondarily invaded by a tumor from the cerebellum or quadrigeminal plate. This paper aims to define clinical and radiological features of tumors primarily arising from the SMV during childhood. Methods The authors observed 6 infants and children harboring neoplasms of the SMV who were treated at Ann & Robert Lurie Children's Hospital of Chicago (formerly Children's Memorial Hospital) in Chicago, Illinois. Pathological diagnosis of the neoplasms was an atypical teratoid/rhabdoid tumor (ATRT) in 5 patients, and a juvenile pilocytic astrocytoma (JPA) in the remaining child. The tumors were diagnosed during infancy in all patients, with ages ranging from 3 months to 10 months, except for the patient with a JPA (diagnosed at 5 years old). All patients presented with signs and symptoms of increased intracranial pressure due to obstructive hydrocephalus. Results Characteristic MRI features were noted, consistent with a mass in both the fourth ventricle and the cerebellomesencephalic fissure and quadrigeminal cistern, resulting in the circumferential displacement of the neural structures surrounding the SMV. The tumor was removed effectively in gross-total fashion through the occipital transtentorial approach in all patients. This approach offers a wide exposure of the region. However, all infants with ATRT suffered tumor dissemination and died between 4 and 11 months after diagnosis, in spite of radical resection and oncological treatment. The 1 child with JPA is alive and well 30 months after tumor resection. Conclusions To the best of the authors' knowledge, this is the first description in the literature that focuses on tumors originating from the SMV. This entity must be promptly recognized on preoperative radiological studies to carefully plan the subsequent surgical and clinical management.
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McCrorie, Phoebe, Harry Porter, Jeffy Vinohar, Mohammed Diksin, David Scurr, and Ruman Rahman. "MODL-34. DECELLULARIZATION OF HUMAN AUTOPSY BRAIN TISSUE TO GENERATE A 3D EXTRACELLULAR MATRIX FOR MEDULLOBLASTOMA AND ATYPICAL TERATOID/RHABDOID TUMOUR MODELLING." Neuro-Oncology 24, Supplement_7 (November 1, 2022): vii298. http://dx.doi.org/10.1093/neuonc/noac209.1161.
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Abstract INTRODUCTION Childhood medulloblastoma (MB) and atypical teratoid/rhabdoid tumours (AT/RT) are malignant brain tumours occurring in the posterior fossa, for which prognoses remains particularly poor for the MB Group 3 subtype characterised by amplification of the Myc oncogene and for AT/RT in general. Current in vitro models for these neoplasms rely on non-coated plastic, various hydrogels, or animal-derived extracellular matrix (ECM), which fail to recapitulate the physiological environment from which the cells are derived from. METHODS We have developed a method to decellularize ex vivo human brain tissue from different anatomical locations for the use in 3D in vitro models. Human cerebellar brain tissue was harvested from autopsy brain and sectioned into small cubes before bathing in a sodium dodecyl sulfate/phosphate-buffered saline mixture for several days, before washing and lyophilising. RESULTS The optimised method for generation of decellularized human brain ECM successfully removes nuclei as confirmed by histological staining and DNA quantification (DNA reduction of ≥ 60%). Orbitrap-Secondary Ion Mass Spectrometry analysis confirmed the retention of the ECM components laminin (C9H11N3O2Na+), fibronectin (C9H14N4O2Na+ and C20H33N7O5Na+) and collagen (C4H5N2O2+), with a reduction in cell membrane lipid components (glycerophosphocholine, C9H19NPO4+; phosphocholine, C5H15NPO4+; and choline, C5H14NO+) relative to control tissue, with a < 2 ppm accuracy, which was further corroborated by glycosaminoglycan and collagen assays. Multiple molecular subtype-specific AT/RT and MB cell lines have been successfully grown on decellularized cerebellar-ECM/PEGDA hydrogel, showing no reduction in metabolic viability using PrestoBlue and Cell Titer Glo assays. CONCLUSIONS This methodology offers an innovative human-only high-throughput 3D drug screening model, whereby patient-derived MB or AT/RT cells are co-cultured with healthy human cerebellar astrocytes upon decellularized cerebellar ECM, which we term ‘Tumoursphere Matrices’.
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Pregúntegui-Loayza, Ivethe, Alejandro Apaza-Tintaya, Alberto Ramírez-Espinoza, Nancy Mayo-Simón, and Mauro Toledo-Aguirre. "Lhermitte-Duclos Disease in Pediatric Population: Report of 2 Cases." Pediatric Neurosurgery 56, no. 3 (2021): 279–85. http://dx.doi.org/10.1159/000514335.
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<b><i>Introduction:</i></b> Lhermitte-Duclos disease (LDD), also known as dysplastic cerebellar gangliocytoma, is an uncommon disorder in children, characterized by being a slow-growing lesion of the posterior fossa, which mainly affects the granular cell layer of the cerebellar parenchyma and may be associated with other multiple hereditary hamartomas and neoplasms. <b><i>Case Presentation:</i></b> We report 2 cases of LDD in pediatric patients and describe clinical symptoms and radiological and histopathological characteristics. In addition, we analyzed the relation to Cowden Syndrome based on the International Cowden Syndrome Consortium Operational Criteria and the most updated guidelines by the National Comprehensive Cancer Network (NCCN Guidelines Version 1.2020). <b><i>Conclusion:</i></b> LDD is a very rare disease in childhood but should be considered in the differential diagnosis of posterior fossa lesions. LDD can mimic low-grade glial tumors or infectious diseases. Patients develop late clinical manifestations due to the slow-growing pattern, and conservative treatment with outpatient follow-up may be an option in asymptomatic children.
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Rubinstein, Lucien J. "Embryonal central neuroepithelial tumors and their differentiating potential." Journal of Neurosurgery 62, no. 6 (June 1985): 795–805. http://dx.doi.org/10.3171/jns.1985.62.6.0795.
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✓ The embryonal central nervous system (CNS) neoplasms are reviewed with special reference to their differentiating potential and in the light of current neuro-oncogenetic concepts partly derived from the experimental induction of neural tumors. The conceptual (and, occasionally, practical) distinction between adult-type and embryonal CNS tumors raises a complex problem, because neoplastic transformation essentially involves replicating stem cells in tissues of renewal and because in the human brain such cells are found mostly in the course of CNS development. A cytogenetic scheme is therefore needed to serve as a frame of reference for a classification of embryonal CNS tumors that will account for the different histological entities documented so far and for the range and the restrictions of their differentiating capabilities. Most embryonal CNS tumors can be fitted into such a scheme. The cerebral medulloepithelioma, the cerebral and cerebellar neuroblastomas, the primitive polar spongioblastoma, and the ependymoblastoma show characteristic morphological features and a correspondingly distinctive cellular differentiating potential. The differentiating capabilities of the cerebellar medulloblastoma, the pineoblastoma, and the retinoblastoma are also distinctive, and are apparently determined by the cytogenesis of the area of the CNS in which the tumors originate. The indiscriminate application of a simplistic concept that would include all the so-called “primitive neuroectodermal tumors” into a single neuroepithelial tumor entity is unlikely to bring further understanding to the problem.
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Lv, Xianli, Chen Li, and Weijian Jiang. "The intracranial vasculature of canines represents a model for neurovascular ischemia and training residents and fellows in endovascular neurosurgery." Neuroradiology Journal 33, no. 4 (May 5, 2020): 292–96. http://dx.doi.org/10.1177/1971400920920787.
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Background We describe use of a canine model to evaluate physiological effects and neuroprotective strategies in the setting of cerebral ischemia and endovascular neurosurgery training. Methods We performed transfemoral digital subtraction cerebral and cervical angiography on eight anesthetized dogs. Angiographic images of cerebral arteries were obtained following cannulation of the femoral artery. Cerebral ischemia models were made after angiography. Results The canine cerebral vasculature exhibited extensive tortuosity of the carotid and vertebral arteries. Conversely, the bilateral anterior spinal arteries were easily catheterized using microcatheters and microguidewires. The basilar artery and its branches were facilely cannulable. Circle of Willis continuity sans hypoplasia or aplasia of its constitutive segments was appreciated in all animals. The middle cerebral arteries could be easily accessed via the posterior communicating arteries. We generated an empirically evaluable therapeutically interventional experimental animal model of cerebral ischemia by occluding the middle cerebral artery using small coils for a duration between 15 and 60 min. Conclusion Unique amenability of the canine intracranial vasculature to selective and microcatheter cannulation renders experimentally induced cerebral, cerebellar, and brainstem via occlusion of the supratentorial and infratentorial arteries a simple matter. The neural vasculature irrigating the canine cerebrum, brainstem, and cerebellum may consequently prove useful in helping young and nascent endovascular neurosurgeons in developing and refining their skills of microcatheter navigation and manipulation and deployment of therapeutic devices to achieve effective occlusion of aneurysms, arteriovenous malformations, arteriovenous fistulas, and neoplasms of the intracranial cavity.
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Juárez-Vignon Whaley, Juan José, Aurelio Carrera-Muiños, Karol Gema Hernandez-Gutierrez, Jerónimo Rafael Rodriguez-Cid, Maria Elisa Otero-Cerdeira, and Vanessa Garcia-Montes. "Paraneoplastic Cerebellar Degeneration with Anti-CV2/CRMP5 Antibodies in Ovarian Cancer: Case Report and Review of the Literature." Case Reports in Oncology 14, no. 3 (December 20, 2021): 1799–805. http://dx.doi.org/10.1159/000519969.
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Paraneoplastic neurological syndromes (PNS) are rare presentations of an underlying oncological disease and more unusual during an oncological disease. They most likely present in small-cell lung carcinomas and thymomas, but present in <1% of the gynecological neoplasms. Acknowledging the pathophysiology is essential for management, explaining its clinical presentation, and future research. We present a patient with an underlying gynecological cancer that during her disease developed a PNS with an unusual autoantibody (anti-CV2/CRMP5) mediating the disease. We report a case of a 62-year-old female diagnosed with ovarian cancer who in the course of her disease developed neurological symptoms associated with cerebellar degeneration. After ruling out differential diagnoses such as metastases, a PNS was suspected and studied, in which anti-CV2/CRMP5 antibodies were positive. With her clinical presentation, radiological features, autoantibody positivity on cerebrospinal fluid, and an underlying oncological disease, cerebellar degeneration was diagnosed. The pathophysiology of PNS is not fully understood; therefore, its diagnosis and management are complex. Diagnosis is based on clinical presentation and specific antibodies associated. Unfortunately, patients have a bad prognosis and diminished quality of life, and therefore a multidisciplinary approach is needed. It is important to mention that the presentation of PNS does not mandatorily appear before the diagnosis of cancer, and multiple cases have been reported in which patients with an underlying oncological disease develop these syndromes. As medical oncologists and neurologists, we must consider and study these syndromes as a possible etiology in cases with an underlying cancer who develop neurological symptoms in the course of their disease.
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Brat, Daniel J., Joseph E. Parisi, Bette K. Kleinschmidt-DeMasters, Anthony T. Yachnis, Thomas J. Montine, Philip J. Boyer, Suzanne Z. Powell, Richard A. Prayson, and Roger E. McLendon. "Surgical Neuropathology Update: A Review of Changes Introduced by the WHO Classification of Tumours of the Central Nervous System, 4th Edition." Archives of Pathology & Laboratory Medicine 132, no. 6 (June 1, 2008): 993–1007. http://dx.doi.org/10.5858/2008-132-993-snuaro.
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Abstract Context.—The World Health Organization (WHO) recently published its 4th edition of the classification of tumors of the central nervous system, incorporating a substantial number of important changes to the previous version (WHO 2000). The new WHO classification introduces 7 changes in the grading of central nervous system neoplasms, ranging in significance from minor to major, in categories of anaplastic oligoastrocytomas, meningiomas, choroid plexus tumors, pineal parenchymal tumors, ganglioglioma, cerebellar liponeurocytoma, and hemangiopericytomas. The 4th edition also introduces 10 newly codified entities, variants, and patterns, as well as 1 new genetic syndrome. A number of established brain tumors are reorganized, including medulloblastomas and primitive neuroectodermal tumors, in an attempt to more closely align classification with current understanding of central nervous system neoplasia. Objective.—To summarize and discuss the most significant updates in the 4th edition for the practicing surgical pathologist, including (1) changes in grading among established entities; (2) newly codified tumor entities, variants, patterns, and syndromes; and (3) changes in the classification of existing brain tumors. Data Sources.—The primary source for this review is the WHO Classification of Tumours of the Central Nervous System, 4th edition. Other important sources include the 3rd edition of this book and the primary literature that supported changes in the 4th edition. Conclusions.—The new edition of the WHO blue book reflects advancements in the understanding of brain tumors in terms of classification, grading, and new entities. The changes introduced are substantial and will have an impact on the practice of general surgical pathologists and neuropathologists.
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Cai, Dan X., Manuela Mafra, Robert E. Schmidt, Bernd W. Scheithauer, Tae Sung Park, and Arie Perry. "Medulloblastomas with extensive posttherapy neuronal maturation." Journal of Neurosurgery 93, no. 2 (August 2000): 330–34. http://dx.doi.org/10.3171/jns.2000.93.2.0330.
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✓ The authors report on two patients with classic medulloblastoma, each of whom underwent extensive therapy-associated neuronal maturation. The first patient presented at 3 months of age with hydrocephalus caused by a 5-cm tumor in the cerebellar vermis. He underwent a gross-total resection of a desmoplastic medulloblastoma. No mature elements were identified. Despite adjuvant chemotherapy, a 1.5-cm recurrent tumor developed 6 months later. Sections from the subtotally resected tumor demonstrated exclusively mature neuronal elements, ranging from neurocytes to ganglion cells. Four months later, a second recurrent tumor was resected. The specimen collected this time demonstrated classic medulloblastoma morphological characteristics. The patient was subsequently treated with radiation therapy, which seemed to have an effect; however, the tumor eventually progressed and the patient died. The second patient presented at 3 years of age with a midline medulloblastoma and was treated with subtotal resection, radiation therapy, and chemotherapy. Although the tumor remained stable on radiographic imaging, a second resection was performed 8 years later to alleviate hydrocephalus. Histological examination revealed predominantly small mature neurons with scattered ganglion cells and extensive calcification. No adjuvant therapy was given and the patient is alive and well as of his last follow-up examination.The mature neuronal neoplasms resected in both patients demonstrated negligible proliferative indices and stained appropriately with neuronal immunohistochemical markers. The smaller neuronal population resembled those of a central neurocytoma and medullocytoma/cerebellar neurocytoma. Analogous to neuroblastoma, our cases suggest that adjuvant therapy can induce extensive or complete neuronal maturation in medulloblastoma. Additional cases must be studied to determine the prognostic significance of this rare phenomenon.
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Zharova, Elena, Anastasia Bondarenko, Elena Vershinina, Olga Titova, and Natalia Talnishnih. "Rehabilitation of patients with facial nerve injuries after neurosurgical treatment." Vestnik of Saint Petersburg University. Medicine 15, no. 1 (2020): 37–48. http://dx.doi.org/10.21638/spbu11.2020.105.
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The facial nerve is most often, as compared with other cranial nerves, damaged due to surgical interventions. In the first place, as the cause of iatrogenic damage, is neurosurgical treatment for neoplasms of the ponto-cerebellar angle and temporal bone, brain injuries. The neuropathy of the facial nerve is the cause of neurological and cosmetic defects that have a serious traumatic effect on the patient. The psychological consequences of facial neuropathy are more important for the patient than physical damage. Paresis of mimic muscles cannot be hidden and often leads to social maladjustment, isolation and a marked reduction in the quality of life. Facial neuropathy, in most cases, is not a life-threatening condition, but it definitely changes the patient’s life. This article proposes an effective rehabilitation system, tested on 172 patients with facial nerve damage after neurosurgical treatment. The combined use of physiotherapy, massage, therapeutic gymnastics, including posture treatment with taping, during the early period of the disease, allows restoring nerve function and maintaining mimic muscles, as well as avoiding undesirable complications such as pathological synkinesis and corneal atrophy.
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Ranalli, Marco, Alessandra Boni, Anna Maria Caroleo, Giada Del Baldo, Martina Rinelli, Emanuele Agolini, Sabrina Rossi, et al. "Molecular Characterization of Medulloblastoma in a Patient with Neurofibromatosis Type 1: Case Report and Literature Review." Diagnostics 11, no. 4 (April 2, 2021): 647. http://dx.doi.org/10.3390/diagnostics11040647.
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Brain tumors are the most common solid neoplasms of childhood. They are frequently reported in children with Neurofibromatosis type 1 (NF1). The most frequent central nervous system malignancies described in NF1 are optic pathway gliomas and brainstem gliomas. Medulloblastoma (MB) in NF1 patients is extremely rare, and to our knowledge, only 10 cases without molecular characterization are described in the literature to date. We report the case of a 14-year-old girl with NF1 that came to our attention for an incidental finding of a lesion arising from cerebellar vermis. The mass was completely resected, revealing a localized classic medulloblastoma (MB), subgroup 4. She was treated as a standard-risk MB with a dose-adapted personalized protocol. The treatment proved to be effective, with minor toxicity. Brain and spine MRI one year after diagnosis confirmed the complete remission of the disease. To our knowledge, this is the only case of MB reported in a patient with NF1 with molecular characterization by the methylation profile. The association between NF1 and MB, although uncommon, may not be an accidental occurrence.
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Pancetti, Saverio, Daoud Rahal, Bethania Fernades, Carlo Galli, Silvia Uccella, Luigi Maria Terracciano, Federico Pessina, Lorenzo Bello, and Arturo Bonometti. "Primary Large B-Cell Lymphoma of Immune-Privileged Sites of the Cerebellum: A Case Series and Review of the Literature." Life 13, no. 1 (January 10, 2023): 201. http://dx.doi.org/10.3390/life13010201.
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Primary large B-cell lymphoma of immune-privileged sites (IP-LBCL) is a rare malignant hematological neoplasm. Involvement of the cerebellum is even rarer and its diagnosis is often difficult to make due to its non-specific clinical and radiological presentation. Methods: We reported 3 cases of cerebellar IP-LBCL followed at our hospital and reviewed the medical literature to unravel the peculiarities of this poorly studied entity. Outcomes: Analyzing our cases and reviewing the literature, we could collect and study 26 cases of cerebellar IP-LBCL. To the best of our knowledge, this is the largest cohort of such patients currently published. Conclusion: Cerebellar IP-LBCL presents more often in adult females with cerebellum-related focal neurological signs such as ataxia, headache, and nausea. Histological confirmation is mandatory for a correct diagnosis and treatment and all cases feature diffuse large B-cell lymphoma histopathology. Compared to other encephalic IP-LBCL, cerebellar cases seem to include a higher number of cases with germinal center B-cell phenotype and better survival. These differences may be related to a different immune microenvironment and especially immunoregulation that distinguishes the cerebellum from other areas of the CNS.
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Rege, S. V., Harshad Patil, and Sharadendu Narayan. "Adult medulloblastoma." Romanian Neurosurgery 30, no. 4 (December 1, 2016): 557–61. http://dx.doi.org/10.1515/romneu-2016-0090.
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Abstract Medulloblastoma is a highly malignant central nervous system (CNS) tumor that arises from the cerebellum. It is the most common primary malignant intracranial childhood neoplasm. In adults, medulloblastoma are much less common, accounting for < 1% of all adult brain tumors. Herein, author has described a rare case of cerebellar medulloblastoma in adult.
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Hall, Walter A., Marsha J. Merrill, Stuart Walbridge, and Richard J. Youle. "Epidermal growth factor receptors on ependymomas and other brain tumors." Journal of Neurosurgery 72, no. 4 (April 1990): 641–46. http://dx.doi.org/10.3171/jns.1990.72.4.0641.
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✓ Epidermal growth factor receptor (EGFR) and transferrin receptor levels were determined in 14 intracranial neoplasms (four glioblastomas multiforme, four medulloblastomas, four ependymomas, one cerebellar astrocytoma, and one acoustic neurinoma) and in four samples of “normal” brain tissue. A competitive radioreceptor assay with 125I-epidermal growth factor and 125I-transferrin was performed using the primitive neuroectodermal tumor-derived TE-671 tissue-culture cell line as a standard. Epidermal growth factor receptors were present on TE-671 cells, all four ependymomas, and two of the four glioblastomas multiforme. The number of EGFR's per cell for ependymomas were estimated to range from 1000 to 6000. Transferrin receptors were detected on TE-671 cells, two of the four medulloblastomas, and one of the four glioblastomas multiforme. A cell surface binding assay, performed directly on the rat ependymal cell monolayer, was also analyzed. The identification of EGFR's on ependymomas and TR's on medulloblastomas suggests that malignant central nervous system tumors that spread by cerebrospinal fluid pathways may be treatable by intrathecal antibody-toxin conjugates. The presence of EGFR's on all of the ependymomas may reflect a role of the receptor in the malignant phenotype of this tumor.
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Gonçalves, Simão Luniére. "Glioblastoma Multiforme Cerebelar." JBNC - JORNAL BRASILEIRO DE NEUROCIRURGIA 27, no. 3 (April 25, 2018): 244–48. http://dx.doi.org/10.22290/jbnc.v27i3.1569.
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Astrocitomas são neoplasias cerebrais derivadas dos astrócitos. Dentre os subtipos histológicos desta neoplasia, o grau IV, também conhecido como glioblastoma multiforme (GBM) é o tumor cerebral primário mais comum. A localização cerebelar para esta neoplasia é extremamente rara e no período entre 1975 a 2011 foram registrados menos de 180 casos no mundo. Há diversas teorias para explicar sua origem (células embrionárias, progressão anaplásica). Entretanto, até o momento, não se obteve conclusão. A clínica de acometimento cerebelar se confunde entre as diversas lesões da fossa posterior. O GBM deve ser sempre considerado como hipótese diagnóstica nas lesões tumorais agressivas do hemisfério cerebelar. O tratamento baseia-se na exérese microcirúrgica, radioterapia e quimioterapia. O presente relato descreve paciente do sexo masculino, acometido por esta rara neoplasia.
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Ghare, A., K. Langdon, A. Andrade, R. Kiwan, A. Ranger, and R. Hammond. "P.158 Feeling Green." Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques 48, s3 (November 2021): S65. http://dx.doi.org/10.1017/cjn.2021.434.
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Background: Myeloid sarcoma (MS) is a rare solid tumour made of myeloblasts or immature myeloid cells in an extramedullary site or in bone, associated with systemic hematologic neoplasms. When they occur in the brain parenchyma, they can often be misdiagnosed. Methods: The authors report a case of a 4-year old boy 6 months out of remission from AML, presenting with a short history of headaches and vomiting, and found to have a heterogenous contrast-enhancing lesion in the right cerebellar hemisphere, with differential diagnosis of myeloid sarcoma, astrocytoma, medulloblastoma and ATRT. Preliminary diagnosis was made flow cytometry from an intraoperative biopsy. The patient had a long course of chemotherapy and radiation, but eventually died from the systemic burden of his AML. Results: The authors present a literature review on 178 published cases of CNS myeloid sarcomas, and their radiological presentation and the basis of immunohistochemical and pathological diagnosis is discussed. Conclusions: Diagnosis rests on a combination of immunohistochemistry and histopathology of biopsied tissue. Surgical resection is controversial, especially given the efficacy of chemotherapy and radiation, and prognosis remains unclear. As with all uncommon and rare clinical entities, further investigation is warranted to determine prognosis and optimal management of CNS myeloid sarcomas.
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Wang, Kunyu, Yan Miao, Haoyong Ning, Feng Guo, Yang Bian, Qingqing Wang, Chenjing Sun, Xiaokun Qi, and Feng Qiu. "Acute-onset paraneoplastic cerebellar degeneration secondary to neuroendocrine carcinoma with atypical prognosis: a case report." Journal of International Medical Research 49, no. 2 (February 2021): 030006052199223. http://dx.doi.org/10.1177/0300060521992231.
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Paraneoplastic cerebellar degeneration (PCD) is a neurological syndrome that is likely caused by tumor-induced autoimmunity against the cerebellum. Neuroendocrine carcinoma (NEC) is a type of neoplasm with high-grade malignant histology and biological behavior. The prognosis for both PCD and NEC is typically poor. We report a case of PCD secondary to metastatic NEC in the lymph nodes, with an unknown primary origin. The case presented acute cerebellar manifestations with typical neuroimaging findings, but with atypical prognosis after lymph node dissection. Neurological symptoms can provide clues to potential tumors, and early antitumor treatment may have contributed to the positive prognosis of PCD secondary to NEC in the present case.
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Popławska-Domaszewicz, Karolina, Jolanta Florczak-Wyspiańska, Wojciech Kozubski, and Sławomir Michalak. "Paraneoplastic movement disorders." Reviews in the Neurosciences 29, no. 7 (September 25, 2018): 745–55. http://dx.doi.org/10.1515/revneuro-2017-0081.
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Abstract Paraneoplastic movement disorders are rare, autoimmune-mediated, nonmetastatic complications of malignant neoplasms. Common paraneoplastic movement disorders include paraneoplastic chorea, dystonia, cerebellar degeneration, different types of encephalitis, opsoclonus-myoclonus syndrome, stiff person syndrome, and neuromyotonia. Syndromes usually develop before tumor diagnosis, have subacute onset, and are associated with serum or cerebrospinal fluid antibodies. Two types of antibodies can be distinguished: antibodies against nuclear and cytoplasmic neuronal antigens (anti-Hu, anti-Ri, anti-Yo, anti-Ma, anti-CV2/CRMP5, anti-Gephrin, and anti-GABATRAP) and antibodies recently identified against cell surface and synaptic proteins (anti-NMDAR, anti-LGI1, and anti-Caspr2). These two types differ from each other in a few important aspects. Antibodies against cell surface and synaptic protein disrupt cell-surface antigens. Clinical symptoms are related to the disruption of antigens and potentially can be reversed by immunotherapy. The association between these antibodies and malignancy is much less consistent. On the other hand, antibodies against nuclear and cytoplasmic neuronal antigens seem to be not pathogenic; however, they most likely indicate a T-cell-mediated immune response against neurons. Due to T-cell-mediated neuronal loss, response to immunotherapy is generally disappointing. Early recognition of all these diseases is crucial because it may lead to the disclosure of occult cancer. This review is focused on paraneoplastic movement disorders with emphasis on clinical presentations, investigational findings, and therapeutic results.
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Chaves, Rafael Oliveira, Diego Vilibaldo Beckmann, Bruna Copat, João Pedro Scussel Feranti, Marília Teresa De Oliveira, Fernando Wiecheteck De Souza, Marcelo Luís Schwab, and Alexandre Mazzanti. "Encephalic Meningioma in Dogs." Acta Scientiae Veterinariae 44, no. 1 (January 16, 2016): 5. http://dx.doi.org/10.22456/1679-9216.84772.
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Background: Meningioma is the most common brain tumor in dogs. These extra-axial tumors originate in one of the meninges, and arachnoid is the most common. Several retrospective studies of brain tumors are found in the international literature. However there are few researches in the national literature. The purpose of this study is to report twelve dogswith brain meningioma. The breed, gender, age, neurological signs, the brain location, the clinical evolution, the tumor classifcation and diagnostics tests were investigated.Cases: Twelve dogs were attended at Veterinary Hospital of Santa Maria University: six mixed-breeds; four Boxer; a Dachs hund; and a Poodle. The age ranged from eight to 14 years, with average of ten years and nine months old. The clinical signs observed were generalized seizures (9/12); behavioral changes (6/12); walk in circle (5/12); swallowing diffculty (2/12 [16%]); hypermetria (2/12); central vestibular syndrome (1/12); and amaurosis (1/12). The presumptive diagnosis was brain neoplasm in all dogs. Six dogs were underwent symptomatic treatment with corticosteroids and anticonvulsants; two dogs were underwent corticosteroids; and four were euthanized without performing treatment. After starting treatment,four dogs (50%) showed clinical improvement in the frst week, however, the clinical signs worsened after two weeks. The thalamus-cortex region was affected in seven cases (59%), followed by cerebellar-pontine region (25%), brainstem (8%) and cerebellum (8%). In the histological classifcation of meningiomas, the meningothelial variant was observed in six dogs, three psammomatous, two transitional and a fbroblast.Discussion: The average age of initiation of clinical signs was ten years and nine months, similar result found in a large study about brain tumor. Female dogs were most affected (n = 8), although some authors did not report sexual predis position. The neurological signs of dogs with brain meningiomas occur through adjacent structures compression, directinvasion of tissues, interruption of circulation, edema, inflammation and necrosis. The thalamus-cortex region was the most affected and the seizures were the most common clinical signs observed in dogs, according to the international literature. The meningiomas canine are histologically classifed into two groups: benign tumors (meningothelial, fbroblast,transitional, psammomatous, angiomatous, papillary, myxoid and granular cells); and malignant tumors (anaplastic). The meningothelial variant was found most frequently in this stud (50%), according to the others authors. The clinical course of time was determined from the onset of signs found in neurological examination until the time of death or euthanasia of dogs, being progressive in all patients. In this study, encephalic neoplasms showed slow evolution of signals between fve to 180 days (mean 58 days). This time is longer compared to other study in which the mean survival of 86 dogs was 30 days. In the present study, there was only symptomatic treatment with corticosteroids and/or anticonvulsant. The conclusion of this study is that brain meningioma is a common tumor; occur in adult and older dogs of different breeds; the clinical signs more frequent were seizures, behavioral changes and walk in circle to the side of the lesion. The palliative treatment with corticosteroids and anticonvulsants may be effcient in controlling the clinical signs, however the long-term prognosis is adverse.Keywords: neoplasm, brain, neurology, dog.
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Mahmood, Asim, Manuel Dujovny, Maximo Torche, Ljubisa Dragovic, and James I. Ausman. "Microvascular anatomy of foramen caecum medullae oblongatae." Journal of Neurosurgery 75, no. 2 (August 1991): 299–304. http://dx.doi.org/10.3171/jns.1991.75.2.0299.
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✓ The foramen caecum (FC) is a triangular-shaped fossa situated in the midline on the base of the brain stem, at the pontomedullary junction. Although this area is known to have a very high concentration of brainstem perforating vessels, its microvascular anatomy has not been studied in detail. The purpose of this study was to detail the microvasculature of this territory. Twenty unfixed brains were injected with silicone rubber solution and dissected under a microscope equipped with a camera. The origin, course, outer diameter, and branching pattern of the perforators were examined. The total number of perforators found in the 20 brains was 287, with an average (± standard deviation) of 14.35 ± 1.24 perforators per brain (range seven to 28). Their origin was as follows: right vertebral artery in 52 perforators (18.11%); left vertebral artery in 35 (12.19%); basilar artery below the anterior inferior cerebellar artery (AICA) in 139 (48.43%); basilar artery above the AICA in 46 (16.02%); AICA in 10 (3.48%); and anterior spinal artery in five (1.74%). Most of the perforators arose as sub-branches of larger trunks; their average outer diameter was 0.16 ± 0.006 mm while that of trunks was 0.35 ± 0.02 mm. These anatomical data are important for those wishing 1) to study the pathophysiology of vascular insults to this area caused by atheromas, thrombi, and emboli; 2) to plan vertebrobasilar aneurysm surgery; 3) to plan surgery for vertebrobasilar insufficiency; and 4) to study foramen magnum neoplasms.
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Carvalho, José, Margarida Teixeira, Francisco Teixeira Silva, Alexandra Esteves, Carlos Ribeiro, and Diana Guerra. "Esophageal Gastrointestinal Stromal Tumor with Rare Intracranial Metastasis." Case Reports in Gastrointestinal Medicine 2020 (October 11, 2020): 1–4. http://dx.doi.org/10.1155/2020/8842006.
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Introduction. Gastrointestinal stromal tumors (GISTs) are mesenchymal tumors and constitute the largest group of nonepithelial digestive neoplasms. However, they do not represent more than 1% of primary digestive tumors. They commonly metastasize to the liver and peritoneum, but brain metastases are extremely rare. Clinical Case. A 76-year-old woman with a diagnosis of esophageal GIST with liver and lung metastases for 13 years, medicated with imatinib, is presented. She was brought to the emergency department after falling and due to changes in behavior and vertigo with 24 hours of evolution. On physical examination, she presented changes in behavior, dysarthria, dysmetria on the right, gait imbalance, and no motor or sensory deficits. On brain computed tomography and posteriorly on magnetic resonance, 2 lesions were observed, left frontal and right cerebellar, compatible with metastatic lesions. After contribution of neurosurgery, histology was obtained that confirmed the lesions were GIST metastases. Imatinib was maintained, and whole brain radiotherapy was performed. After 6 months, she died. Discussion. The rarity of GIST brain metastases is noteworthy, and because of that, there is not enough experience to be certain of the best treatment. Our patient lived for 13 years with excellent disease control with imatinib, but the fact that it does not cross the blood-brain barrier makes it not useful in preventing or treating brain lesions. New tyrosine kinase inhibitors that may cross the blood-brain barrier could be the answer to these cases.
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Cherubini, Giunio Bruto, Clare Rusbridge, Bhanu P. Singh, Sandra Schoeniger, and Paul Mahoney. "Rostral cerebellar arterial infarct in two cats." Journal of Feline Medicine and Surgery 9, no. 3 (June 2007): 246–53. http://dx.doi.org/10.1016/j.jfms.2006.12.003.
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A 10-year-old female neutered domestic shorthair (DSH) cat and a 6-year-old female neutered Siamese cat were presented following a peracute onset of decerebellate rigidity and a cerebellar vestibular syndrome, respectively. In both cats, physical examination and routine blood tests were unremarkable, as was routine analysis of cerebrospinal fluid obtained from the DSH cat. Based on the magnetic resonance imaging (MRI) features – focal wedge-shaped lesion in the cerebellum characterised by hyperintensity in T2-weighted, T2∗-gradient echo and fluid attenuated inversion recovery (FLAIR) images – a presumptive diagnosis of cerebellar infarct was made in both cases. In the DSH cat, the post-mortem examination confirmed the diagnosis of cerebellar infarct and additionally found acute renal infarcts and a pulmonary neoplasia. In the Siamese cat, ultrasonographic evaluation of the heart revealed a probable low-grade chronic valvular endocarditis which was thought to be a potential source of thromboembolism. This paper describes the first two cases – one confirmed and the other suspected – of cerebellar infarct in the cat. The in vivo potential diagnostic value of the MRI study is highlighted. Cerebellar infarcts should be included in the differential diagnosis of cat with a peracute onset of cerebellar signs regardless of the severity of neurological deficits.