RESUMO
Chiari malformation type I and Poland's syndrome are two rare diseases and their simultaneous presentation had not been previously described in the literature. We report the case of a 27 year old male with history of Poland's syndrome, who referred headache and motor impairment of the intrinsic muscles of the left hand. In a cervical spine MR a Chiari I malformation with syringomyelia from C1 to T2 was found, which was treated by foramen magnum decompression, dural plasty and removal of the posterior arch of the atlas. A discussion of the embryological mechanisms that might be involved in the coexistence of these two entities is presented, emphasizing the role of para-axial mesoderm.
Assuntos
Malformação de Arnold-Chiari/epidemiologia , Síndrome de Poland/epidemiologia , Adulto , Malformação de Arnold-Chiari/etiologia , Malformação de Arnold-Chiari/cirurgia , Comorbidade , Humanos , Imageamento por Ressonância Magnética , Masculino , Síndrome de Poland/etiologia , Síndrome de Poland/cirurgiaRESUMO
Clear cell meningioma is a rare variety of meningiomas, occurring frequently at the cerebellopontine angle and spinal canal. A case of a female patient 28 years of age with a complete cauda equina syndrome was described. Magnetic resonance imaging of lumbo-sacral spine revealed a mass lesion occupying the spinal canal from L3 to S1. Subtotal resection was performed and pathological pathological examination revealed a clear cell meningioma. Radiotherapy was indicated, however, it was delayed because we discovered that the patient was pregnant. The recurrence was clinically evident at seven months and a new surgical resection previous complementary radiotherapy was necessary. A systematic review of literature was performed, exposing the behavior of clear cell meningioma in the spinal canal.
Assuntos
Neoplasias Meníngeas/patologia , Meningioma/patologia , Adulto , Feminino , Humanos , Região Lombossacral/patologia , Imageamento por Ressonância Magnética , Neoplasias Meníngeas/diagnóstico , Neoplasias Meníngeas/cirurgia , Meningioma/diagnóstico , Meningioma/cirurgia , Recidiva Local de Neoplasia/radioterapia , Recidiva Local de Neoplasia/cirurgia , Polirradiculopatia , GravidezRESUMO
Metastases of prostate cancer to intracranial meninges are rare and often confused with meningiomas or chronic subdural hematomas. These usually occur in patients with a known cancer diagnosis in advanced stages of the disease, and only in some rare cases do its manifestations precede the detection of the primary tumour. The clinical presentation is unspecific. However, due to the affinity of this tumour for the base of the skull, it must be included in the differential diagnosis of men over 70 years of age with cranial nerve palsy. The treatment of these lesions has not been standardized. Within the therapeutic options we find surgical resection, chemotherapy, radiotherapy or a combination of these measures, and yet survival is poor. We present the case of a 77 year old male patient whose initial symptoms of prostate cancer were caused by a metastatic lesion to the dura, confirmed by histopathology. We also review the epidemiological, clinical and imaging highlights of this condition.