1
|
Jain S, Helmy A, Santarius T, Owen N, Grieve K, Hutchinson P, Timofeev I. Customised pre-operative cranioplasty to achieve maximal surgical resection of tumours with osseous involvement-a case series. Acta Neurochir (Wien) 2024; 166:152. [PMID: 38532155 DOI: 10.1007/s00701-024-06055-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Accepted: 03/15/2024] [Indexed: 03/28/2024]
Abstract
PURPOSE Surgical resection with bony margins would be the treatment of choice for tumours with osseous involvement such as meningiomas and metastasis. By developing and designing pre-operative customised 3D modelled implants, the patient can undergo resection of meningioma and repair of bone defect in the same operation. We present a generalisable method for designing pre-operative cranioplasty in patients to repair the bone defect after the resection of tumours. MATERIALS AND METHODS We included six patients who presented with a tumour that was associated with overlying bone involvement. They underwent placement of customised cranioplasty in the same setting. A customised implant using a pre-operative imaging was designed with a 2-cm margin to allow for any intra-operative requirements for extending the craniectomy. RESULTS Six patients were evaluated in this case series. Four patients had meningiomas, 1 patient had metastatic breast cancer on final histology, and 1 patient was found to have an intra-osseous arteriovenous malformation. Craniectomy based on margins provided by a cutting guide was fashioned. After tumour removal and haemostasis, the cranioplasty was then placed. All patients recovered well post-operatively with satisfactory cosmetic results. No wound infection was reported in our series. CONCLUSION Our series demonstrate the feasibility of utilising pre-designed cranioplasty for meningiomas and other tumours with osseous involvement. Following strict infection protocols, minimal intra-operative handling/modification of the implant, and close follow-up has resulted in good cosmetic outcomes with no implant-related infections.
Collapse
Affiliation(s)
- Swati Jain
- Divison of Neurosurgery, Department of Clinical Neurosciences, University of Cambridge, Cambridge, CB2 1TN, UK.
| | - Adel Helmy
- Divison of Neurosurgery, Department of Clinical Neurosciences, University of Cambridge, Cambridge, CB2 1TN, UK
| | - Thomas Santarius
- Divison of Neurosurgery, Department of Clinical Neurosciences, University of Cambridge, Cambridge, CB2 1TN, UK
| | - Nicola Owen
- Divison of Neurosurgery, Department of Clinical Neurosciences, University of Cambridge, Cambridge, CB2 1TN, UK
| | - Kirsty Grieve
- Divison of Neurosurgery, Department of Clinical Neurosciences, University of Cambridge, Cambridge, CB2 1TN, UK
| | - Peter Hutchinson
- Divison of Neurosurgery, Department of Clinical Neurosciences, University of Cambridge, Cambridge, CB2 1TN, UK
| | - Ivan Timofeev
- Divison of Neurosurgery, Department of Clinical Neurosciences, University of Cambridge, Cambridge, CB2 1TN, UK
| |
Collapse
|
2
|
Choi JW, Ho R, Zhang YJ, Sae-Ow W, Hui FK, Brown SC, Tsappidi S. A rare case of solitary, isolated dural metastasis from hepatocellular carcinoma mimicking a meningioma. Surg Neurol Int 2023; 14:398. [PMID: 38053699 PMCID: PMC10695471 DOI: 10.25259/sni_733_2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2023] [Accepted: 10/24/2023] [Indexed: 12/07/2023] Open
Abstract
Background Distinguishing an isolated metastatic dural tumor from a meningioma on imaging is challenging and may lead to a delay in treatment. Here, we present the first known case of isolated, solitary dural metastasis from hepatocellular carcinoma (HCC) mimicking a meningioma. Case Description A 64-year-old male with a history of liver cirrhosis presented with a 5.8 cm enhancing left parafalcine hemorrhagic dural-based mass extending across the midline. Cerebral angiography revealed a distal left anterior pseudoaneurysm, and tumor contrast blush with feeders from the left ophthalmic and right middle meningeal artery. The pseudoaneurysm was successfully embolized to stop the bleeding, followed by an uneventful bi-coronal frontal craniotomy for falcine tumor resection to relieve brain compression. Histopathological analysis of the dural-based tumor showed poorly differentiated carcinoma with positive albumin in situ hybridization and cytokeratin tumor markers, consistent with dural metastases from HCC. Conclusion When encountering a solitary, highly vascular mass bearing resemblance to a meningioma, it may be prudent to consider the possibility of a dural-based metastatic carcinoma.
Collapse
Affiliation(s)
- Joo Won Choi
- John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu, Hawaii, United States
| | - Richard Ho
- John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu, Hawaii, United States
| | - Yi Jonathan Zhang
- Department of Neurosurgery, The Queen’s Medical Center, Honolulu, Hawaii, United States
| | - Wichit Sae-Ow
- Department of Pathology, The Queen’s Medical Center, Honolulu, Hawaii, United States
| | - Ferdinand K. Hui
- Department of Neurointerventional Surgery, The Queen’s Medical Center, Honolulu, Hawaii, United States
| | - Stacy C. Brown
- Department of Neuroscience Institute, The Queen’s Medical Center, Honolulu, Hawaii, United States
| | - Samuel Tsappidi
- Department of Neurointerventional Surgery, The Queen’s Medical Center, Honolulu, Hawaii, United States
| |
Collapse
|
3
|
Wogram E, Schlunk F, Shah MJ, Prinz M, Urbach H, Erny D, Taschner CA. Freiburg Neuropathology Case Conference : A 51-year-old Patient Presenting with Epistaxis and Occasional Headaches 16 Years after Diagnosis of a Grade 1 Chondrosarcoma of the Left Petrous Apex. Clin Neuroradiol 2023; 33:569-575. [PMID: 37171609 DOI: 10.1007/s00062-023-01294-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/17/2023] [Indexed: 05/13/2023]
Affiliation(s)
- E Wogram
- Department of Neuropathology, Medical Centre, University of Freiburg, Freiburg, Germany
- Faculty of Medicine, Medical Centre, University of Freiburg, Freiburg, Germany
| | - F Schlunk
- Department of Neuroradiology, Medical Centre, University of Freiburg, Breisacherstraße 64, 79106, Freiburg, Germany
- Faculty of Medicine, Medical Centre, University of Freiburg, Freiburg, Germany
| | - M J Shah
- Department of Neurosurgery, Medical Centre, University of Freiburg, Freiburg, Germany
- Faculty of Medicine, Medical Centre, University of Freiburg, Freiburg, Germany
| | - M Prinz
- Department of Neuropathology, Medical Centre, University of Freiburg, Freiburg, Germany
- Faculty of Medicine, Medical Centre, University of Freiburg, Freiburg, Germany
| | - H Urbach
- Department of Neuroradiology, Medical Centre, University of Freiburg, Breisacherstraße 64, 79106, Freiburg, Germany
- Faculty of Medicine, Medical Centre, University of Freiburg, Freiburg, Germany
| | - D Erny
- Department of Neuropathology, Medical Centre, University of Freiburg, Freiburg, Germany
- Faculty of Medicine, Medical Centre, University of Freiburg, Freiburg, Germany
| | - C A Taschner
- Department of Neuroradiology, Medical Centre, University of Freiburg, Breisacherstraße 64, 79106, Freiburg, Germany.
- Faculty of Medicine, Medical Centre, University of Freiburg, Freiburg, Germany.
| |
Collapse
|
4
|
Survival in patients with surgically treated dural based metastases: A single-center retrospective study. INTERDISCIPLINARY NEUROSURGERY 2022. [DOI: 10.1016/j.inat.2022.101584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
|
5
|
Song S, Chang D, Li H, Liu C, Li H, Cui Y. Application of optic neuro-ophthalmology imaging in latent meningeal metastases of lung cancer. Thorac Cancer 2021; 12:2614-2617. [PMID: 34505347 PMCID: PMC8487808 DOI: 10.1111/1759-7714.14128] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Revised: 08/11/2021] [Accepted: 08/12/2021] [Indexed: 11/28/2022] Open
Abstract
Latent intracranial meningeal metastases (IMM) of lung cancer is difficult to determine, yet it is critical to do so given that it impacts the treatment agent. Studies on this disease are rare, thus necessitating further investigation. As a case study, we will explore the application of optic neuroimaging in IMM. A 62-year-old female patient was diagnosed with lung adenocarcinoma, which had progressed to osseous metastasis. During the course of chemotherapy, the patient had bilateral vision loss and paralysis of extraocular muscles. Ophthalmologists ruled out disease of the retina and suspected intracranial metastasis; however, brain-enhanced magnetic resonance angiography and magnetic resonance venography were normal. Given the patient's severe osteoarthropathy and poor physical condition, she refused to undergo a lumbar puncture examination. Optic neuro-ophthalmology imaging was ultimately used. Utilizing optical coherence tomography, we found that the basement membrane layer in the papilledema was protruding up towards the vitreous cavity. To assist in visualization, the optic nerve sheath was enhanced with optic magnetic resonance imaging. With these methods, the dural metastasis was identified, the treatment agent was changed for the patient, and she had a successful recovery. Thus, optic neuro-ophthalmology imaging should be recommended for patients who are in the latent course of dural metastasis, and it could also be used to evaluate therapeutic efficacy.
Collapse
Affiliation(s)
- Shuai Song
- Department of Thoracic Surgery, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Dong Chang
- Department of Thoracic Surgery, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Hao Li
- Department of Thoracic Surgery, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Chunquan Liu
- Department of Thoracic Surgery, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Hongyang Li
- Department of Ophthalmology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Yong Cui
- Department of Thoracic Surgery, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| |
Collapse
|
6
|
Antonelli V, Maimone G, D'Andrea M, Tomassini A, Bassi M, Tosatto L. "Single-step" resection and cranio-orbital reconstruction for spheno-orbital metastasis with custom made implant. A case report and review of the literature. Int J Surg Case Rep 2021; 81:105755. [PMID: 33752032 PMCID: PMC8010640 DOI: 10.1016/j.ijscr.2021.105755] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 03/05/2021] [Accepted: 03/05/2021] [Indexed: 11/26/2022] Open
Abstract
Skull Base Metastases need multidisciplinary treatment. Surgical decompression has a decisive role in relieving neurological symptoms and improving Quality of Life. The virtual planning step consists of a phantom-base procedure with the aid of Stealth Navigation. New generations of custom-made PolyMethyl MethAcrylate (PMMA) cranioplasty allow a quick access to complementary therapies. Stealth navigation during the surgical step allows a precise tumor resection and drives to an accurate cranial reconstruction.
Introduction and importance Brain metastasis involving the skull base is a rare complication of malignant tumors. Besides radiotherapy, surgical treatment is a therapeutical option even though it may apply complex technical procedures that may delay complementary therapies. However, in recent days, the innovation of custom-made implants allows treating selected patients with fewer complications and better results. Case presentation We describe a single case of a complex fronto-orbital skull base metastasis requiring skull bone reconstruction that we treated with a single-step surgery and custom-made implant. Our procedure consists of two steps: in the first one, we perform a “virtual” craniotomy on a 3D phantom model previously built on a high-resolution bone CT scan. In the second step, the actual surgical procedure, the patient undergoes the resection and reconstruction of the cranial defect with an implant of PMMA custom-made cranioplasty. A three-month clinical and radiological follow-up is reported, which documented the extent of resection and good aesthetic results. Clinical discussion In our case, we performed a skull reconstruction of cranio-orbital region with macroscopic gross-total resection of the tumor. Complementary radiotherapy was obtained after one month. Three-month follow-up showed good esthetic results and progression-free disease. A recent review of the literature is provided to discuss different reconstruction techniques. Conclusion “Single-Step” resection and custom-made reconstruction is a relatively new technique that could be helpful not only for benign tumors, which remains its main application but also in selected cases of malignant tumors when immediate reconstruction and faster complementary treatments are needed.
Collapse
Affiliation(s)
- Vincenzo Antonelli
- Department of Neurosurgery, Hospital "M. Bufalini" - AUSL della Romagna, 286 Viale Ghirotti, 47521 Cesena, Italy
| | - Giuseppe Maimone
- Department of Neurosurgery, Hospital "M. Bufalini" - AUSL della Romagna, 286 Viale Ghirotti, 47521 Cesena, Italy.
| | - Marcello D'Andrea
- Department of Neurosurgery, Hospital "M. Bufalini" - AUSL della Romagna, 286 Viale Ghirotti, 47521 Cesena, Italy
| | - Alessia Tomassini
- Department of Neurosurgery, Hospital "M. Bufalini" - AUSL della Romagna, 286 Viale Ghirotti, 47521 Cesena, Italy
| | - Massimo Bassi
- Department of Maxillo-Facial Surgery, Hospital "M. Bufalini" - AUSL della Romagna, 286 Viale Ghirotti, 47521 Cesena, Italy
| | - Luigino Tosatto
- Department of Neurosurgery, Hospital "M. Bufalini" - AUSL della Romagna, 286 Viale Ghirotti, 47521 Cesena, Italy
| |
Collapse
|
7
|
A solitary hypothalamic metastasis from prostatic cancer mimicking a giant thrombotic aneurysm and presenting with intraventricular hemorrhage and acute hydrocephalus: a case report. THE EGYPTIAN JOURNAL OF RADIOLOGY AND NUCLEAR MEDICINE 2020. [PMCID: PMC7729140 DOI: 10.1186/s43055-020-00367-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Background Despite the high prevalence of prostate cancer, its brain parenchymal metastasis is not common and intracranial hemorrhage due to such a metastasis is even less common. This report presents a challenging case of solitary brain metastasis secondary to prostate cancer that gave rise to intraventricular hemorrhage and acute hydrocephalus mimicking a giant aneurysm. Case presentation A 77-year-old man with a history of prostate cancer, hypertension, and morbid obesity presented to the emergency room with a severe headache. He was afebrile with a blood pressure of 144/79 mmHg, alert, without any sign of sensory or motor deficit. Shortly after admission, he became unresponsive and was immediately intubated. His blood tests revealed hypernatremia at 154 mmol/L; otherwise, the lab data including the COVID-19 screening proved normal. The cerebral CT and MR images, with and without contrast, were interpreted as a giant thrombotic aneurysm extending to the suprasellar region by the emergency radiologist. Also, moderate intraventricular hemorrhage, acute hydrocephalus, and sub-ependymal interstitial edema were observed. Upon further evaluation of the images, the lesion was determined to be an exophytic hemorrhagic hypothalamic mass, and the subsequent biopsy was consistent with prostate cancer metastasis. Conclusions The exophytic hemorrhagic hypothalamic metastasis can mimic a ruptured aneurysm on imaging. Given the improved survival of patients with prostate cancer, radiologists may encounter such unusual cerebral metastases from prostate cancers more frequently in the future.
Collapse
|
8
|
Management of osteomeningeal defects in a case of lung adenocarcinoma with metastasis. Neurochirurgie 2020; 66:487-489. [PMID: 33058906 DOI: 10.1016/j.neuchi.2020.08.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2020] [Revised: 06/30/2020] [Accepted: 08/26/2020] [Indexed: 11/21/2022]
|
9
|
Pisani P, Airoldi M, Allais A, Aluffi Valletti P, Battista M, Benazzo M, Briatore R, Cacciola S, Cocuzza S, Colombo A, Conti B, Costanzo A, della Vecchia L, Denaro N, Fantozzi C, Galizia D, Garzaro M, Genta I, Iasi GA, Krengli M, Landolfo V, Lanza GV, Magnano M, Mancuso M, Maroldi R, Masini L, Merlano MC, Piemonte M, Pisani S, Prina-Mello A, Prioglio L, Rugiu MG, Scasso F, Serra A, Valente G, Zannetti M, Zigliani A. Metastatic disease in head & neck oncology. ACTA OTORHINOLARYNGOLOGICA ITALICA : ORGANO UFFICIALE DELLA SOCIETA ITALIANA DI OTORINOLARINGOLOGIA E CHIRURGIA CERVICO-FACCIALE 2020; 40:S1-S86. [PMID: 32469009 PMCID: PMC7263073 DOI: 10.14639/0392-100x-suppl.1-40-2020] [Citation(s) in RCA: 78] [Impact Index Per Article: 19.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
The head and neck district represents one of the most frequent sites of cancer, and the percentage of metastases is very high in both loco-regional and distant areas. Prognosis refers to several factors: a) stage of disease; b) loco-regional relapses; c) distant metastasis. At diagnosis, distant metastases of head and neck cancers are present in about 10% of cases with an additional 20-30% developing metastases during the course of their disease. Diagnosis of distant metastases is associated with unfavorable prognosis, with a median survival of about 10 months. The aim of the present review is to provide an update on distant metastasis in head and neck oncology. Recent achievements in molecular profiling, interaction between neoplastic tissue and the tumor microenvironment, oligometastatic disease concepts, and the role of immunotherapy have all deeply changed the therapeutic approach and disease control. Firstly, we approach topics such as natural history, epidemiology of distant metastases and relevant pathological and radiological aspects. Focus is then placed on the most relevant clinical aspects; particular attention is reserved to tumours with distant metastasis and positive for EBV and HPV, and the oligometastatic concept. A substantial part of the review is dedicated to different therapeutic approaches. We highlight the role of immunotherapy and the potential effects of innovative technologies. Lastly, we present ethical and clinical perspectives related to frailty in oncological patients and emerging difficulties in sustainable socio-economical governance.
Collapse
Affiliation(s)
- Paolo Pisani
- ENT Unit, ASL AT, “Cardinal Massaja” Hospital, Asti, Italy
| | - Mario Airoldi
- Medical Oncology, Città della Salute e della Scienza, Torino, Italy
| | | | - Paolo Aluffi Valletti
- SCDU Otorinolaringoiatria, AOU Maggiore della Carità di Novara, Università del Piemonte Orientale, Italy
| | | | - Marco Benazzo
- SC Otorinolaringoiatria, Fondazione IRCCS Policlinico “S. Matteo”, Università di Pavia, Italy
| | | | | | - Salvatore Cocuzza
- Department of Medical, Surgical and Advanced Technologies “G.F. Ingrassia”, University of Catania, Italy
| | - Andrea Colombo
- ENT Unit, ASL AT, “Cardinal Massaja” Hospital, Asti, Italy
| | - Bice Conti
- Department of Drug Sciences, University of Pavia, Italy
- Polymerix S.r.L., Pavia, Italy
| | | | - Laura della Vecchia
- Unit of Otorhinolaryngology General Hospital “Macchi”, ASST dei Settelaghi, Varese, Italy
| | - Nerina Denaro
- Oncology Department A.O.S. Croce & Carle, Cuneo, Italy
| | | | - Danilo Galizia
- Medical Oncology, Candiolo Cancer Institute, FPO-IRCCS, Candiolo,Italy
| | - Massimiliano Garzaro
- SCDU Otorinolaringoiatria, AOU Maggiore della Carità di Novara, Università del Piemonte Orientale, Italy
| | - Ida Genta
- Department of Drug Sciences, University of Pavia, Italy
- Polymerix S.r.L., Pavia, Italy
| | | | - Marco Krengli
- Dipartimento Medico Specialistico ed Oncologico, SC Radioterapia Oncologica, AOU Maggiore della Carità, Novara, Italy
- Dipartimento di Medicina Traslazionale, Università del Piemonte Orientale, Novara, Italy
| | | | - Giovanni Vittorio Lanza
- S.O.C. Chirurgia Toracica, Azienda Ospedaliera Nazionale “SS. Antonio e Biagio e Cesare Arrigo”, Alessandria, Italy
| | | | - Maurizio Mancuso
- S.O.C. Chirurgia Toracica, Azienda Ospedaliera Nazionale “SS. Antonio e Biagio e Cesare Arrigo”, Alessandria, Italy
| | - Roberto Maroldi
- Department of Radiology, University of Brescia, ASST Spedali Civili Brescia, Italy
| | - Laura Masini
- Dipartimento Medico Specialistico ed Oncologico, SC Radioterapia Oncologica, AOU Maggiore della Carità, Novara, Italy
| | - Marco Carlo Merlano
- Oncology Department A.O.S. Croce & Carle, Cuneo, Italy
- Medical Oncology, Candiolo Cancer Institute, FPO-IRCCS, Candiolo,Italy
| | - Marco Piemonte
- ENT Unit, University Hospital “Santa Maria della Misericordia”, Udine, Italy
| | - Silvia Pisani
- Immunology and Transplantation Laboratory Fondazione IRCCS Policlinico “S. Matteo”, Pavia, Italy
| | - Adriele Prina-Mello
- LBCAM, Department of Clinical Medicine, Trinity Translational Medicine Institute, Trinity College Dublin, Dublin 8, Ireland
- Centre for Research on Adaptive Nanostructures and Nanodevices (CRANN), Trinity College Dublin, Dublin 2, Ireland
| | - Luca Prioglio
- Department of Otorhinolaryngology, ASL 3 “Genovese”, “Padre Antero Micone” Hospital, Genoa, Italy
| | | | - Felice Scasso
- Department of Otorhinolaryngology, ASL 3 “Genovese”, “Padre Antero Micone” Hospital, Genoa, Italy
| | - Agostino Serra
- University of Catania, Italy
- G.B. Morgagni Foundation, Catania, Italy
| | - Guido Valente
- Dipartimento di Medicina Traslazionale, Università del Piemonte Orientale, Novara, Italy
| | - Micol Zannetti
- Dipartimento di Medicina Traslazionale, Università del Piemonte Orientale, Novara, Italy
| | - Angelo Zigliani
- Department of Radiology, University of Brescia, ASST Spedali Civili Brescia, Italy
| |
Collapse
|
10
|
Zhao C, Wei Y, Liu J, Xu S, Jiang X, Di G. Spontaneous acute epidural hematoma associated with chronic subdural hematoma due to dural metastasis of gastric carcinoma: a case report and literature review. Int J Neurosci 2020; 131:405-410. [PMID: 32186217 DOI: 10.1080/00207454.2020.1744599] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Background: Non-traumatic spontaneous acute epidural hematoma (EDH) happening to chronic subdural hematoma (SDH) caused by dural metastases is a rare entity. Pathogenesis can be derived from infection, coagulopathy, and inflammation. Malignant tumors metastasize to dura mater is one of the most infrequent causes. The exact mechanism remains elusive in spite of several possible speculations. The clinical manifestations, management and outcomes vary among reported cases.Case Description: A 45-year-old woman without history of trauma presented with headache, vomiting and disturbance of consciousness and developed brain hernia rapidly. On arival, she has lost into coma with Glasgow coma scale (GCS) score 5, bilateral pupils were not equal, with disappeared reflectance. Emergency imaging prompted large acute EDH, combined with SDH, arising from dural granular neoplasm confirmed intraoperatively. Four days after surgery, the bilateral pupils were equal in size and sensitive to light reflection.Conclusion: Dural metastases can cause EDH, chronic SDH can also be resulted from metastatic tumors of dura mater. When dealing with spontaneous non-traumatic hematoma around the dura mater, to make the precise diagnosis is sometimes doubtful and confusing. The stream of diagnostic thinking should be opened, including medical diseases such as liver and kidney disease, drug history, history of cancer and other possible clues. Thus, a detailed and purposeful systematic medical history review and physical examination is important in order to make more appropriate strategies for the clinic.
Collapse
Affiliation(s)
- Chenhui Zhao
- Department of Neurosurgery, The First Affiliated Hospital of Wannan Medical College, Wuhu, China
| | - Yi Wei
- Department of Hepatobiliary Surgery, The First People's Hospital of Jining, Jining, China
| | - Jie Liu
- Department of Neurosurgery, The First Affiliated Hospital of Wannan Medical College, Wuhu, China
| | - Shanshui Xu
- Department of Neurosurgery, The First Affiliated Hospital of Wannan Medical College, Wuhu, China
| | - Xiaochun Jiang
- Department of Neurosurgery, The First Affiliated Hospital of Wannan Medical College, Wuhu, China
| | - Guangfu Di
- Department of Neurosurgery, The First Affiliated Hospital of Wannan Medical College, Wuhu, China
| |
Collapse
|
11
|
[Spheno orbitary metastasis mimicking meningioma]. Presse Med 2019; 48:1339-1342. [PMID: 31727480 DOI: 10.1016/j.lpm.2019.09.041] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2018] [Revised: 06/14/2019] [Accepted: 09/30/2019] [Indexed: 11/23/2022] Open
|
12
|
Burns Z, Omar L, Compton L, Hayes J, Sahoo S, Merchant K. Lymphangitic spread of invasive lobular carcinoma to the contralateral breast. Clin Imaging 2019; 58:187-190. [PMID: 31450057 DOI: 10.1016/j.clinimag.2019.08.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2019] [Revised: 07/20/2019] [Accepted: 08/12/2019] [Indexed: 12/24/2022]
Abstract
Breast cancer typically spreads primarily to regional lymph nodes and subsequently to distant sites via hematogenous routes. Occasionally metastasis can occur through lymphangitic spread, usually to the lungs, resulting in lymphangitic carcinomatosis. Lymphangitic spread of several malignancies have been reported at other sites in the body with varying degrees of clinical significance. In this case report, we describe a rare case of lymphangitic spread of invasive lobular carcinoma to the contralateral breast identified on imaging as significant background enhancement without a discrete suspicious mass.
Collapse
Affiliation(s)
- Zachariah Burns
- Department of Radiology, UT Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX 75390, United States of America.
| | - Lena Omar
- Department of Radiology, UT Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX 75390, United States of America.
| | - Lindsay Compton
- Department of Radiology, UT Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX 75390, United States of America.
| | - Jody Hayes
- Department of Radiology, UT Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX 75390, United States of America.
| | - Sunati Sahoo
- Department of Pathology, UT Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX 75390, United States of America.
| | - Kanwal Merchant
- Department of Radiology, UT Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX 75390, United States of America.
| |
Collapse
|
13
|
Benevento I, DE Felice F, Bulzonetti N, Caiazzo R, Cassese R, Musio D, Tombolini V. Successful Treatment of Anal Canal Cancer Metastasis to the Cranial Bones: A Case Report and Literature Review. In Vivo 2019; 33:1347-1353. [PMID: 31280229 DOI: 10.21873/invivo.11610] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2019] [Revised: 05/09/2019] [Accepted: 05/10/2019] [Indexed: 11/10/2022]
Abstract
Single metastasis to the cranial bone represents a very uncommon occurrence that can arise from an anal canal cancer. No cases of cranial bone metastasis from anal canal carcinoma are available in the literature. Herein, we present a case of a unique metastatic lesion to the right parietal bone that occurred after curative chemoradiotherapy of primary squamous cell anal canal carcinoma. The patient received radiotherapy and systemic platinum-based chemotherapy, with optimal local control, high compliance and a well tolerable level of toxicity.
Collapse
Affiliation(s)
- Ilaria Benevento
- Department of Radiotherapy, Policlinico Umberto I, "Sapienza" University of Rome, Rome, Italy
| | - Francesca DE Felice
- Department of Radiotherapy, Policlinico Umberto I, "Sapienza" University of Rome, Rome, Italy
| | - Nadia Bulzonetti
- Department of Radiotherapy, Policlinico Umberto I, "Sapienza" University of Rome, Rome, Italy
| | - Rossella Caiazzo
- Department of Radiotherapy, Policlinico Umberto I, "Sapienza" University of Rome, Rome, Italy
| | - Raffaele Cassese
- Department of Radiotherapy, Policlinico Umberto I, "Sapienza" University of Rome, Rome, Italy
| | - Daniela Musio
- Department of Radiotherapy, Policlinico Umberto I, "Sapienza" University of Rome, Rome, Italy
| | - Vincenzo Tombolini
- Department of Radiotherapy, Policlinico Umberto I, "Sapienza" University of Rome, Rome, Italy
| |
Collapse
|