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Chen H, Raza HK, Shi H, Zhu J, Cui G. A rare case of small cell carcinoma of lung with intraventricular metastasis. Br J Neurosurg 2019; 33:261-263. [PMID: 28497995 DOI: 10.1080/02688697.2017.1327020] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2017] [Accepted: 04/27/2017] [Indexed: 10/19/2022]
Abstract
Our case report involves a Chinese patient who was presented to our hospital with the chief complaint of dizziness and double vision for one week. He was diagnosed with small cell carcinoma of lung in the past. The patient undertook various test at our hospital. His MR scan revealed an intraventricular metastasis from small cell carcinoma of lung which is very rare. We have analyzed the clinical data of this patient and related literature. We report this case to increase the awareness of this rare metastasis of small cell carcinoma of lung.
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Affiliation(s)
- Hao Chen
- a Department of Neurology , the Affiliated Hospital of Xuzhou Medical University , Xuzhou , China
| | - Hafiz Khuram Raza
- a Department of Neurology , the Affiliated Hospital of Xuzhou Medical University , Xuzhou , China
| | - Hongjuan Shi
- a Department of Neurology , the Affiliated Hospital of Xuzhou Medical University , Xuzhou , China
| | - Jienan Zhu
- a Department of Neurology , the Affiliated Hospital of Xuzhou Medical University , Xuzhou , China
| | - Guiyun Cui
- a Department of Neurology , the Affiliated Hospital of Xuzhou Medical University , Xuzhou , China
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2
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Ospina-García N, Román GC, Pascual B, Schwartz MR, Preti HA. Hypothalamic relapse of a cardiac large B-cell lymphoma presenting with memory loss, confabulation, alexia-agraphia, apathy, hypersomnia, appetite disturbances and diabetes insipidus. BMJ Case Rep 2018; 2018:bcr-2016-217700. [PMID: 30150329 PMCID: PMC6119376 DOI: 10.1136/bcr-2016-217700] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/26/2018] [Indexed: 01/12/2023] Open
Abstract
A 37-year-old Hispanic man with a right atrial intracardiac mass diagnosed as diffuse large B-cell lymphoma (DLBCL) was successfully treated with surgery and chemotherapy. During 4 years, several total-body positron emission tomography and MRI scans showed no extracardiac lymphoma. On year 5 after the cardiac surgery, patient presented with sleepiness, hyperphagia, memory loss, confabulation, dementia and diabetes insipidus. Brain MRI showed a single hypothalamic recurrence of the original lymphoma that responded to high-dose methotrexate treatment. Correction of diabetes insipidus improved alertness but amnesia and cognitive deficits persisted, including incapacity to read and write. This case illustrates two unusual locations of DLBCL: primary cardiac lymphoma and hypothalamus. We emphasise the importance of third ventricle tumours as causing amnesia, confabulation, behavioural changes, alexia-agraphia, endocrine disorders and alterations of the circadian rhythm of wakefulness-sleep secondary to lesions of specific hypothalamic nuclei and disruption of hypothalamic-thalamic circuits.
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MESH Headings
- Adult
- Antimetabolites, Antineoplastic/therapeutic use
- Cerebral Ventricle Neoplasms/complications
- Cerebral Ventricle Neoplasms/diagnostic imaging
- Cerebral Ventricle Neoplasms/physiopathology
- Cerebral Ventricle Neoplasms/secondary
- Diabetes Insipidus/etiology
- Heart Neoplasms/diagnostic imaging
- Heart Neoplasms/pathology
- Heart Neoplasms/therapy
- Humans
- Hyperphagia/etiology
- Lymphoma, Large B-Cell, Diffuse/diagnostic imaging
- Lymphoma, Large B-Cell, Diffuse/pathology
- Lymphoma, Large B-Cell, Diffuse/therapy
- Magnetic Resonance Imaging
- Male
- Memory Disorders/etiology
- Methotrexate/therapeutic use
- Neoplasm Recurrence, Local/diagnostic imaging
- Neoplasm Recurrence, Local/physiopathology
- Neoplasm Recurrence, Local/therapy
- Positron Emission Tomography Computed Tomography
- Third Ventricle/diagnostic imaging
- Third Ventricle/pathology
- Treatment Outcome
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Affiliation(s)
| | - Gustavo C Román
- Department of Neurology, Methodist Neurological Institute, Houston, Texas, USA
| | - Belén Pascual
- Department of Neurology, Methodist Neurological Institute, Houston, Texas, USA
| | - Mary R Schwartz
- Department of Pathology, Houston Methodist Hospital, Houston, Texas, USA
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3
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Paiva ALC, Araujo JLV, Ferraz VR, Veiga JCE. Simultaneous meningioma and brain metastasis from renal cell carcinoma - a rare presentation. Case report. SAO PAULO MED J 2017; 135:296-301. [PMID: 28562734 PMCID: PMC10019849 DOI: 10.1590/1516-3180.2016.016228102016] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2016] [Accepted: 10/28/2016] [Indexed: 02/04/2023] Open
Abstract
CONTEXT: Brain metastases are the most common tumors of the central nervous system. Because of their high frequency, they may be associated with rare situations. Among these are tumor-to-tumor metastasis and an even a rarer situation called simultaneous brain tumors, which are more related to primary tumors of the reproductive and endocrine systems. CASE REPORT: A 56-year-old male patient with a history of renal cell carcinoma (which had previously been resected) presented with a ventricular lesion (suggestive of metastatic origin) and simultaneous olfactory groove lesion (probably a meningioma). First, only the ventricular lesion was dealt with, but after a year, the meningothelial lesion increased and an occipital lesion appeared. Therefore, both of these were resected in a single operation. All the procedures were performed by the same neurosurgeon. The patient evolved without neurological deficits during the postoperative period. After these two interventions, the patient remained well and was referred for adjuvant treatment. CONCLUSIONS: This study provides the first description of an association between these two tumors. Brain metastases may be associated with several lesions, and rare presentations such as simultaneity with meningioma should alert neurosurgeons to provide the best oncological treatment.
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Affiliation(s)
- Aline Lariessy Campos Paiva
- MD. Neurosurgery Resident, Faculdade de Ciências Médicas da Santa Casa de São Paulo (FCMSCSP), São Paulo (SP), Brazil.
| | - João Luiz Vitorino Araujo
- PhD. Assistant Neurosurgeon, Faculdade de Ciências Médicas da Santa Casa de São Paulo (FCMSCSP), and Neurosurgeon, Instituto do Câncer Arnaldo Vieira de Carvalho (ICAVC), Oncocenter and Hospital Nove de Julho, São Paulo (SP), Brazil.
| | - Vinicius Ricieri Ferraz
- MD. Neurosurgery Resident, Faculdade de Ciências Médicas da Santa Casa de São Paulo (FCMSCSP), São Paulo (SP), Brazil.
| | - José Carlos Esteves Veiga
- PhD. Full Professor and Head, Discipline of Neurosurgery, Faculdade de Ciências Médicas da Santa Casa de São Paulo (FCMSCSP), São Paulo (SP), Brazil.
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Abstract
Pituitary carcinomas, which are rare, generally present with craniospinal and systemic metastases. Although several treatments exist, the prognoses of patients with pituitary carcinomas are extremely poor to date. In this report, the authors describe the case of a 23-year-old male who had undergone trans-sphenoidal surgery and radiotherapy for an invasive prolactinoma. Seven years later, he presented with a new 4th ventricle metastasis from the pituitary lesion, and it was diagnosed with a pituitary carcinoma. He underwent resection and Gamma-knife radiosurgery (GKRS). The tumor has been well controlled for over 3 years. To our knowledge, there have been no reports of the effects of GKRS in patients with pituitary carcinomas. GKRS might have considerable effects in the treatment of pituitary carcinomas.
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Affiliation(s)
- Ki-Su Park
- Department of Neurosurgery, Kyungpook National University School of Medicine, Daegu, Republic of Korea
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Shapira Y, Hadelsberg UP, Kanner AA, Ram Z, Roth J. The ventricular system and choroid plexus as a primary site for renal cell carcinoma metastasis. Acta Neurochir (Wien) 2014; 156:1469-74. [PMID: 24809532 DOI: 10.1007/s00701-014-2108-7] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2014] [Accepted: 04/19/2014] [Indexed: 12/16/2022]
Abstract
BACKGROUND Brain metastases (BM) are the most common intracranial tumours amongst adults. Ten to 40 % of patients with cancer will develop BM. In this study, we observed a high affinity of renal cell carcinoma (RCC) to the ventricular system, with close association to the choroid plexus. METHODS This is a retrospective study evaluating data of our prospectively maintained brain tumour database, focusing on consecutive BM patients, who were treated at our center between March 2003 and December 2011. Data collected included primary pathologies, anatomical distribution of the brain metastasis according to neuroimaging, and treatment modalities. RESULTS We identified 614 patients with BM, of whom 24 (3.9 %) were diagnosed with RCC, harboring 33 lesions. Nine of the 24 patients (37.5 %) presented with an intraventricular location (10 of 33 RCC BM lesions). Of the remaining 590 patients with non-RCC pathologies, five patients (0.8 %) were diagnosed with intraventricular lesions (p < 0.0001). CONCLUSION In this unselected, consecutive treated BM patient cohort we observed a high affinity of RCC BM to the ventricular system with close association to the choroid plexus. The reason for this affinity is unknown. Surgical approaches for resection of these lesions should be planned to include early control on the vascular supply from the choroidal vessels.
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Affiliation(s)
- Yuval Shapira
- Department of Neurosurgery, Tel Aviv Medical Center, Tel Aviv University School of Medicine, 6 Weizman Street, Tel Aviv, 64239, Israel
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6
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Oguri H, Miyazawa M, Nishikawa T, Hayashi S. [A case of intraventricular dissemination arising from hepatocelullar carcinoma effectively treated with intrathecal administration of methotrexate]. Nihon Shokakibyo Gakkai Zasshi 2014; 111:1120-1127. [PMID: 24898491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
A 78-year-old man with hepatocellular carcinoma was admitted to our hospital for vertigo after transcatheter arterial chemoembolization. Contrast-enhanced magnetic resonance imaging revealed metastasis in the cerebellar vermis. Although the cerebellar metastasis decreased in size after cyberknife radiotherapy, multiple enhancing nodules appeared in the cerebral ventricles. A diagnosis of intraventricular dissemination from the cerebellar metastatic lesion originating from the hepatocellular carcinoma was made. Six intrathecal administrations of 20 mg of methotrexate through lumbar puncture resulted in a dramatic decrease in the intraventricular dissemination. Although intraventricular dissemination recurred 4 months later, these lesions disappeared after an additional 8 administrations of intrathecal methotrexate. Intraventricular dissemination arising from hepatocellular carcinoma is rare. Here we report a case that was successfully treated by intrathecal chemotherapy with methotrexate.
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Affiliation(s)
- Hikaru Oguri
- Department of Internal Medicine, Koseiren Namerikawa Hospital
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7
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Leitmeyer K, Brand Y, Storck C. [CME ORL 11. Right sided cervical space occupying lesion with left sided hemianopsia. Diffuse large cell B-cell lymphoma with multiple organ manifestations]. Praxis (Bern 1994) 2014; 103:544-545. [PMID: 24755507 DOI: 10.1024/1661-8157/a001621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
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8
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Iordache A, Cosman M, Dumitrescu GF, Poeată I. Singular case of third ventricle metastasis of colorectal carcinoma--case report. Rev Med Chir Soc Med Nat Iasi 2014; 118:427-431. [PMID: 25076711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Third ventricle tumors are uncommon central nervous system lesions and unusual locations for metastatic colorectal cancer. We present a case of a 68 year old woman with a solitary 3rd ventricle lesion found on a computed tomography scan of the brain and the synchronous mass of the right colon. The aim in this case was local control of cerebral lesion with pathological diagnosis. Surgery was followed by a short-term good evolution but with sudden death.
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Sava I, Sava A, Şapte E, Mihailov C, Dumitrescu G, Poeată I, Sava F, Haba D. Intraventricular metastatic clear cell renal carcinoma. Rom J Morphol Embryol 2013; 54:447-450. [PMID: 23771097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
BACKGROUND Intraventricular tumors represent a diagnostic problem, due to a wide range of differential diagnosis, with an important variability of tumoral histological types in adult and pediatric population. Patient, METHODS AND RESULTS Our case is represented by a patient, aged 48 years, without any history of significant personal pathology, accusing nausea, vomiting, and intensive headache. In the morning, he became confused, having hallucinations for a short period of time, and has accused drowsiness for several weeks. Imaging (CT and MRI) shows a neoformation in the third ventricle, accompanied by bilateral lateral ventricles dilatation, with predominantly annular enhancement. During surgery, through the middle third transcallosal interhemispheric approach, it was revealed a reddish, well-demarcated intraventricular mass, well vascularized and with a firm consistency. Final pathologic diagnosis was metastatic clear cell renal carcinoma. Initial postoperative evolution was good, and then neurological and respiratory condition worsened as a bronchopneumonia lead to patient's death in 12 days after surgery. CONCLUSIONS Clear cell carcinoma metastasis located in the third ventricle should be taken into consideration for patients presenting a single intraventricular lesion even they have no documented primary malignancy.
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Affiliation(s)
- I Sava
- Discipline of Radiology, "Grigore T. Popa" University of Medicine and Pharmacy, Iassy, Romania
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10
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Byval'tsev VA, Sorokovikov VA, Panasenkov SI, Belykh EG, Egorov AV, Golubev SS, Kalinin AA. [A rare case of intraventricular recurrence of melanoma metastasis treated by endoscope-assisted surgery]. Zh Vopr Neirokhir Im N N Burdenko 2010:29-33. [PMID: 20827813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
In the paper we describe a rare case of intraventricular recurrence of melanoma metastasis treated by endoscope-assisted surgery. Total resection was performed using microsurgical approach with endoscopic assistance. Full regression of neurological deficit, physical rehabilitation and recurrence-free 6-month follow-up was achieved in this case.
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11
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Shinoura N, Suzuki Y, Yamada R, Tabei Y, Saito K, Yagi K. Relationships between brain tumor and optic tract or calcarine fissure are involved in visual field deficits after surgery for brain tumor. Acta Neurochir (Wien) 2010; 152:637-42. [PMID: 20063172 DOI: 10.1007/s00701-009-0582-0] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2009] [Accepted: 12/14/2009] [Indexed: 11/24/2022]
Abstract
PURPOSE Diffusion tensor tractography provides useful information regarding the surgical strategy for brain tumors. The goal of the present study was to analyze relationships between visual field deficits and the locations of brain tumors compared with optic tracts as visualized by tractography, and compared with the calcarine fissure. METHODS Subjects comprised 11 patients with brain tumor in the occipital lobe or atrium of the lateral ventricle who underwent surgery between October 2006 and February 2009. Tumors were categorized as Type A, with almost all the optic tract in the occipital lobe or atrium of the lateral ventricle running close to and stretched by the brain tumor; and Type B, with the optic tract running at least partially distant to the brain tumor and remaining unstretched. RESULTS Those type A optic tracts that were laterally compressed by brain tumors (Cases 1-3) displayed hemianopsia after surgery. When the brain tumor was located rostro-medial to the calcarine fissure and optic tracts were compressed caudally by the tumor, lower quadrant hemianopsia remained after surgery (Cases 4, 5). In other cases, the visual field remained or improved to normal after surgery. CONCLUSION The relationship between optic tracts or the calcarine fissure, and brain tumors in the occipital lobe or atrium of the lateral ventricle is related to visual field deficits after surgery. In particular, those Type A optic tracts that are compressed laterally show hemianopsia of the visual field after surgery.
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Affiliation(s)
- Nobusada Shinoura
- Department of Neurosurgery, Komagome Metropolitan Hospital, Bunkyo-ku, Tokyo 113-8677, Japan.
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Sajko T, Rotim K, Kudelić N, Krpina H, Miletić L. Intraventricular location of metastatic breast carcinoma: a case report. Acta Clin Croat 2009; 48:55-58. [PMID: 19623874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023] Open
Abstract
Intraventricular neoplasms are uncommon central nervous system lesions that account for only 10% of all neoplasms and are unusual location of metastatic breast cancer. A 73-year-old woman with a medical history of breast carcinoma without any signs of metastatic lesions in the liver, lungs or bones and with an intraventricular tumorous lesion found on multislice computed tomography of the brain is presented. Surgery was indicated in order to confirm the diagnosis histologically and to gain local control of the metastasis. The patient was operated on using the neuronavigation guided transcortical approach. The tumor was removed using the Cavitron ultrasonic aspirator. Histopathologic examination revealed a metastatic breast carcinoma. Postoperative irradiation of the whole brain was performed.
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Affiliation(s)
- Tomislav Sajko
- University Department of Neurosurgery, Sestre milosrdnice University Hospital, Zagreb, Croatia.
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Rook J, Rosser T, Fangusaro J, Finlay J. Acute transient encephalopathy following paclitaxel treatment in an adolescent with a recurrent suprasellar germinoma. Pediatr Blood Cancer 2008; 50:699-700. [PMID: 16991134 DOI: 10.1002/pbc.21040] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Paclitaxel is an antineoplastic agent that is used in the treatment of a variety of solid tumors. Dose-limiting side effects of myelosuppression and peripheral neuropathy are well known. Paclitaxel has minimal penetration of the blood-brain barrier and central nervous system side effects are rare. However, transient encephalopathy following paclitaxel infusion has been described in adults but not in children. We present the case of a 14-year-old female with a recurrent suprasellar germinoma who developed an acute encephalopathy 4-6 hr following paclitaxel infusion.
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Affiliation(s)
- James Rook
- Department of Pediatrics, Loma Linda University Children's Hospital, Loma Linda University School of Medicine, Loma Linda, California, USA
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Jinhu Y, Jianping D, Jun M, Hui S, Yepeng F. Metastasis of a histologically benign choroid plexus papilloma: case report and review of the literature. J Neurooncol 2007; 83:47-52. [PMID: 17387433 DOI: 10.1007/s11060-006-9300-4] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2006] [Accepted: 11/14/2006] [Indexed: 10/23/2022]
Abstract
Cerebrospinal metastases of benign choroid plexus papillomas (CPPs) are extremely rare. We report a case of 32-year-old woman who presented with a 6-month history of vertigo and intermittent headache. Plain CT scan of the cranium revealed a partly calcified tumor filling the fourth ventricle and its right recess. Cranial MRI showed an inhomogeneously contrast-enhancing tumor and leptomeningeal enhancement encasing the brain stem. Complete resection of the tumor was carried out, and seedings to the floor of the fourth ventricle and cervico-medullary junction were found during the operation. While intraoperative frozen section suggested pathology of papillary ependymoma or CPP, to our surprise, final histological examination revealed a benign choroid plexus papilloma. One month after the first operation, a metastatic nodule was found in the spinal subarachnoidal space at the level of T8-9. Two months after the first operation, on follow-up MRI of the cranium, the leptomeningeal enhancement encasing the brain stem had resolved spontaneously. This special case helps increase our understanding of benign CPPs and expands our differential diagnostic consideration of lesions with similar manifestations.
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Affiliation(s)
- Ye Jinhu
- Department of Neuroradiology, Beijing Tiantan Hospital, Tiantan xili street 10, Beijing 100050, China.
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15
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Pauciulo A, Polito R, Masini V, Del Ciello A, Tartaglione T, Campioni P. Mucinous metastases from occult breast carcinoma. Rays 2005; 30:11-7. [PMID: 16022115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
The case of a 34-year-old female patient come to the Emergency Department for neurological symptoms of recent onset is presented. No-contrast CT documented the presence of a neoformation approximately 3 cm in size in the 4th ventricle. For an in-depth diagnostic study of the lesion contrast enhanced MRI was performed. The examination detected a second minute (< 1cm) intraparenchymal nodule highly suspicious of metastasis from primary extra-cerebral neoplasm. The differential diagnosis of infratentorial lesions is discussed. It is concluded that the diagnostic combination of standard MRI with contrast sequences in the three conventional planes plays a major role in typing the nature of focal brain lesions.
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Affiliation(s)
- Alfredo Pauciulo
- Istituto di Radiologia, Università Cattolica del S. Cuore, Policlinico "A. Gemelli", Roma Italy
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Yang C, Jagjivan B, Rao K. Germinoma-unusual presentation: a case report. Conn Med 2004; 68:617-9. [PMID: 15626137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/01/2023]
Abstract
Germinoma accounts for two-thirds of germ cell tumors and about 40% of all pineal region neoplasms. This case illustrates an unusual manifestation of metatastic germinoma with spread to ventricles and meninges without a pineal mass. A 24-year-old man presented with nausea, vertigo, and left facial droop. Cerebrospinal fluid aspirate showed malignant cells most suggestive of a germinoma.
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Affiliation(s)
- Clifford Yang
- University of Connecticut Health Center, Department of Diagnostic Imaging and Therapeutics, Farmington, CT 06030, USA.
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Abstract
A 79-year-old female presented with difficulty ambulating and was found to have weakness and hyperreflexia in the lower extremities. Magnetic resonance imaging (MRI) revealed a large T8-T9 intraspinal tumor. She underwent a thoracic laminectomy, and excision of an intradural extramedullary lesion. The surgical specimen was soft, black tissue that consisted of a moderately cellular, deeply pigmented tumor. The neoplastic cells proved to be melanocytic, and were devoid of overt features of anaplasia, i.e., prominent nuclear pleomorphism, necrosis, significant mitotic activity, and high proliferation indices. Four months postoperatively, MRI demonstrated focal areas of enhancement in the conus medullaris and in the fourth ventricle, indicating leptomeningeal spread. Subsequently, the patient underwent whole brain radiation. On repeat imaging, there was nodular enhancement of the fourth ventricle and throughout the spinal cord. Despite chemotherapy and radiation therapy, the disease advanced and the patient expired. Meningeal melanocytoma is a rare, histologically benign tumor with good prognosis. However, local aggressive behavior has been recorded, especially in cases of subtotal gross resection. On a literature review, there was one case of cranial posterior fossa meningeal melanocytoma with associated lesions in both suprarenal glands and the left kidney, but there were no cases with distant metastasis. In this report, we present an unusual case of spinal meningeal melanocytoma with diffuse spread throughout the craniospinal axis that proved to be fatal.
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Affiliation(s)
- Ali Bydon
- Hermelin Brain Tumor Center, Henry Ford Hospital, Detroit, MI 48202, USA.
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Abstract
The ventricle is a rare site of brain metastases. Renal cell carcinoma has a higher propensity to metastasize to the ventricle compared with more common metastatic tumors (e.g., lung cancer). The trigone is the predominant location for intraventricular metastases, presumably because of the high concentration of choroid plexus in this region. Surgical resection is an important component of the management of these lesions, particularly if there is only a single intraventricular lesion. Despite the deep location of these tumors within the ventricle, survival in patients undergoing surgery for them is comparable to that in patients receiving surgery for intraparenchymal metastases.
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Affiliation(s)
- Giacomo G Vecil
- Department of Neurosurgery, University of Texas, M.D. Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 442, Houston, TX 77030-4009, USA
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Jean WC, Abdel Aziz KM, Keller JT, van Loveren HR. Subtonsillar approach to the foramen of Luschka: an anatomic and clinical study. Neurosurgery 2003; 52:860-6; discussion 866. [PMID: 12657182 DOI: 10.1227/01.neu.0000053146.83780.74] [Citation(s) in RCA: 48] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2001] [Accepted: 12/04/2002] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE Conventional approaches to tumors of the foramen of Luschka are limited because the foramen is viewed from either the fourth ventricle laterally (transvermian approach) or the cerebellopontine angle medially (suboccipital approach). The definitive approach is subtonsillar, because the foramen of Luschka is actually the end of the natural cleavage plane between the cerebellar tonsil and the medulla. We describe the microsurgical anatomic features of the foramen of Luschka region and the operative technique for the subtonsillar approach to this region. METHODS In the anatomic study, five formalin-fixed, silicone-injected, cadaveric heads were used. In the clinical study, the records for five patients treated via the subtonsillar approach were examined; several illustrative cases are presented. RESULTS The foramen of Luschka is formed by the tela choroidea and the rhomboid lip and exists at the lateral end of the cerebellomedullary fissure, which is a natural cleavage plane between the cerebellar tonsil and the medulla. The subtonsillar approach is performed via a suboccipital craniotomy; the patient is positioned in the lateral decubitus position, with the tumor side down. After the cerebellar tonsil is freed from arachnoid adhesions, it can be retracted rostrodorsally from the medulla, to expose the cerebellomedullary fissure. Clinically, the tela choroidea and rhomboid lip are significantly attenuated by tumor expansion. Therefore, by dissecting in a subtonsillar manner around the tumor, one can reach the foramen of Luschka without traversing any neural tissue. CONCLUSION The subtonsillar approach yields a panoramic view to the foramen of Luschka laterally and up to the middle cerebellar peduncle superiorly. This approach minimizes the distance between the tumor and the surgeon, while maximizing neural preservation. We think this is the definitive approach to this difficult region of the posterior fossa.
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Affiliation(s)
- Walter C Jean
- The Neuroscience Institute, Department of Neurosurgery, University of Cincinnati College of Medicine, Cincinnati, Ohio 45267-0515, USA
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Brown HM, McCutcheon IE, Leeds NE, Schomer DS, Luna MA, Fuller GN. Melanoma metastatic to central neurocytoma: a novel case of tumor-to-tumor metastasis. J Neurooncol 2003; 61:209-14. [PMID: 12675313 DOI: 10.1023/a:1022599622949] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
We report a case of a 43-year-old man with known metastatic melanoma and two intracranial tumors, one of which was resected and confirmed to be melanoma. At autopsy, the second lesion was found to be a central neurocytoma harboring metastatic melanoma. To our knowledge, this represents the first reported case of tumor-to-tumor metastasis to a central neurocytoma. The most common pattern of tumor-to-tumor metastasis for intracranial neoplasms, in which an aggressive high-grade malignancy serves as the source tumor and a more indolent neoplasm serves as the recipient tumor, is affirmed by the present novel example.
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Affiliation(s)
- Heather M Brown
- Department of Pathology, The University of Texas, M.D. Anderson Cancer Center, Houston, TX 77030, USA
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21
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Affiliation(s)
- Sami Khoshyomn
- Department of Surgery, University of Vermont College of Medicine, Burlington, USA
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22
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Riegel T, Freudenstein D, Alberti O, Duffner F, Hellwig D, Bartel V, Bertalanffy H. Novel multipurpose bipolar instrument for endoscopic neurosurgery. Neurosurgery 2002; 51:270-4; discussion 274. [PMID: 12182431 DOI: 10.1097/00006123-200207000-00046] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVE Hemorrhage control in endoscopic neurosurgery is critical because of the lack of suitable instruments for coagulation. One reason for this problem is that miniaturization of the instruments is still a technical problem. In this article, we present a solution: the use of bipolar microforceps with a small diameter of 1.5 mm. METHODS With the use of modern synthetic and metallic materials, the construction of the bipolar microforceps was designed without the use of mechanical joints. All movable elements are integrated within the instrument shaft. This design provides optimal visibility of the operating field because the sheath has a diameter of only 1.5 mm along its entire length. Therefore, this instrument is compatible with most working channels of neuroendoscopes. RESULTS The new, joint-free design of the forceps and the electric insulation of the branches were the technical innovations that led to the development of this novel, multipurpose instrument. CONCLUSION This new instrument may enhance endoscopic resection and shrinkage of cystic lesions and may offer new possibilities in endoscopic tumor resection and the treatment of hemorrhage.
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Affiliation(s)
- Thomas Riegel
- Department of Neurosurgery, Philipps University Marburg, Germany.
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23
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Weber MA, Lichy M, Reimer P. [Space-occupying lesion in the area of the 3rd ventricle. Cerebral pseudocystic metastasis of a neuroendocrine carcinoma of unknown primary tumor]. Radiologe 2002; 42:392-6. [PMID: 12132128 DOI: 10.1007/s00117-002-0739-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- M A Weber
- Abteilung Onkologische Diagnostik und Therapie, Deutsches Krebsforschungszentrum Heidelberg.
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24
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Cohen ZR, Hassenbusch SJ, Maor MH, Pfeffer RM, Ram Z. Intractable vomiting from glioblastoma metastatic to the fourth ventricle: three case studies. Neuro Oncol 2002; 4:129-33. [PMID: 11916505 PMCID: PMC1920655 DOI: 10.1093/neuonc/4.2.129] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2001] [Accepted: 11/14/2001] [Indexed: 11/14/2022] Open
Abstract
Dissemination of malignant glioma to the fourth ventricle with metastatic deposits and intractable vomiting is rare. Leptomeningeal extension of malignant glioma is an uncommon condition that has been reported in patients with end-stage disease and is usually unresponsive to any treatment modality. We describe 3 patients with progressing recurrent glioblastoma multiforme in whom leptomeningeal invasion manifested itself as intractable vomiting due to tumor metastases in the floor of the fourth ventricle. All patients received additional radiation therapy focused to the posterior fossa, with complete resolution of vomiting occurring within 10 days after irradiation. The remission of symptoms in these patients persisted until their death 3-4 months after the repeat radiation therapy. These reports indicate that additional focused radiation should be considered because of its significant therapeutic effect in alleviating intractable nausea and vomiting in patients with glioma metastasized to the posterior fossa.
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Affiliation(s)
- Zvi R Cohen
- Department of Neurosurgery, The University of Texas M. D. Anderson Cancer Center, Houston, TX 77030, USA
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25
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Abstract
A 41-year-old male presented to our clinic with a 1-month history of left hemiparesis. He had marked left arm weakness. The diagnostic work-up revealed an intramedullary mass at spinal level C2-4. Laminectomies were performed at C2-3-4 and the tumor was subtotally resected. Histological examination identified the mass as a non-Hodgkin's diffuse B-cell lymphoma. The patient was treated with corticosteroids, chemotherapy, and adjuvant radiotherapy. The residual tumor tissue had completely disappeared by 6 months of follow-up; however, the patient presented with intraventricular metastasis at 11 months postsurgery.
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MESH Headings
- Adult
- Cerebral Ventricle Neoplasms/secondary
- Chemotherapy, Adjuvant
- Diagnosis, Differential
- Humans
- Laminectomy
- Lymphoma, B-Cell/complications
- Lymphoma, B-Cell/diagnosis
- Lymphoma, B-Cell/pathology
- Lymphoma, B-Cell/therapy
- Lymphoma, Non-Hodgkin/complications
- Lymphoma, Non-Hodgkin/diagnosis
- Lymphoma, Non-Hodgkin/pathology
- Lymphoma, Non-Hodgkin/therapy
- Magnetic Resonance Imaging
- Male
- Paresis/etiology
- Radiotherapy, Adjuvant
- Spinal Cord Neoplasms/complications
- Spinal Cord Neoplasms/diagnosis
- Spinal Cord Neoplasms/pathology
- Spinal Cord Neoplasms/therapy
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Affiliation(s)
- A Bekar
- Department of Neurosurgery, Uludağ University, Bursa, Turkey
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26
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Romaguera RL, Minagar A, Bruce JH, Jagid JR, Falcone S, Curless RG, Ragheb J, Morrison G. Adrenocortical carcinoma with cerebral metastasis in a child: case report and review of the literature. Clin Neurol Neurosurg 2001; 103:46-50. [PMID: 11311478 DOI: 10.1016/s0303-8467(01)00105-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
OBJECTIVE AND IMPORTANCE Adrenocortical carcinoma (ACC) is rare in the pediatric population, and brain metastasis seldom occurs. CLINICAL PRESENTATION The authors report a case of metastatic ACC to the brain in a 9-year-old patient who had an adrenal cortex neoplasm removed at 4 years of age, and was free of symptoms for 5 years. Two weeks before admission she complained of blurred vision in both eyes. INTERVENTION Examination revealed bilateral papilledema, and a Magnetic Resonance Imaging (MRI) of the brain revealed a mass in the left lateral ventricle with extensive vasogenic edema and hydrocephalus. The tumor was removed, and histopathologic examination demonstrated metastatic ACC. CONCLUSION Although ACC is a rare neoplasm it must be considered in the differential diagnosis of cerebral lesions in patients with a history of this tumor. Periodic long-term brain imaging is suggested as part of the follow up in patients with adrenocortical neoplasms.
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Affiliation(s)
- R L Romaguera
- Department of Pathology, University of Miami, Jackson Memorial Hospital, East Tower Room # 2142, 1611 NW 12th Ave., Miami, FL 33136, USA.
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27
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Affiliation(s)
- S A Grossman
- Johns Hopkins Oncology Center, Baltimore, MD 21231, USA
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28
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Abstract
OBJECTIVE AND IMPORTANCE Intracranial germinomas often disseminate via the ventricular and subarachnoid pathways, but seeding to the perioptic arachnoid space is extremely unusual. We report two cases of recurrent germinoma seeding in the optic nerve. CLINICAL PRESENTATION Two men with pure germinoma were initially treated with three cycles of a three-drug regimen of bleomycin, etoposide, and cisplatin, and a complete response was achieved. Patient 1 experienced ventricle wall dissemination 10 months after undergoing the initial treatment and was successfully treated with three cycles of carboplatin and etoposide and then by 24-Gy whole-ventricle radiation. Twelve months later, he complained of progressive visual acuity loss, and magnetic resonance imaging demonstrated bilateral enhancement of the optic nerves. Patient 2 also experienced ventricle wall dissemination 3 months after undergoing the initial chemotherapy, but he exhibited a complete response after undergoing 24-Gy whole-ventricle radiation. Two years later, he complained of progressive visual acuity loss. Magnetic resonance imaging demonstrated bilateral enhancement of the optic nerves and cerebellar hemispheres. INTERVENTION None of the locations of recurrence were included in the irradiation field, whereas there was no recurrence within the radiation field. Complete responses were obtained with three cycles of a three-drug regimen of ifosfamide, cisplatin, and etoposide and then by 24-Gy whole-brain radiation that included the bilateral optic nerves. The visual acuity of each patient improved slightly. CONCLUSION Delayed seeding in the optic nerve may result from germinoma cells that remain dormant, so they cannot be destroyed by chemotherapy regimens alone.
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Affiliation(s)
- T Nakajima
- Department of Neurosurgery, Tohoku University School of Medicine, Sendai, Japan
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29
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Abstract
Twelve patients underwent endoscopic biopsy of a tumor involving the third ventricle. Nine patients had no significant medical history while 3 had a history of cancer. Unique characteristics of each case dictated the optimal surgical technique. Endoscopic tumor biopsy was combined with additional procedures in 9 cases; shunt insertion (3), shunt insertion with endoscopic septostomy (5), and transcallosal craniotomy (1). Diagnosis was established in 11 patients (92%); 6 primary brain tumors, 3 metastatic central nervous system tumors, 1 metastatic systemic cancer, and 1 region of post-treatment gliosis. One case was aborted due to poor visualization. Therapy was directly influenced by endoscopic biopsy in 11/12 cases (92%) and craniotomy for tumor resection was avoided in 10/12 patients (83%). Of the 5 patients who underwent endoscopic septostomy, 4 required no subsequent procedures for hydrocephalus. There were no complications, and hospital stay averaged 1.78 days for patients who underwent successful endoscopic biopsy. Tumors of the third ventricle are amenable to endoscopic biopsy with excellent diagnostic yield and low morbidity. The procedure must be tailored depending upon the tumor location within the third ventricle, the degree of ventriculomegaly, and the need to perform a septostomy. Singularly or combined with other endoscopic procedures, patients can be spared multiple and more invasive surgical procedures.
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Affiliation(s)
- M M Souweidane
- Neurosurgical Service, Memorial Sloan-Kettering Cancer Center, New York, NY 10021, USA.
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30
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Vallat-Decouvelaere AV, Gauchez P, Varlet P, Delisle MB, Popovic M, Boissonnet H, Gigaud M, Mikol J, Hassoun J. So-called malignant and extra-ventricular neurocytomas: reality or wrong diagnosis? A critical review about two overdiagnosed cases. J Neurooncol 2000; 48:161-72. [PMID: 11083081 DOI: 10.1023/a:1006494308864] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Central neurocytoma (CN) is described as a rare intra-ventricular benign neuronal tumor of the brain. Two primary tumors first diagnosed as malignant and extra-ventricular neurocytomas are reported here. Histologically, the tumor of the first patient, a forty-one-year-old man, consisted of monotonous cells with round nuclei, but no fibrillar background. The second tumor, in a nineteen-year-old girl, showed areas of moderately pleomorphic round cells, with numerous rosettes and ganglion cell differentiation, in an abundant fibrillary network. Both presented calcifications. Mitoses were more frequent in recurrences and spinal locations than in the primaries. All tumors stained strongly for synaptophysin, and GFAP was partly positive in the first case only. Patients received post-surgical radiotherapy and were still alive eight and six years, respectively, after initial surgery. The interpretation of atypical cases, such as ours is not easy: the diagnoses finally retained were oligodendroglioma in the first case and ganglioneuroblastoma in the second case. Furthermore, neurocytomas atypical either by their unusual topographical or histological presentation or by their poor prognosis, have been frequently entitled in this way on synaptophysin positivity. So, we were prompted to reassess the entity of CN, seventeen years after the first description, to re-appreciate the reality of anatomo-clinical variants and to discuss the value of synaptophysin positivity in these tumors. In conclusion, it seems preferable to individualize true classical CN, which has a favorable outcome, from so-called extra-ventricular, atypical and anaplastic, clinically malignant neurocytomas for which complementary treatment is required.
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31
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Iwatsuki K, Sato M, Taguchi J, Fukui T, Kiyohara H, Yoshimine T, Hayakawa T. [Choroid plexus metastasis of renal cell carcinoma causing intraventricular hemorrhage: a case report]. No Shinkei Geka 1999; 27:359-63. [PMID: 10347852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
Abstract
We report a rare case of choroid plexus metastasis of renal cell carcinoma causing intraventricular hemorrhage. A 75-year-old female was admitted to our hospital for SAH. Preoperative examination evoked suspicion of an anterior communicating aneurysm as a cause of SAH. Furthermore, there were lesions on the tuberculum sellae and in the left trigone of the lateral ventricle, which were enhanced by Gd-DTPA on MRI. The patient was operated on via the pterional approach on December 3, 1996, but no aneurysm was found. She underwent total removal of the tuberculum sellae mass, which was postoperatively proved to be a meningioma by histological examination. The intraventricular tumor was supposed to be a meningioma, but it was not treated surgically. Two months later, the patient presented hematuria and was diagnosed as having a right renal cancer and underwent right nephrectomy on March 18, 1997. However, postoperatively, disturbance of consciousness continued. A CT scan revealed intraventricular hemorrhage around the tumor in the trigone of the lateral ventricle on March 21. An emergency operation for tumor and clot removal succeeded in improving the patient's condition. Histological examination of the tumor revealed clear-cell type renal cell carcinoma. Solitary choroidal plexus metastasis from renal cell carcinoma is quite rare: only 5 cases have been reported. But only our case was accompanied by intraventricular hemorrhage. Renal cell carcinomas are divided into two types: a slowly progressive type and a rapidly progressive type. Four cases among the reported 5 cases were the slowly progressive type, and our case was regarded as being of the same type.
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Affiliation(s)
- K Iwatsuki
- Department of Neurosurgery, Toyonaka Municipal Hospital, Osaka, Japan
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32
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Abstract
We report an unusual case of massive intraventricular spread of B-cell lymphoma of the breast, presenting with rapidly progressive ataxia and impaired cognition with need for ventriculostomy. Rapid resolution followed intravenous dexamethasone and radiation therapy.
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33
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Kato H, Mashiyama S, Fukawa O, Sasaki T, Yamane Y, Asano S. [A case of thymic carcinoma with brain metastasis]. Kyobu Geka 1997; 50:1059-63. [PMID: 9388357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
A 43-year-old female with a thymic carcinoma spreading to the extrathorac region is reported. She had received radiation and chemotherapy, after that thymic carcinoma was extirpated. Five months later, the patient was noticed to have a right side hemiparesis, following consciousness disturbance. CT and MRI revealed a left thalamic mass with a heterogenous enhancement effect. The tumor was diminished dramatically due to radiation. Metastasis of thymic carcinoma to the central nervous system is discussed.
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Affiliation(s)
- H Kato
- Department of Neurosurgery, Iwaki Kyoritsu General Hospital, Fukushima, Japan
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34
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Veto F, Horváth Z, Dóczi T. Biportal endoscopic management of third ventricle tumors in patients with occlusive hydrocephalus: technical note. Neurosurgery 1997; 40:871-5; discussion 875-7. [PMID: 9092866 DOI: 10.1097/00006123-199704000-00048] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
OBJECTIVE To present the feasibility and advantages of the biportal endoscopic management of posterior third ventricle tumors. As a result of recent developments in neuroendoscopy, classical third ventriculostomy has become a standard single burr hole procedure and a real alternative to shunting in the treatment of occlusive hydrocephalus. In patients with third ventricle tumors occluding the aqueduct, the acute development of hydrocephalus may often precede debilitating focal symptoms and signs. Forty percent of those tumors are radiosensitive, rendering craniotomy unnecessary. The goal of primary management is the alleviation of raised intracranial pressure and determination of the histological nature of the tumor. Cerebrospinal fluid shunting and the performance of a computed tomography- or magnetic resonance imaging-guided biopsy are generally suggested as the methods of choice. METHODS Three patients with posterior third ventricle tumors and acute hydrocephalus were treated in one session by computed tomography-guided endoscopic third ventriculostomy and endoscopic tumor biopsy was performed by means of two rigid ventriculoscopes. RESULTS Ventriculostomy was performed in three patients, and tumor biopsy was performed in two patients. The maximum 40-minute operation did not involve mortality or morbidity. Histological findings were established in all patients. In two patients with malignant infiltrative tumors, postoperative radiotherapy was used; in one patient with a small cavernoma, no further measures were taken. At the 6-month follow-up, flow-sensitive magnetic resonance imaging confirmed ventriculostomy patency in all patients. CONCLUSION The biportal endoscopic approach allowed independent visual control of both procedures, safe passages of the ventriculoscopes via the narrow foramen of Monro, and facile control of the intracranial pressure in the ventricles via the available four irrigation channels during the performance of tumor biopsy and fenestration of the floor of the third ventricle. In selected patients with infiltrating posterior third ventricle tumors, this procedure and postoperative radiotherapy may be an alternative to direct surgery or to shunting and performance of image-guided biopsy.
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Affiliation(s)
- F Veto
- Department of Neurosurgery, University Medical School, Pécs, Hungary
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35
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Santoro M, Santoro A, Maiorino L, Di Buono E, Quarto G, Forestieri P. Medulloblastoma in an adult: case report. J Chemother 1997; 9:161. [PMID: 9176773 DOI: 10.1179/joc.1997.9.2.161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Affiliation(s)
- M Santoro
- Cattedra di Chirurgia Generale, Facoltà di Medicina e Chirurgia, Università degli Studi di Napoli Federico II, Italy
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36
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Brandicourt P, Toussaint P, Le Gars D, Depriester D, Deramond H. [Metastasis to the 3rd ventricle of colonic adenocarcinoma]. Presse Med 1997; 26:75. [PMID: 9082415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
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37
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Spetzger U, Mull M, Sure U, Gilsbach J. Subarachnoid and intraventricular hemorrhage caused by hypernephroma metastasis, accompanied by innocent bilateral posterior communicating artery aneurysms. Surg Neurol 1995; 44:275-8. [PMID: 8545781 DOI: 10.1016/0090-3019(95)00170-0] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
We present a case of subarachnoid and intraventricular hemorrhage due to an infratentorial metastasis of a renal cell carcinoma. The lesion was not apparent on initial magnetic resonance imaging (MRI) or in a follow-up examination (MRI and angiography) 6 weeks after the bleeding. The innocent bilateral posterior communicating artery aneurysms detected by cerebral angiography were treated surgically. The origin of the hemorrhage, however, remained unclear. Five months later, a surgically proven metastasis in the fourth ventricle subsequently gave the explanation for the bleeding.
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Affiliation(s)
- U Spetzger
- Department of Neurosurgery, Technical University (RWTH) Aachen, Germany
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38
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Chou MS, Tsai TC, Lin MB, Liu GC, Howng SL. [Metastasis involving the leptomeninges and ventricles of the brain--CT evaluation]. Gaoxiong Yi Xue Ke Xue Za Zhi 1994; 10:256-62. [PMID: 8040929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
The diagnosis of leptomeningeal or ventricular metastasis by cranial computerized tomography (CT) contributes to earlier treatment and sometimes alters the management of patients with intra- or extra-cranial malignancy. In 20 cases whose metastasis were spreaded via CSF seeding, the abnormal CT findings were 1) mass or nodule in the ventricles or subarachnoid space, 2) ependymal, subependymal enhancement, 3) sulcal, gyral or cisternal enhancement, 4) hydrocephalus not related to the obstruction of primary tumor, 5) falx or tentorial enhancement. In another 8 cases, the metastasis developed through hematogeneous spreading to the choroid plexus or paraventricular parenchyma. The mass or nodule within the ventricles could be well identified with enhanced CT scan. The involved ventricles, in order of frequency, were lateral, 3rd, and 4th ventricles in our series.
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Affiliation(s)
- M S Chou
- Department of Radiology, Kaohsiung Medical College, Taiwan, Republic of China
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39
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Gualdi GF, Trasimeni G, Di Biasi C, Iannilli M, Polettini E, Melone A, Volpe A, D'Amico D. [Computerized tomography and magnetic resonance in the evaluation of neoplastic processes localized on the floor of the third ventricle]. Clin Ter 1993; 143:57-65. [PMID: 8243024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
In our experience, neoplastic lesions of the floor of the third ventricle are frequently responsible for neurologic and dysendocrine symptoms. Ct scan and MR imaging are the most reliable techniques of neuroimaging in the diagnostic study of neoplastic masses affecting this region. In this work, CT and MR appearance of lesions of the III ventricle floor are discussed with the aim of contributing to the differential diagnosis of neoplasms and their surgical and medical management.
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Affiliation(s)
- G F Gualdi
- Istituto di I Clinica Medica, Università degli Studi di Roma La Sapienza
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40
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Tanimoto M, Tatsumi S, Tominaga S, Kamikawa S, Nagao T, Tamaki N, Matsumoto S. Choroid plexus metastasis of lung carcinoma--case report. Neurol Med Chir (Tokyo) 1991; 31:152-5. [PMID: 1715049 DOI: 10.2176/nmc.31.152] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Metastatic tumors in the choroid plexus are generally considered to be very rare. The authors present a case of lung large cell carcinoma with a single metastatic tumor in the choroid plexus of the lateral ventricle trigone. Precontrast computed tomographic (CT) scans showed an isodensity mass with extensive peritumoral edema, which was considerably enhanced on the postcontrast CT scans. Magnetic resonance (MR) images demonstrated the mass as a low-intensity area on the T1-weighted image and an iso-intensity area on the T2-weighted image. The tumor was clearly differentiated from the peritumoral edema by both CT and MR imaging. The diagnosis was confirmed by surgery.
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Affiliation(s)
- M Tanimoto
- Department of Neurosurgery, Nagao Hospital, Kochi, Japan
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41
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Palomo F, Madero S, García-Albea E, Fernández R. [Carcinomatous ventriculitis]. Med Clin (Barc) 1989; 93:679. [PMID: 2559267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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42
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Nakatsukasa M, Toya S, Otani M, Yoshida K, Ishida Y, Ogawa Y. [Cystic pineocytoma successfully treated with synchronized chemoradiotherapy. Case report]. Neurol Med Chir (Tokyo) 1989; 29:333-7. [PMID: 2478917 DOI: 10.2176/nmc.29.333] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
A case of pineocytoma associated with intraventricular and meningeal metastasis is reported. The patient, a 25-year-old female, was admitted complaining of headache. Computed tomography revealed an irregular-shaped pineal lesion enhanced by contrast medium and accompanied by a cyst. An intraventricular cystic metastatic lesion and meningeal metastasis were also suggested. Biopsy of the pineal region proved the lesion to be a pineocytoma without neuronal or glial differentiation. Ventriculoperitoneal shunting was performed, and radiation therapy combined with chemotherapy (ACNU and vincristine) was administered. This treatment apparently destroyed both the primary and metastatic lesions, and the patient returned to her normal life. In 4 years of follow-up there has been no recurrence of the tumor. Pineocytoma with meningeal metastasis usually has a poor prognosis, but in this case combined radiation therapy and chemotherapy was curative. Although pineocytoma is rarely accompanied by a cyst, in cases of a pineal lesion coexistent with a cyst, a diagnosis of pineocytoma should be considered.
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43
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Abstract
Bruns nystagmus is an uncommon, bidirectional optokinetic disturbance associated with advanced cerebellopontine angle tumours. In a retrospective analysis of 115 such tumours, Bruns nystagmus was observed in 18 patients (16%). All tumours in this group were 3 cm or greater in diameter. Fourth ventricle displacement as assessed by computerized cranial tomography was present in all cases where the fourth ventricle was visualized (89%). Seven of 15 cases (47%) had significant contralateral N5 delay on brainstem auditory evoked potential testing, 5 (33%) were normal and 3 (20%) gave no consistent result. It was concluded that Bruns nystagmus occurs in large tumours associated with significant brainstem distortion. The neurophysiological abnormalities demonstrated by brainstem audiometry appear to be a less sensitive measure of brainstem compression than neuro-anatomical assessment using CT.
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44
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Abstract
Three cases are reported of primary bronchial carcinoma with metastatic deposits in an intracranial glioma (two cerebral astrocytomas and one fourth ventricle ependymoma). The rarity of this phenomenon is emphasised and the literature critically reviewed.
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Affiliation(s)
- S J Mörk
- Department of Pathology, University of Virginia School of Medicine, Charlottesville 22908
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45
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Bots GT, Tijssen CC, Wijnalda D, Teepen JL. Alveolar soft part sarcoma of the pituitary gland with secondary involvement of the right cerebral ventricle. Br J Neurosurg 1988; 2:101-7. [PMID: 3268152 DOI: 10.3109/02688698808999666] [Citation(s) in RCA: 22] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
An alveolar soft part sarcoma localised in the pituitary gland extended into the suprasellar region. Three years after surgical removal there was a recurrency in the occipital horn of the right cerebral ventricle. This type of tumour predominantly occurs in the limbs and has never been reported in the pituitary region.
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Affiliation(s)
- G T Bots
- Department of Pathology, State University of Leiden, The Netherlands
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46
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Abstract
We report on a newborn with disseminated neuroblastoma, intracerebral metastasis, localized in the right choroid plexus could be visualized by sonography and computed tomography. Despite low dose chemotherapy with adriamycin and cyclophosphamide skin and plexus metastasis showed marked progression. Therefore multiagent chemotherapy (NBL-82-Study) was initiated and further investigations revealed complete regression of the intra- and extracranial metastases and the leftsided adrenal tumor as well. Two years after the end of therapy, the patient is in good condition without signs of relapse. This case report underlines the importance of cranial sonography or computed tomography in disseminated neuroblastoma of young infants in order to detect or exclude intracranial metastases.
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Affiliation(s)
- R Mertens
- Abteilung Kinderheilkunde der Medizinischen Fakultät der RWTH Aachen
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47
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Lazzarino LG, Nicolai A. Single cerebral metastasis mimicking a colloid cyst of the third ventricle. Acta Neurol (Napoli) 1987; 9:364-7. [PMID: 3508359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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48
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Abstract
Three cases of giant cystic craniopharyngiomas with large areas of extension beyond the suprasellar area are presented. The magnetic resonance (MR) appearance in one case is described. These giant tumors had large, multilobulated cysts that comprised the bulk of the tumors. In one case, there was an unusual extension of the large tumor cyst into the lateral ventricle. In two cases, the tumors extended to the level of the foramen magnum. On CT, the cyst contents of these two tumors were hyperdense and became hypodense postoperatively. All three tumors harbored calcifications in the form of clumps in the suprasellar region and rim calcifications around the cysts. None of the tumors exhibited contrast enhancement. A literature review of the radiographic features of craniopharyngiomas is discussed.
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Affiliation(s)
- S C Young
- Hospital of the University of Pennsylvania, Department of Radiology, Philadelphia
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49
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Abstract
Three clinicopathologic cases with a remarkable pattern of extensive diffuse subependymal periventricular spread of cerebral metastases from solid systemic cancer are reported. Two patients had a small cell carcinoma of the lung. In the third case, the histologic features of the brain metastases were consistent with a neuron-specific enolase-positive, small cell anaplastic carcinoma. Involvement of the choroid plexus and leptomeninges was moderate or absent. Intraparenchymatous nodular metastases were not found except in one case in which rare nodular superficial cortical metastases were present. The clinical data were nonspecific except for orthostatic hypotension, in one patient, which was probably due to the infiltration of the floor of the third and fourth ventricles. Results of the cerebrospinal fluid examination, available in two cases, were normal. The only diagnostic investigation was contrast-enhanced computed tomography scanning.
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50
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Kawaguchi T, Kawaguchi M, Miner KM, Lembo TM, Nicolson GL. Brain meninges tumor formation by in vivo-selected metastatic B16 melanoma variants in mice. Clin Exp Metastasis 1986; 1:247-59. [PMID: 6546202 DOI: 10.1007/bf00736408] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
The murine melanoma subline B16-F1 of low brain- and lung-colonizing potential has been used to obtain brain-colonizing variant sublines by sequential selection in vivo for their abilities to form brain meningeal tumors. After fourteen and fifteen selections in syngeneic C57BL/6 mice sublines B16-B14b and B16-B15b, respectively, were established in culture. These were then assayed in vivo by injection of single tumor cell suspensions into the tail vein (i.v.), left ventricle of the heart (i.c.) or left common carotid artery (i.a.), and the resulting tumors were examined histologically. Injection of subline B16-B14b or B16-B15b resulted in brain meningeal tumor formation in the dura mater and leptomeninges with invasion into underlying brain parenchyma and also some brain ventricular tumors at the sites of i.a. injection. Lung colonization ability remained in the brain-selected sublines, although it was remarkably reduced in i.a. tumor cell-injected animals. The brain meningeal tumors that formed were of three types: intravascular, nodular or infiltrative. Injection of tumor cells i.v. resulted mainly in the establishment of the intravascular type of brain meningeal tumors with eventual perivascular invasion, while injection i.a. or i.c. resulted mostly in nodular or infiltrative type brain meningeal tumors. The B16-B14b brain meningeal tumors formed were small (less than 1 mm in diameter) and usually nonpigmented, while B16-B15b tumors were generally large (up to 7 mm in diameter) and pigmented. Host reactions towards B16-B14b and B16-B15b tumors at meningeal sites differed. The former B16 subline was characterized by extensive fibrosis with some immunocytic cell infiltration in and around the meningeal tumors, while the latter subline did not elicit such host reactions. In contrast, tumors in brain parenchyma failed to evoke observable host reactions, and there was little evidence of immunocyte cell infiltration or glial cell alterations.
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