RESUMEN
Bilateral lesions were seen in the subpleural region in a 23-week-old aborted male fetus. This fetus was not macerated and showed no central nervous system abnormality on physical examination and vertebral magnetic resonance imaging (MRI). Postmortem examination revealed bilateral, paravertebral, subpleural, circumscribed, yellowish-white, fluent lesions 2.5 x 1 x 1 cm in size. These lesions were localized on the upper part of both lungs and there was no other internal malformation. Histological examination of lesions showed adult neurones and well-differentiated neural tissue with white and gray matter, choroid plexus, ependymal structures and, rarely, some peripheral neural cells in addition to immature neuroectodermal cells. These cells were more mature than those in the brain tissue.
Asunto(s)
Encéfalo , Coristoma/patología , Enfermedades Fetales/patología , Enfermedades Pulmonares/patología , Aborto Espontáneo , Femenino , Humanos , EmbarazoRESUMEN
We describe a 25-week-old female fetus of consanguineous parents with ultrasonographic findings of increased echogenicity of lungs mimicking CAM (cystic adenomatoid malformation) type III, olygohydramnios and fetal ascites. A therapeutic abortion was performed and unilateral cryptophthalmos, laryngeal atresia and bilateral syndactyly of the hands and feet were observed at post-mortem. These findings confirmed the diagnosis of Fraser syndrome after abortion.
Asunto(s)
Anomalías Múltiples/diagnóstico por imagen , Ascitis/etiología , Malformación Adenomatoide Quística Congénita del Pulmón/diagnóstico por imagen , Enfermedades Fetales/diagnóstico por imagen , Laringe/anomalías , Oligohidramnios/diagnóstico por imagen , Diagnóstico Diferencial , Anomalías del Ojo/diagnóstico por imagen , Femenino , Edad Gestacional , Humanos , Sindactilia/diagnóstico por imagen , Síndrome , Ultrasonografía PrenatalRESUMEN
The authors previously have reported the effects of neodymiumyttrium-aluminum-garnet (Nd: YAG) laser on the cartilage end-plates (CEPs) in an animal model. However, there is no experimental study in the literature which specifically addresses the effects of the laser on CEP vascularity. The aim of our study is to investigate the vascular response of the CEP to Nd: YAG laser. In this study, sixteen guinea pigs were used. Experimental intervertebral disc (IVD) degeneration was induced in 12 animals by a ventral disc incision to study the effects of Nd: YAG laser on the CEP of the degenerated IVD from the aspects of pathology and radiology. At 2 months after the experimental annular lesion, the CEP vascular channel counts had increased significantly (p = 0.00) in the cranial CEP to 104%, and to 99% in the caudal CEP. In the early period after laser irradiation the vessel counts from both CEPs decreased due to the extensive damage of Nd: YAG laser on disc tissue (p = 0.00). Accordingly, the value of CEP index and MR signal intensity of the CEPs (cranial and caudal) had decreased one month after laser application. Thereafter, both the CEP vascular channel counts and the MR signal intensity remained relatively constant throughout the course of the experiment, but the value of CEP index had increased to 68% of the normal IVD. From the results of present study, it is evident that laser application had a significant negative influence on the CEP vascularization of the degenerated IVD.
Asunto(s)
Vasos Sanguíneos/efectos de la radiación , Cartílago Articular/irrigación sanguínea , Disco Intervertebral/irrigación sanguínea , Disco Intervertebral/efectos de la radiación , Rayos Láser , Enfermedades de la Columna Vertebral/patología , Animales , Vasos Sanguíneos/patología , Cartílago Articular/patología , Cartílago Articular/efectos de la radiación , Cobayas , Disco Intervertebral/patología , Imagen por Resonancia Magnética , Masculino , Periodo Posoperatorio , Enfermedades de la Columna Vertebral/diagnóstico , Factores de TiempoRESUMEN
Oligodendrogliomas are relatively rare tumors that arise from the oligodendrocyte or its precursors. The role of postoperative radiotherapy (RT) in these tumors still remains unclear. Data concerning a study on 77 histologically verified cases of oligodendrogliomas of the brain among a total number of 1884 cases of an intracranial glioma treated at the Hacettepe Medical Centre between 1964 and 1991 were reviewed and analyzed (6.5%). One patient died in the early postoperative period and 8 patients in pediatric age group with an aggressive from of the tumor died within 6 months of treatment. The results suggest that oligodendrogliomas which arise in childhood primarily in the intraventricular region should be considered potentially more malignant than other lesions of this type. Because of this, we believe that postoperative radiotherapy is necessary to prevent the recurrences.
Asunto(s)
Neoplasias Encefálicas/cirugía , Oligodendroglioma/cirugía , Neoplasias Encefálicas/patología , Neoplasias Encefálicas/radioterapia , Humanos , Oligodendroglioma/patología , Oligodendroglioma/radioterapia , Radioterapia Adyuvante , Tasa de Supervivencia , Resultado del TratamientoRESUMEN
A 35-year-old woman, who had had an intrauterine device inserted 7 years earlier, presented with dysuria, pollakiuria, suprapubic pain and urethral irritation. The intrauterine device was found in the bladder with stone formation and was removed by endoscopy.
Asunto(s)
Cuerpos Extraños/diagnóstico por imagen , Cuerpos Extraños/etiología , Migración de Cuerpo Extraño/diagnóstico , Dispositivos Intrauterinos/efectos adversos , Cálculos de la Vejiga Urinaria/etiología , Vejiga Urinaria/diagnóstico por imagen , Adulto , Cistoscopía/métodos , Supervivencia sin Enfermedad , Femenino , Cuerpos Extraños/terapia , Migración de Cuerpo Extraño/terapia , Humanos , Cálculos de la Vejiga Urinaria/diagnóstico , Cálculos de la Vejiga Urinaria/terapia , UrografíaRESUMEN
Carpenter syndrome (acrocephalopolysyndactyly type II) is an autosomal recessive syndrome. The case we present was diagnosed prenatally at 20 weeks. Postmortem examination revealed severe central nervous system malformations. The central nervous system anomalies in this 23-week-old fetus merit emphasis, since these anomalies in such a young fetus may explain Carpenter syndrome cases, which do not improve in spite of early surgical intervention.
Asunto(s)
Acrocefalosindactilia/diagnóstico por imagen , Acrocefalosindactilia/genética , Aborto Espontáneo , Adulto , Anomalías Craneofaciales , Craneosinostosis , Femenino , Humanos , Embarazo , Segundo Trimestre del Embarazo , Diagnóstico Prenatal , UltrasonografíaRESUMEN
To date, there have been no reports of experiments demonstrating the effects of neodymium:YAG laser (Nd:YAG laser) on the vertebral end-plates. In this study the effect of Nd:YAG laser on end-plates was examined in 32 guinea pigs which were randomly divided into two groups. The first group was the control group, the second one the Nd:YAG laser group. All animals had experimental disc degeneration at three levels. Re-exploration was performed two months after the surgical ventral disc herniation. In the second group the same procedure was performed but at the end of the re-exploration, Nd:YAG laser irradiation of the degenerated discs was done. The wounds in both groups were closed again. Two months later all animals were sacrificed for histological and biochemical analysis. The cervical spine was excised en bloc and the overlying muscles were removed. Determination of hydroxyproline was done colorimetrically in the specimens harvested from each of these groups. Light microscopy was undertaken to evaluate the extent of morphological changes. The differences observed between the two groups were statistically significant (p < 0.05). From the results of this study, there is the question whether the Nd:YAG laser is a useful instrument in neurosurgery. Therefore, it remains to be proven whether or not this is of real benefit in the treatment of patients with degenerated disc disease.
Asunto(s)
Discectomía/instrumentación , Desplazamiento del Disco Intervertebral/cirugía , Disco Intervertebral/lesiones , Complicaciones Intraoperatorias/patología , Terapia por Láser/instrumentación , Animales , Cartílago Articular/lesiones , Cartílago Articular/patología , Vértebras Cervicales/lesiones , Vértebras Cervicales/patología , Modelos Animales de Enfermedad , Cobayas , Hidroxiprolina/análisis , Disco Intervertebral/patología , Desplazamiento del Disco Intervertebral/patología , MasculinoRESUMEN
The occurrence of a meningioma within the jugular foramen is very rare. We present the case of a 33-year-old man who presented with five-year history of hoarseness and was found to have paralysis of lower four cranial nerves on the left. High resolution computed tomography showed a dumbbell shaped tumor of the left jugular foramen extending intracranially over the jugular tubercle and extracranially into the parapharyngeal space. The patient underwent staged neuro-otological surgery and the mass was removed subtotally with no recurrence in six years. Histopathologic diagnosis was transitional meningioma. Our review of the literature revealed 33 previously reported cases. Four of these cases had neurofibromatosis. All but one underwent some form of otolaryngologic surgery. Although twenty had an intracranial component to their tumor, only 11 had a craniotomy. The majority of the tumors were meningothelial meningiomas (60%). Only two cases were malignant meningiomas. We reviewed the clinical and radiological characteristics and summarized the benefits and pitfalls of existing surgical options.
Asunto(s)
Venas Yugulares/patología , Neoplasias Meníngeas/cirugía , Meningioma/cirugía , Adulto , Humanos , Venas Yugulares/diagnóstico por imagen , Masculino , Neoplasias Meníngeas/diagnóstico , Meningioma/diagnóstico , Tomografía Computarizada por Rayos XRESUMEN
We report a case of a 32-year old woman with radicular symptoms associated with a low cervical chordoma. According to our knowledge this is the 10th case of low cervical chordoma reported in the literature.
Asunto(s)
Cordoma/patología , Neoplasias de la Médula Espinal/patología , Adulto , Cordoma/diagnóstico por imagen , Femenino , Humanos , Imagen por Resonancia Magnética , Cintigrafía , Médula Espinal/diagnóstico por imagen , Médula Espinal/patología , Neoplasias de la Médula Espinal/diagnóstico por imagenRESUMEN
We report on three patients who presented with a cerebellar medulloblastoma at age 48, 53, and 59 years. Histopathology showed typical features of medulloblastoma, in one case with marked neuronal differentiation. In addition, all neoplasms contained focal accumulations of mature fat cells. Immunoreactivity of adipocytes for S-100 protein, neuron-specific enolase, synaptophysin, microtubule-associated protein-2, and glial fibrillary acidic protein and the lack of immunoreactivity to type IV collagen suggest lipomatous differentiation of neoplastic primitive neuroectodermal cells rather than an admixture of mesenchymal elements. Mitotic activity was low and the growth faction, as determined by the MIB-1 labeling index, was less than 5%. All patients are alive with a recurrence-free interval ranging from 3.5 to 12 years. These three patients and five similar previously reported cases all fit into the concept of the lipomatous medulloblastoma as a new clinicopathological entity characterized by (a) typical features of a cerebellar medulloblastoma with advanced neuronal differentiation, (b) areas of lipomatous differentiation, (c) low proliferative potential, (d) manifestation in adults (mean age, 50 years), and (e) apparent favorable clinical prognosis.
Asunto(s)
Tejido Adiposo/patología , Neoplasias Cerebelosas/patología , Meduloblastoma/patología , Tejido Adiposo/ultraestructura , Adulto , Neoplasias Cerebelosas/química , Neoplasias Cerebelosas/ultraestructura , Femenino , Humanos , Masculino , Meduloblastoma/química , Meduloblastoma/ultraestructura , Persona de Mediana EdadRESUMEN
Balo's concentric sclerosis was diagnosed antemortem in 2 patients, by magnetic resonance (MR) imaging showing striking concentric alternating rings in 1 patient and by characteristic histopathological features in the other. The course of the lesions and the concentric pattern were followed by MR imaging for 3 years and 18 months, respectively. One patient demonstrated spontaneous remission that has not been reported in Balo's disease. Balo's disease may not have a fulminant course as described in the past and the MR appearance of the chronic lesion may resemble that of a chronic multiple sclerosis plaque.
Asunto(s)
Esclerosis Cerebral Difusa de Schilder/diagnóstico , Imagen por Resonancia Magnética , Adulto , Encefalopatías/diagnóstico , Encefalopatías/patología , Medios de Contraste , Esclerosis Cerebral Difusa de Schilder/patología , Femenino , Estudios de Seguimiento , Gadolinio , Gadolinio DTPA , Humanos , Aumento de la Imagen , Esclerosis Múltiple/diagnóstico , Esclerosis Múltiple/patología , Compuestos Organometálicos , Ácido Pentético/análogos & derivados , Remisión EspontáneaRESUMEN
We report two siblings who had intracranial gliomas, one with glioblastoma multiforme and the other with mixed oligo-astrocytoma. The genetic influences in the development of glioma are discussed.
Asunto(s)
Neoplasias Encefálicas/genética , Glioma/genética , Adulto , Femenino , Humanos , CariotipificaciónRESUMEN
Metastatic tumors to the skull, though relatively rare, are most often from lung, breast or prostate. In this report, we describe a case of skull metastasis from occult thyroid carcinoma and discuss the differential diagnosis of these lesions.
Asunto(s)
Adenocarcinoma Folicular/secundario , Neoplasias Primarias Desconocidas/patología , Neoplasias Craneales/secundario , Neoplasias de la Tiroides/patología , Adenocarcinoma Folicular/patología , Adenocarcinoma Folicular/cirugía , Angiografía Cerebral , Femenino , Humanos , Persona de Mediana Edad , Neoplasias Primarias Desconocidas/cirugía , Neoplasias Craneales/patología , Neoplasias Craneales/cirugía , Neoplasias de la Tiroides/cirugía , Tiroidectomía , Tomografía Computarizada por Rayos XRESUMEN
Calcification of pituitary adenomas as a histopathologic finding is reported in up to 25% of all degenerated adenomas. On the other hand, ossification of these adenomas is an extremely rare finding, with only one reported case, a prolactinoma. Here, we report a case of somatotropinoma in a 42-year-old acromegalic female. The adenoma, about 2 cm in diameter, was removed by the transsphenoidal route. Pathologic examination revealed ossification areas in the adenoma and the patient showed dramatic progress with relief of acromegaly signs and normalization of serum growth hormone levels. This case seems to be a unique report of osteoid metaplasia of a somatotropinoma.
Asunto(s)
Adenoma/patología , Osificación Heterotópica , Neoplasias Hipofisarias/patología , Adulto , Femenino , Hormona del Crecimiento/metabolismo , HumanosRESUMEN
Thirteen patients admitted to hospital mainly with visual disturbances (100%), retarded growth (39%) and diabetes insipidus (23%) were all diagnosed as ossified adamantinous craniopharyngioma. Tumour size was found to be large in all patients. Localization displayed a heterogenous dissemination; 8% intra-suprasellar, 69% suprasellar-extraventricular, 15% extra-intraventricular, and 8% in the suprasellar region extending bilaterally to the frontal and temporal lobes. During the early postoperative period, four patients died with hypothalamic deterioration. Three patients underwent a second operation in view of recurrence, and one died from an infection. Thus, the postoperative survival rate was 62%. All the patients who survived continued to have visual disturbances, but only one deteriorated. Five patients exhibited diabetes insipidus during the postoperative period, among them 4 after surgical intervention and 5 patients displayed panhypothyroidism, three of them after surgery. Consequently, it is confirmed by the present review that craniopharyngiomas still offer a potential dilemma in their management. Difficulties caused by adhesion or invasion of ossified craniopharyngiomas and thus the increase in morbidity and mortality during surgical intervention and in the postoperative period are discussed.
Asunto(s)
Craneofaringioma/cirugía , Osificación Heterotópica/cirugía , Neoplasias Hipofisarias/cirugía , Adolescente , Adulto , Calcinosis/diagnóstico , Calcinosis/patología , Calcinosis/cirugía , Niño , Craneofaringioma/diagnóstico , Craneofaringioma/patología , Femenino , Humanos , Hipofisectomía , Masculino , Examen Neurológico , Osificación Heterotópica/diagnóstico , Osificación Heterotópica/patología , Hipófisis/patología , Neoplasias Hipofisarias/diagnóstico , Neoplasias Hipofisarias/patología , Tomografía Computarizada por Rayos XRESUMEN
The authors report the case of a patient harbouring a spinal dural arteriovenous fistula adjacent to an intradural neurofibroma. Only the latter could be demonstrated by the diagnostic modalities employed. Such a coexistence proved misleading and two interventions were needed to cure both lesions. Only one report has appeared in the literature dealing with such a condition. The possibility of such a coexistence is stressed and mechanisms are discussed.
Asunto(s)
Fístula Arteriovenosa/complicaciones , Duramadre/irrigación sanguínea , Neurofibroma/complicaciones , Neoplasias de la Médula Espinal/complicaciones , Adulto , Fístula Arteriovenosa/diagnóstico , Fístula Arteriovenosa/cirugía , Humanos , Imagen por Resonancia Magnética , Masculino , Neurofibroma/diagnóstico , Neurofibroma/cirugía , Médula Espinal , Neoplasias de la Médula Espinal/diagnóstico , Neoplasias de la Médula Espinal/cirugíaRESUMEN
Extension of neuroepithelial tumors outside the neuroaxis is uncommon and usually follows surgical intervention. We report a patient with medulloblastoma of the right cerebellar hemisphere with extracranial extension presenting as a large neck tumor and discuss the clinical and pathological features of this case.
Asunto(s)
Neoplasias Cerebelosas/diagnóstico , Neoplasias de Cabeza y Cuello/diagnóstico , Meduloblastoma/diagnóstico , Adulto , Neoplasias Cerebelosas/diagnóstico por imagen , Neoplasias Cerebelosas/patología , Neoplasias Cerebelosas/cirugía , Humanos , Masculino , Meduloblastoma/diagnóstico por imagen , Meduloblastoma/patología , Meduloblastoma/cirugía , Tomografía Computarizada por Rayos XRESUMEN
A couple who were first cousins were referred for genetic counselling because of a previous spontaneous abortion and two female stillbirths with cyclopia. In the 18th week of the mother's fifth pregnancy a holoprosencephalic fetus was diagnosed by ultrasonography. The pregnancy was terminated. Postmortem computed tomography and pathological examination revealed that the female fetus had alobar holoprosencephaly with cyclopia. Chromosomal analysis of the fetus was normal.
Asunto(s)
Anomalías del Ojo/genética , Genes Recesivos , Holoprosencefalia/genética , Diagnóstico Prenatal , Aborto Inducido , Anomalías del Ojo/diagnóstico por imagen , Femenino , Feto/anomalías , Holoprosencefalia/diagnóstico por imagen , Humanos , Embarazo , UltrasonografíaRESUMEN
A spinal tumor complicating pregnancy is a rare condition. A 25-year-old woman who became paraplegic during the 35th week of her second pregnancy presented during the postpartum period. She underwent two surgical interventions, and the cord compression caused by a T5 vertebral body hemangioma with laminar involvement and extradural extension was relieved. The occurrence of vertebral hemangiomas during pregnancy is discussed; the radiological features with special reference to magnetic resonance imaging are outlined; and cases from the literature are reviewed.
Asunto(s)
Hemangioma/cirugía , Complicaciones Neoplásicas del Embarazo/cirugía , Neoplasias de la Columna Vertebral/cirugía , Vértebras Torácicas/cirugía , Adulto , Femenino , Hemangioma/diagnóstico , Hemangioma/patología , Humanos , Recién Nacido , Laminectomía , Imagen por Resonancia Magnética , Embarazo , Complicaciones Neoplásicas del Embarazo/diagnóstico , Complicaciones Neoplásicas del Embarazo/patología , Trastornos Puerperales/diagnóstico , Trastornos Puerperales/patología , Trastornos Puerperales/cirugía , Compresión de la Médula Espinal/diagnóstico , Compresión de la Médula Espinal/patología , Compresión de la Médula Espinal/cirugía , Neoplasias de la Columna Vertebral/patología , Vértebras Torácicas/patologíaRESUMEN
Cranial chondrosarcomas are rare. The majority of cases arise from the base of the skull and are most common in adult life. In this report, an infant with a chondrosarcoma of the temporal bone is discussed. We are not aware of a previously reported case of chondrosarcoma of the temporal bone in this age group.