RESUMEN
Report of clinical features, diagnostic and surgical aspects observed in a case of adult peripheral neuroblastoma infiltrative of the lumbosacral plexuses. The patient, a 39-year-old male, presented with sciatalgia and progressive crural monoplegia. Characteristic histological features of this rare tumor are described. Surgical resection was attempted via a posterior transgluteal approach to the retroperitoneum through the greater sciatic foramen.
Asunto(s)
Neuroblastoma/diagnóstico , Neoplasias del Sistema Nervioso Periférico/diagnóstico , Adulto , Humanos , Masculino , Neuroblastoma/patología , Neoplasias del Sistema Nervioso Periférico/patología , Tomografía Computarizada por Rayos XRESUMEN
Relato de caso de neuroblastoma periférico em paciente adulto, com 39 anos de idade, do sexo masculino. O tumor de localizaçäo retroperitoneal, acometeu o plexo lombossacral esquerdo. Os primeiros sintomas foram de lombociatalgia, progredindo com monoparesia crural pronunciada e dor incapacitante. Säo descritas as características histológicas dessa neoplasia rara na idade adulta, incluindo estudo imuno-histoquímico e microscopia eletrônica, bem como a técnica cirúrgica empregada para sua ressecçäo (via posterior) transglutea, sendo a cavidade pélvica alcancada atravéz do forame isquiático maior). Os neuroblastomas devem ser considerados no diagnóstico diferencial do chamdo grupo histológico dos tumores malignos de células pequenas, mesmo em se tratando de pacientes adultos
Asunto(s)
Adulto , Humanos , Masculino , Neuroblastoma/diagnóstico , Neoplasias del Sistema Nervioso Periférico/diagnóstico , Neuroblastoma/patología , Neoplasias del Sistema Nervioso Periférico/patología , Tomografía Computarizada por Rayos XRESUMEN
A case of progressive bulbar and long tract symptoms with hydrocephalus of eleven years duration in a 23-year-old man, in whom an arachnoid cyst of the cisterna magna cerebellomedullaris was disclosed at operation.
Asunto(s)
Aracnoides/cirugía , Quistes/cirugía , Foramen Magno/cirugía , Adulto , Aracnoides/diagnóstico por imagen , Parálisis Bulbar Progresiva/cirugía , Cisterna Magna/cirugía , Quistes/diagnóstico por imagen , Foramen Magno/diagnóstico por imagen , Humanos , Hidrocefalia/cirugía , Masculino , Espina Bífida Oculta/cirugía , Tomografía Computarizada por Rayos XRESUMEN
Oropharyngeal pain was referred by five fully conscious and collaborative patients during lateral suboccipital puncture (LSP) of the cisterna magna, performed for myelography and/or cerebrospinal fluid collection. The anastomotic connections between the lower cranial nerves, the sympathetic nerves and the upper cervical spinal nerves are reviewed, with emphasis on the relationship between the first cervical nerve (C1), the superior cervical ganglion of the sympathetic trunk, and the spinal accessory nerve (nerve XI), and their central connections. The authors conclude that pharyngeal pain during LSP is provoked by the stimulation of afferent visceral fibers of C1, or of the gray communicating branches of the superior cervical ganglion to C1.