· AIM: To evaluate the visual findings as primary manifestations in patients with intracranial tumors.·METHODS: The medical charts of the patients with intracranial tumors who initially admitted to the Neuro...· AIM: To evaluate the visual findings as primary manifestations in patients with intracranial tumors.·METHODS: The medical charts of the patients with intracranial tumors who initially admitted to the Neuro-ophthalmology and Strabismus Department with ocular complaints between August 1999 and December 2012 were reviewed retrospectively. The detailed clinical history and the findings of neuro-ophthalmologic examination were recorded. Ocular symptoms and signs,the types and locations of intracranial tumors, and the duration of symptoms before the diagnosis were evaluated.·RESULTS: The mean age of 11 women(61.1%) and 7men(38.9%) was 42.2±11.0(range 20-66y) at the time of intracranial tumor diagnosis. Initial symptoms were transient visual obscurations, visual loss or visual field defect in 16 cases(88.9%), and diplopia in 2 cases(11.1%). Neuro-ophthalmologic examination revealed normal optic discs in both eyes of 6 patients(33.3%),paleness, atrophy or edema of optic disc in 12 patients(66.7%), and sixth cranial nerve palsy in 2 patients(11.1%). Visual acuity ranged between normal vision and loss of light perception. Cranial imaging demonstrated craniopharyngioma(n =1), plasmacytoma(n =1),meningioma(n =6; olfactory groove and tuberculum sellae, pontocerebellar angle, anterior cranial fossa,frontal vertex, suprasellar region), and pituitary macroadenoma(n =10). The mean duration between the onset of visual disturbances and the diagnosis of intracranial tumor was 9.8±18mo(range 3d-6y).·CONCLUSION: The ophthalmologist is frequently the first physician to encounter a patient with clinical manifestations of intracranial tumors that may cause neurological and ocular complications. Neuro-ophthalmologic findings should be carefully evaluated to avoid a delay in the diagnosis of intracranial tumors.展开更多
Angioarchitecture plays an important role in the malignant development of intracranial hemangiopericytoma. It remains poorly understood whether high frequency of hemorrhage during clinical surgery for intracranial hem...Angioarchitecture plays an important role in the malignant development of intracranial hemangiopericytoma. It remains poorly understood whether high frequency of hemorrhage during clinical surgery for intracranial hemangiopericytoma is associated with angioarchitecture. The present study utilized hematoxylin-eosin staining, and immunohistochemical staining with epithelial membrane antigen, vimentin, CD34, von Willebrand factor (vWF) and CD133 to observe characteristics of angioarchitecture. In addition, silver stains were used to demonstrate changes in reticular fibers in the wall of vessel channels in intracranial hemangiopericytoma and meningioma. Five patterns of angioarchitecture were identified in intracranial hemangiopericytoma, namely tumor cell islands, vasculogenic mimicry, mosaic blood vessels, sprouting angiogenesis, and intussusceptive angiogenesis. Several CD133+ tumor cells were found to form tumor cell islands. A connection between vWF ^+ and vWF channels was detected in the pattern of intussusceptive angiogenesis, and some vimentin^+ tumor cells were embedded in the periodic acid-Schiff positive channel wall. Incomplete threads of reticular fibers formed the walls of larger pseudo-vascular channels and some tumor clumps or scattered tumor cells were detected "floating" in them. The angioarchitecture, specific markers and reticular fibers of intracranial hemangiopericytoma were significantly different from meningioma. Angioarchitecture provides a functional vascular network for vascular evolution in intracranial hemangiopericytoma and contributes to significant intra-operative bleeding.展开更多
Background: The efficacy and safety of dexmedetomidine during the anesthesia induction of intracranial tumor patients remain unknown. We wondered whether loading infusion of dexmedetomidine 1 μg/kg over 10 min to int...Background: The efficacy and safety of dexmedetomidine during the anesthesia induction of intracranial tumor patients remain unknown. We wondered whether loading infusion of dexmedetomidine 1 μg/kg over 10 min to intracranial tumor patients was as efficient and safe as to those abdominal disease patients. Methods: Patients aged 18-60 years, male or female, ASA I or II, scheduled for intracranial tumor resection (Group N, n = 30) or abdominal operation (Group A, n = 30) were enrolled in this observational trial. Dexmedetomidine was administrated with a loading dosage of 1 μg/kg over 10 min following with continuous infusing of 0.5 μg/kg/h. Fentanyl, propofol and rocuronium were sequentially administered for anesthesia induction. Heart rate (HR), blood pressure (BP), pulse oxygen saturation (SpO2), bispectral index (BIS) and other adverse effects were recorded from the beginning of loading infusion of dexmedetomidine to the end of endotracheal intubation. Results: Among with loading infusion, HR and BIS value decreased and were significantly lower at the end of infusion than before infusion (P P > 0.05). One patient of Group N dropped out from this trial because of a serious headache. 14 of 29 patients during dexmedetomidine loading infusion suffered hypoxemia (SpO2 P Conclusion: A loading dosage of 1 μg/kg of dexmedetomidine was not suitable for the anesthesia induction of intracranial tumor patients as compared to patients undergoing abdominal operation.展开更多
BACKGROUND Solitary fibrous tumor(SFT)is a rare fibroblastic mesenchymal neoplasm that affects spindle cell soft tissues with broad-spectrum biological behavior;it is predominantly benign,and rarely metastasizes.SFT o...BACKGROUND Solitary fibrous tumor(SFT)is a rare fibroblastic mesenchymal neoplasm that affects spindle cell soft tissues with broad-spectrum biological behavior;it is predominantly benign,and rarely metastasizes.SFT occurs mainly in the tissue structure of the serosa in the pleura and the thorax,and can be found throughout the body,though extra-thoracic localization,including the cephalic region,is uncommon.We reported the first case of intracranial malignant SFT metastasized to the chest wall.CASE SUMMARY An 81-year-old Japanese man was referred to our hospital due to progressive gait disturbance and appetite loss.His medical history included partial resection due to brain tumor,four times,and 50-Gray radiation therapy at another hospital,starting when he was 74 years old.An unenhanced head computed tomography(CT)scan revealed an 8 cm×5.1 cm×6.5 cm mixed-density mass at the left frontal lobe,accompanying a midline shift,and an unenhanced chest-abdomen CT scan revealed a 6 cm×4.1 cm×6.5 cm low-density mass in the left chest wall.A CT-guided percutaneous lung biopsy was performed,and the pathological findings were SFT corresponding to brain tumor.Finally,the correct diagnosis of his brain tumor in history of past illness revealed to be SFT,and the unremovable tumor,namely present brain lesions enlarged and metastasized to the chest wall.We established a definitive diagnosis of intracranial malignant SFT metastasized to the chest wall.We notified him and his family of the disease,and offered palliative care.He passed away on the 29 th hospital day.CONCLUSION This case suggests the need for careful,detailed examination,and careful followup when encountering patients presenting with a mass.展开更多
Objective: To evaluate the clinical application of proton magnetic resonance spectroscopy (1HMRS) in patients with radiotherapy treated intracranial tumors. Methods: Forty patients with intracranial tumors underwe...Objective: To evaluate the clinical application of proton magnetic resonance spectroscopy (1HMRS) in patients with radiotherapy treated intracranial tumors. Methods: Forty patients with intracranial tumors underwent multivoxel 1HMRS examination before and after radiotherapy. The concentrations of N-acetyl aspartate (NAA), choline (Cho) and creatine (Cr) were obtained both in the tumors and the contralateral normal brain regions, The ratios of NANCr, Cho/Cr and Cho/NAA were calculated at the same time and follow-up one year. Results: (1) After radiotherapy, tumors inhibited by radiation had decreased Cho, NAA and Cr on proton MRS. Some cases showed necrotic wave. (2) During the one year follow-up, local tumor recurred in 8 cases and their Cho and Cho/NAA increased high again. Other cases without recurrence, HMRS showed no change. Conclusion: Multivoxel proton MR spectroscopy is available for study of tumor metabolites after radiotherapy and it is a valuable method in the evaluation of radiotherapy treated tumors,展开更多
BACKGROUND: Inflammatory reaction correlates with sporadic intracranial aneurysm (IA). Variation of tumor necrosis factor receptor superfamily 13B (TNFRSF13B), an inflammatory mediator receptor, may associate wit...BACKGROUND: Inflammatory reaction correlates with sporadic intracranial aneurysm (IA). Variation of tumor necrosis factor receptor superfamily 13B (TNFRSF13B), an inflammatory mediator receptor, may associate with IA. OBJECTIVE: To explore the relationship between TNFRSF13B gene and sporadic IA, as well as the clinical characteristics of sporadic IA. DESIGN, TIME AND SETTING: Case-control study of genetic association was performed at the Experimental Technology Center of China Medical University from November 2006 to January 2008. PARTICIPANTS: A total of 367 patients with IA, confirmed by three-dimensional computed tomography angiography, magnetic resonance angiography, digital subtraction angiography, and neuro surgery, were admitted to the Department of Neurosurgery, First Affiliated Hospital of China Medical University from 2006 to 2007, and were selected as the case group. All patients were Han, with no family history of IA. In addition, a total of 396 non-lA patients were selected as control subjects. METHODS: Peripheral vein blood was harvested to extract whole blood genomic DNA. Genotyping and TNFRSF13B single nucleotide polymorphism (SNP) rs11078355 G〉A allele polymorphisms were determined by polymerase chain reaction-restriction fragment length polymorphism. The relationship of TNFRSF13B SNP rs11078355 G〉A polymorphisms to IA and IA clinical characteristics were analyzed using the chi-square and two-sided test. MAIN OUTCOME MEASURES: TNFRSF13B SNP rs11078355 G〉A genotype distribution. RESULTS: In the IA patients, TNFRSF13B SNP rs11078355 G〉A genotype frequency was significantly increased (X2 = 16.306, odds ratio = 1.881,95% confidence interval = 1.382 2.560, P 〈 0.001). In IA patients aged 〉 65 years, the frequency of TNFRSF13B SNP rs11078355 GA + AA genotype was significantly greater than the GG genotype (X2 = 26.604, odds ratio = 5.248, 95% confidence interval = 2.662 10.345, P 〈 0.001). CONCLUSION: The TNFRSF13B gene may associate with sporadic IA in Han Chinese populations In elderly patients, allele A may be an independent risk factor for IA, in addition to senile diseases, such as hypertension and diabetes mellitus.展开更多
Aims: Trigeminal neuralgia is generally caused by neurovascular compression. In rare cases intracranial tumors may also lead to this condition. The present study was conducted to identify clinical symptoms and testing...Aims: Trigeminal neuralgia is generally caused by neurovascular compression. In rare cases intracranial tumors may also lead to this condition. The present study was conducted to identify clinical symptoms and testing methods that are useful for early detection of trigeminal neuralgia associated with intracranial tumor. Methods: Five patients with trigeminal neuralgia suspected to be due to intracranial tumor, who visited our department for the first time during the period between February 2007 and March 2009, were examined. We analyzed the medical records and MRI findings of these patients. The clinical symptoms of subjects were compared to those presented at the International Classification of Headache Disorders. Results: There were no feature symptoms to trigeminal neuralgia caused by intracranial tumors compared with trigeminal neuralgia in general. None of the patients complained of spontaneous headache and nausea, which are clinical symptoms characteristic of brain tumor. Head MRI at our hospital was the most accurate method to detect intracranial tumors. Finally four of five patients received brain surgery to remove tumors. Conclusion: Small tumors and roots of the trigeminal nerve may not create accurate images by regular head MRI. Therefore, MRI using the imaging sequence which enables accurate visualization of roots of the trigeminal nerve is essential to confirm the presence of tumors in patients with suspected trigeminal neuralgia.展开更多
Tuberculoma is a common condition in developing countries. In some cases, it may mimic a glial lesion, making differential diagnosis challenging. The authors report two cases of giant tuberculoma in young patients age...Tuberculoma is a common condition in developing countries. In some cases, it may mimic a glial lesion, making differential diagnosis challenging. The authors report two cases of giant tuberculoma in young patients aged 14 and 16. A literature review was conducted on these cases. Both patients underwent partial excision. Histology concluded tuberculoma. Anti-tubercular treatment was implemented. The evolution one year later was marked by the persistence of neurological disorders, although they had improved.展开更多
<strong>Objective:</strong> To describe the pattern of intracranial tumors in Sylvanus Olympio teaching hospital of Lomé (Togo). <strong>Method:</strong> We conducted a retrospective and d...<strong>Objective:</strong> To describe the pattern of intracranial tumors in Sylvanus Olympio teaching hospital of Lomé (Togo). <strong>Method:</strong> We conducted a retrospective and descriptive study between November 2017 and December 2019. Data were obtained from the clinical records of patients with intracranial tumors treated in our neurosurgery unit, and histology obtained. Patients without a definitive histological diagnosis were excluded. <strong>Results:</strong> 53 patients were operated and had a histological diagnosis in the period of the study. The mean age at diagnosis was 32 ± 27.1 years. The majority of tumors were seen in adults at 88.7% with age range between 23 - 75 years and a mean age of 40 ± 10.5 years. Meningioma was the commonest intracranial tumor in adults (47.2%) and more seen in females. The histological type of meningioma is meningotheliomatous in our study. In children, principal tumors were medulloblastoma and ependymoma (11.3%). <strong>Conclusion: </strong>Meningioma is the most common intracranial tumor in adults, while embryonal tumors (medulloblastoma and ependymoma) are the most frequent in children in our environment.展开更多
BACKGROUND Synovial sarcoma(SS)is a highly malignant tumor of unknown histological origin.This tumor can occur in various parts of the body,including those without synovial structures,but mainly in and around the join...BACKGROUND Synovial sarcoma(SS)is a highly malignant tumor of unknown histological origin.This tumor can occur in various parts of the body,including those without synovial structures,but mainly in and around the joints,mostly in the lower extremities.Primary intracranial SSs are remarkably rare.This paper aims to report a case of primary intracranial SS with hemorrhage.CASE SUMMARY A 35-year-old male patient suffered a headache and slurred speech during manual labor and was sent to the emergency department.Through imaging examination,the patient was considered to have high-grade glioma complicated with hemorrhage and was treated with craniotomy.Postoperative pathology revealed SS.positron emission tomography/computed tomography was performed,which ruled out the possibility of metastasis to the intracranial from other parts of the body.Postoperative radiotherapy was given to the patient,during which radiation necrosis occurred.Sixteen months after craniotomy,cranial magnetic resonance imaging revealed recurrence of the tumor.CONCLUSION Primary intracranial SS is a rare malignant tumor.Primary intracranial SS with hemorrhage and radiation necrosis should be carefully monitored during postoperative radiotherapy.Surgical resection of the tumor combined with postoperative radiotherapy and chemotherapy is currently used,but the prognosis is poor.展开更多
BACKGROUND Primary intracranial malignant melanoma(PIMM)is rare,and its prognosis is very poor.It is not clear what systematic treatment strategy can achieve long-term survival.This case study attempted to identify th...BACKGROUND Primary intracranial malignant melanoma(PIMM)is rare,and its prognosis is very poor.It is not clear what systematic treatment strategy can achieve long-term survival.This case study attempted to identify the optimal strategy for long-term survival outcomes by reviewing the PIMM patient with the longest survival following comprehensive treatment and by reviewing the related literature.CASE SUMMARY The patient is a 47-year-old Chinese man who suffered from dizziness and gait disturbance.He underwent surgery for right cerebellum melanoma and was subsequently diagnosed by pathology in June 2000.After the surgery,the patient received three cycles of chemotherapy but relapsed locally within 4 mo.Following the second surgery for total tumor resection,the patient received an injection of Newcastle disease virus-modified tumor vaccine,interferon,andβ-elemene treatment.The patient was tumor-free with a normal life for 21 years before the onset of the recurrence of melanoma without any symptoms in July 2021.A third gross-total resection with adjuvant radiotherapy and temozolomide therapy was performed.Brain magnetic resonance imaging showed no residual tumor or recurrence 3 mo after the 3rd operation,and the patient recovered well without neurological dysfunction until the last follow-up in June 2022,which was 22 years following the initial treatment.CONCLUSION It is important for patients with PIMM to receive comprehensive treatment to enable the application of the most appropriate treatment strategies.Long-term survival is not impossible in patients with these malignancies.展开更多
Objective The occurrence of large-cell neuroendocrine carcinoma(LCNEC), a kind of neuroendocrine tumor(NET), in the cranium is extremely rare. Here we report two such cases and review the literature in order to improv...Objective The occurrence of large-cell neuroendocrine carcinoma(LCNEC), a kind of neuroendocrine tumor(NET), in the cranium is extremely rare. Here we report two such cases and review the literature in order to improve the diagnosis and treatment of intracranial LCNEC.Methods We report two cases of metastatic intracranial LCNEC. In case 1, the patient was diagnosed with lung carcinoma and underwent chemotherapy. Brain metastases were found six months later. The lung and intracranial lesions in case 2 were found at the same time. Results Intracranial multiple-tumor resection was performed in case 1 and the patient died 2 months later. Case 2 patient underwent surgery followed by chemotherapy with etoposide and carboplatin. Six months postoperatively, a recurrence lesion was found in the left cerebellar hemisphere. The patient was treated surgically. At present, a year after the diagnosis, the patient is still alive.Conclusion NETs of the intracranial region are extremely rare, and hence, most of our knowledge is based on lung NETs, and standard treatment strategies for intracranial NETs remain unclear. Our patients had different survival times probably due to different treatments, indicating that effective surgical resection and subsequent multi-agent chemotherapy should be administered to promote long-term survival of intracranial LCNEC patients.展开更多
A 42-year-old male with a history of recurrent intracranial hemangiopericytoma presented to the Emergency Department with urinary retention. Ensuing work-up revealed a 10-centimeter circumscribed pelvic mass that appe...A 42-year-old male with a history of recurrent intracranial hemangiopericytoma presented to the Emergency Department with urinary retention. Ensuing work-up revealed a 10-centimeter circumscribed pelvic mass that appeared anatomically distinct from the sacrum. This metastasis was found 10 years after the initial resection of his intracranial lesion. An abdominal resection was performed, and the patient recovered uneventfully. Final pathology and staining findings were consistent with metastatic hemangiopericytoma. Hemangiopericytoma is a rare mesenchymal soft tissue neoplasm with potential for late local recurrence and metastasis. Here, we review the case and discuss the clinical relevance of narrowing the diagnosis to HPC or the growing umbrella of Solitary Fibrous Tumor (SFT). To our knowledge, this is the first report of intracranial HPC metastatic to the pelvis.展开更多
The huge?congenital?intracranial teratoma is very rare. We report a case of a 77 years old male with giant congenital brain teratoma without clinical symptoms. His computed tomography (CT) scan showed a massive tumor ...The huge?congenital?intracranial teratoma is very rare. We report a case of a 77 years old male with giant congenital brain teratoma without clinical symptoms. His computed tomography (CT) scan showed a massive tumor (6 × 5 × 6 cm) of irregular high density (inside with some point flaky low density) in left temporal lobe region, the lower corner of the left ventricle downward shift, and enhanced CT scan no enhancement. Magnetic resonance imaging (MRI) on brain showed an irregular huge tumor in the left temporal lobe area, with multiple nodular or lobulated mixd high and low or equal signal changes, in which the liquid signal based. The midline was shift to the right, and the posterior horn of the left ventricle was compressed and downward shift, expansion, and hydrocephalus. After follow-up 12 months, the patient presents a normal daily life and work and no neurological signs as usual. Our observations show that the huge tumor in brain with multiple nodular or lobulated variety of mixed signal changes on MRI without symptoms is a congenital intracranial silent teratoma.展开更多
文摘· AIM: To evaluate the visual findings as primary manifestations in patients with intracranial tumors.·METHODS: The medical charts of the patients with intracranial tumors who initially admitted to the Neuro-ophthalmology and Strabismus Department with ocular complaints between August 1999 and December 2012 were reviewed retrospectively. The detailed clinical history and the findings of neuro-ophthalmologic examination were recorded. Ocular symptoms and signs,the types and locations of intracranial tumors, and the duration of symptoms before the diagnosis were evaluated.·RESULTS: The mean age of 11 women(61.1%) and 7men(38.9%) was 42.2±11.0(range 20-66y) at the time of intracranial tumor diagnosis. Initial symptoms were transient visual obscurations, visual loss or visual field defect in 16 cases(88.9%), and diplopia in 2 cases(11.1%). Neuro-ophthalmologic examination revealed normal optic discs in both eyes of 6 patients(33.3%),paleness, atrophy or edema of optic disc in 12 patients(66.7%), and sixth cranial nerve palsy in 2 patients(11.1%). Visual acuity ranged between normal vision and loss of light perception. Cranial imaging demonstrated craniopharyngioma(n =1), plasmacytoma(n =1),meningioma(n =6; olfactory groove and tuberculum sellae, pontocerebellar angle, anterior cranial fossa,frontal vertex, suprasellar region), and pituitary macroadenoma(n =10). The mean duration between the onset of visual disturbances and the diagnosis of intracranial tumor was 9.8±18mo(range 3d-6y).·CONCLUSION: The ophthalmologist is frequently the first physician to encounter a patient with clinical manifestations of intracranial tumors that may cause neurological and ocular complications. Neuro-ophthalmologic findings should be carefully evaluated to avoid a delay in the diagnosis of intracranial tumors.
基金the Science and Technology Projects in Liaoning Province, No. 2010225036
文摘Angioarchitecture plays an important role in the malignant development of intracranial hemangiopericytoma. It remains poorly understood whether high frequency of hemorrhage during clinical surgery for intracranial hemangiopericytoma is associated with angioarchitecture. The present study utilized hematoxylin-eosin staining, and immunohistochemical staining with epithelial membrane antigen, vimentin, CD34, von Willebrand factor (vWF) and CD133 to observe characteristics of angioarchitecture. In addition, silver stains were used to demonstrate changes in reticular fibers in the wall of vessel channels in intracranial hemangiopericytoma and meningioma. Five patterns of angioarchitecture were identified in intracranial hemangiopericytoma, namely tumor cell islands, vasculogenic mimicry, mosaic blood vessels, sprouting angiogenesis, and intussusceptive angiogenesis. Several CD133+ tumor cells were found to form tumor cell islands. A connection between vWF ^+ and vWF channels was detected in the pattern of intussusceptive angiogenesis, and some vimentin^+ tumor cells were embedded in the periodic acid-Schiff positive channel wall. Incomplete threads of reticular fibers formed the walls of larger pseudo-vascular channels and some tumor clumps or scattered tumor cells were detected "floating" in them. The angioarchitecture, specific markers and reticular fibers of intracranial hemangiopericytoma were significantly different from meningioma. Angioarchitecture provides a functional vascular network for vascular evolution in intracranial hemangiopericytoma and contributes to significant intra-operative bleeding.
文摘Background: The efficacy and safety of dexmedetomidine during the anesthesia induction of intracranial tumor patients remain unknown. We wondered whether loading infusion of dexmedetomidine 1 μg/kg over 10 min to intracranial tumor patients was as efficient and safe as to those abdominal disease patients. Methods: Patients aged 18-60 years, male or female, ASA I or II, scheduled for intracranial tumor resection (Group N, n = 30) or abdominal operation (Group A, n = 30) were enrolled in this observational trial. Dexmedetomidine was administrated with a loading dosage of 1 μg/kg over 10 min following with continuous infusing of 0.5 μg/kg/h. Fentanyl, propofol and rocuronium were sequentially administered for anesthesia induction. Heart rate (HR), blood pressure (BP), pulse oxygen saturation (SpO2), bispectral index (BIS) and other adverse effects were recorded from the beginning of loading infusion of dexmedetomidine to the end of endotracheal intubation. Results: Among with loading infusion, HR and BIS value decreased and were significantly lower at the end of infusion than before infusion (P P > 0.05). One patient of Group N dropped out from this trial because of a serious headache. 14 of 29 patients during dexmedetomidine loading infusion suffered hypoxemia (SpO2 P Conclusion: A loading dosage of 1 μg/kg of dexmedetomidine was not suitable for the anesthesia induction of intracranial tumor patients as compared to patients undergoing abdominal operation.
文摘BACKGROUND Solitary fibrous tumor(SFT)is a rare fibroblastic mesenchymal neoplasm that affects spindle cell soft tissues with broad-spectrum biological behavior;it is predominantly benign,and rarely metastasizes.SFT occurs mainly in the tissue structure of the serosa in the pleura and the thorax,and can be found throughout the body,though extra-thoracic localization,including the cephalic region,is uncommon.We reported the first case of intracranial malignant SFT metastasized to the chest wall.CASE SUMMARY An 81-year-old Japanese man was referred to our hospital due to progressive gait disturbance and appetite loss.His medical history included partial resection due to brain tumor,four times,and 50-Gray radiation therapy at another hospital,starting when he was 74 years old.An unenhanced head computed tomography(CT)scan revealed an 8 cm×5.1 cm×6.5 cm mixed-density mass at the left frontal lobe,accompanying a midline shift,and an unenhanced chest-abdomen CT scan revealed a 6 cm×4.1 cm×6.5 cm low-density mass in the left chest wall.A CT-guided percutaneous lung biopsy was performed,and the pathological findings were SFT corresponding to brain tumor.Finally,the correct diagnosis of his brain tumor in history of past illness revealed to be SFT,and the unremovable tumor,namely present brain lesions enlarged and metastasized to the chest wall.We established a definitive diagnosis of intracranial malignant SFT metastasized to the chest wall.We notified him and his family of the disease,and offered palliative care.He passed away on the 29 th hospital day.CONCLUSION This case suggests the need for careful,detailed examination,and careful followup when encountering patients presenting with a mass.
基金a grant from the Medical Foundation of Wu Jieping(No.32067000501).
文摘Objective: To evaluate the clinical application of proton magnetic resonance spectroscopy (1HMRS) in patients with radiotherapy treated intracranial tumors. Methods: Forty patients with intracranial tumors underwent multivoxel 1HMRS examination before and after radiotherapy. The concentrations of N-acetyl aspartate (NAA), choline (Cho) and creatine (Cr) were obtained both in the tumors and the contralateral normal brain regions, The ratios of NANCr, Cho/Cr and Cho/NAA were calculated at the same time and follow-up one year. Results: (1) After radiotherapy, tumors inhibited by radiation had decreased Cho, NAA and Cr on proton MRS. Some cases showed necrotic wave. (2) During the one year follow-up, local tumor recurred in 8 cases and their Cho and Cho/NAA increased high again. Other cases without recurrence, HMRS showed no change. Conclusion: Multivoxel proton MR spectroscopy is available for study of tumor metabolites after radiotherapy and it is a valuable method in the evaluation of radiotherapy treated tumors,
文摘BACKGROUND: Inflammatory reaction correlates with sporadic intracranial aneurysm (IA). Variation of tumor necrosis factor receptor superfamily 13B (TNFRSF13B), an inflammatory mediator receptor, may associate with IA. OBJECTIVE: To explore the relationship between TNFRSF13B gene and sporadic IA, as well as the clinical characteristics of sporadic IA. DESIGN, TIME AND SETTING: Case-control study of genetic association was performed at the Experimental Technology Center of China Medical University from November 2006 to January 2008. PARTICIPANTS: A total of 367 patients with IA, confirmed by three-dimensional computed tomography angiography, magnetic resonance angiography, digital subtraction angiography, and neuro surgery, were admitted to the Department of Neurosurgery, First Affiliated Hospital of China Medical University from 2006 to 2007, and were selected as the case group. All patients were Han, with no family history of IA. In addition, a total of 396 non-lA patients were selected as control subjects. METHODS: Peripheral vein blood was harvested to extract whole blood genomic DNA. Genotyping and TNFRSF13B single nucleotide polymorphism (SNP) rs11078355 G〉A allele polymorphisms were determined by polymerase chain reaction-restriction fragment length polymorphism. The relationship of TNFRSF13B SNP rs11078355 G〉A polymorphisms to IA and IA clinical characteristics were analyzed using the chi-square and two-sided test. MAIN OUTCOME MEASURES: TNFRSF13B SNP rs11078355 G〉A genotype distribution. RESULTS: In the IA patients, TNFRSF13B SNP rs11078355 G〉A genotype frequency was significantly increased (X2 = 16.306, odds ratio = 1.881,95% confidence interval = 1.382 2.560, P 〈 0.001). In IA patients aged 〉 65 years, the frequency of TNFRSF13B SNP rs11078355 GA + AA genotype was significantly greater than the GG genotype (X2 = 26.604, odds ratio = 5.248, 95% confidence interval = 2.662 10.345, P 〈 0.001). CONCLUSION: The TNFRSF13B gene may associate with sporadic IA in Han Chinese populations In elderly patients, allele A may be an independent risk factor for IA, in addition to senile diseases, such as hypertension and diabetes mellitus.
文摘Aims: Trigeminal neuralgia is generally caused by neurovascular compression. In rare cases intracranial tumors may also lead to this condition. The present study was conducted to identify clinical symptoms and testing methods that are useful for early detection of trigeminal neuralgia associated with intracranial tumor. Methods: Five patients with trigeminal neuralgia suspected to be due to intracranial tumor, who visited our department for the first time during the period between February 2007 and March 2009, were examined. We analyzed the medical records and MRI findings of these patients. The clinical symptoms of subjects were compared to those presented at the International Classification of Headache Disorders. Results: There were no feature symptoms to trigeminal neuralgia caused by intracranial tumors compared with trigeminal neuralgia in general. None of the patients complained of spontaneous headache and nausea, which are clinical symptoms characteristic of brain tumor. Head MRI at our hospital was the most accurate method to detect intracranial tumors. Finally four of five patients received brain surgery to remove tumors. Conclusion: Small tumors and roots of the trigeminal nerve may not create accurate images by regular head MRI. Therefore, MRI using the imaging sequence which enables accurate visualization of roots of the trigeminal nerve is essential to confirm the presence of tumors in patients with suspected trigeminal neuralgia.
文摘Tuberculoma is a common condition in developing countries. In some cases, it may mimic a glial lesion, making differential diagnosis challenging. The authors report two cases of giant tuberculoma in young patients aged 14 and 16. A literature review was conducted on these cases. Both patients underwent partial excision. Histology concluded tuberculoma. Anti-tubercular treatment was implemented. The evolution one year later was marked by the persistence of neurological disorders, although they had improved.
文摘<strong>Objective:</strong> To describe the pattern of intracranial tumors in Sylvanus Olympio teaching hospital of Lomé (Togo). <strong>Method:</strong> We conducted a retrospective and descriptive study between November 2017 and December 2019. Data were obtained from the clinical records of patients with intracranial tumors treated in our neurosurgery unit, and histology obtained. Patients without a definitive histological diagnosis were excluded. <strong>Results:</strong> 53 patients were operated and had a histological diagnosis in the period of the study. The mean age at diagnosis was 32 ± 27.1 years. The majority of tumors were seen in adults at 88.7% with age range between 23 - 75 years and a mean age of 40 ± 10.5 years. Meningioma was the commonest intracranial tumor in adults (47.2%) and more seen in females. The histological type of meningioma is meningotheliomatous in our study. In children, principal tumors were medulloblastoma and ependymoma (11.3%). <strong>Conclusion: </strong>Meningioma is the most common intracranial tumor in adults, while embryonal tumors (medulloblastoma and ependymoma) are the most frequent in children in our environment.
基金the National Natural Science Foundation of China,No.81971085.
文摘BACKGROUND Synovial sarcoma(SS)is a highly malignant tumor of unknown histological origin.This tumor can occur in various parts of the body,including those without synovial structures,but mainly in and around the joints,mostly in the lower extremities.Primary intracranial SSs are remarkably rare.This paper aims to report a case of primary intracranial SS with hemorrhage.CASE SUMMARY A 35-year-old male patient suffered a headache and slurred speech during manual labor and was sent to the emergency department.Through imaging examination,the patient was considered to have high-grade glioma complicated with hemorrhage and was treated with craniotomy.Postoperative pathology revealed SS.positron emission tomography/computed tomography was performed,which ruled out the possibility of metastasis to the intracranial from other parts of the body.Postoperative radiotherapy was given to the patient,during which radiation necrosis occurred.Sixteen months after craniotomy,cranial magnetic resonance imaging revealed recurrence of the tumor.CONCLUSION Primary intracranial SS is a rare malignant tumor.Primary intracranial SS with hemorrhage and radiation necrosis should be carefully monitored during postoperative radiotherapy.Surgical resection of the tumor combined with postoperative radiotherapy and chemotherapy is currently used,but the prognosis is poor.
文摘BACKGROUND Primary intracranial malignant melanoma(PIMM)is rare,and its prognosis is very poor.It is not clear what systematic treatment strategy can achieve long-term survival.This case study attempted to identify the optimal strategy for long-term survival outcomes by reviewing the PIMM patient with the longest survival following comprehensive treatment and by reviewing the related literature.CASE SUMMARY The patient is a 47-year-old Chinese man who suffered from dizziness and gait disturbance.He underwent surgery for right cerebellum melanoma and was subsequently diagnosed by pathology in June 2000.After the surgery,the patient received three cycles of chemotherapy but relapsed locally within 4 mo.Following the second surgery for total tumor resection,the patient received an injection of Newcastle disease virus-modified tumor vaccine,interferon,andβ-elemene treatment.The patient was tumor-free with a normal life for 21 years before the onset of the recurrence of melanoma without any symptoms in July 2021.A third gross-total resection with adjuvant radiotherapy and temozolomide therapy was performed.Brain magnetic resonance imaging showed no residual tumor or recurrence 3 mo after the 3rd operation,and the patient recovered well without neurological dysfunction until the last follow-up in June 2022,which was 22 years following the initial treatment.CONCLUSION It is important for patients with PIMM to receive comprehensive treatment to enable the application of the most appropriate treatment strategies.Long-term survival is not impossible in patients with these malignancies.
文摘Objective The occurrence of large-cell neuroendocrine carcinoma(LCNEC), a kind of neuroendocrine tumor(NET), in the cranium is extremely rare. Here we report two such cases and review the literature in order to improve the diagnosis and treatment of intracranial LCNEC.Methods We report two cases of metastatic intracranial LCNEC. In case 1, the patient was diagnosed with lung carcinoma and underwent chemotherapy. Brain metastases were found six months later. The lung and intracranial lesions in case 2 were found at the same time. Results Intracranial multiple-tumor resection was performed in case 1 and the patient died 2 months later. Case 2 patient underwent surgery followed by chemotherapy with etoposide and carboplatin. Six months postoperatively, a recurrence lesion was found in the left cerebellar hemisphere. The patient was treated surgically. At present, a year after the diagnosis, the patient is still alive.Conclusion NETs of the intracranial region are extremely rare, and hence, most of our knowledge is based on lung NETs, and standard treatment strategies for intracranial NETs remain unclear. Our patients had different survival times probably due to different treatments, indicating that effective surgical resection and subsequent multi-agent chemotherapy should be administered to promote long-term survival of intracranial LCNEC patients.
文摘A 42-year-old male with a history of recurrent intracranial hemangiopericytoma presented to the Emergency Department with urinary retention. Ensuing work-up revealed a 10-centimeter circumscribed pelvic mass that appeared anatomically distinct from the sacrum. This metastasis was found 10 years after the initial resection of his intracranial lesion. An abdominal resection was performed, and the patient recovered uneventfully. Final pathology and staining findings were consistent with metastatic hemangiopericytoma. Hemangiopericytoma is a rare mesenchymal soft tissue neoplasm with potential for late local recurrence and metastasis. Here, we review the case and discuss the clinical relevance of narrowing the diagnosis to HPC or the growing umbrella of Solitary Fibrous Tumor (SFT). To our knowledge, this is the first report of intracranial HPC metastatic to the pelvis.
文摘The huge?congenital?intracranial teratoma is very rare. We report a case of a 77 years old male with giant congenital brain teratoma without clinical symptoms. His computed tomography (CT) scan showed a massive tumor (6 × 5 × 6 cm) of irregular high density (inside with some point flaky low density) in left temporal lobe region, the lower corner of the left ventricle downward shift, and enhanced CT scan no enhancement. Magnetic resonance imaging (MRI) on brain showed an irregular huge tumor in the left temporal lobe area, with multiple nodular or lobulated mixd high and low or equal signal changes, in which the liquid signal based. The midline was shift to the right, and the posterior horn of the left ventricle was compressed and downward shift, expansion, and hydrocephalus. After follow-up 12 months, the patient presents a normal daily life and work and no neurological signs as usual. Our observations show that the huge tumor in brain with multiple nodular or lobulated variety of mixed signal changes on MRI without symptoms is a congenital intracranial silent teratoma.