RESUMO
Extraneural metastases of glioblastoma multiforme (GBM) are a relatively rare occurrence which usually manifest after de novo GBM. We report a case of a patient with an oligodendroastrocytoma who developed over a period of 12 years malignant progression to glioblastoma followed by multiple cytologically confirmed bone metastases. No 1p deletions were detected in the original tumour. GBM cells disclosed the EGFr(+) and p53(-) immunophenotype more characteristic of a primary GBM.
Assuntos
Neoplasias Ósseas/secundário , Neoplasias Encefálicas/patologia , Glioblastoma/secundário , Adulto , Biópsia por Agulha , Neoplasias Ósseas/diagnóstico por imagem , Neoplasias Encefálicas/diagnóstico por imagem , Glioblastoma/diagnóstico por imagem , Humanos , Masculino , Cintilografia , Tomografia Computadorizada por Raios XRESUMO
Cerebral tumor-like American trypanosomiasis (CTLAT) is an uncommon complication of Chagas' disease, observed only in immunosuppressed patients. We assessed 10 human immunodeficiency virus-positive patients with Chagas' disease who presented with CTLAT. All patients had neurological involvement and 6 developed intracranial hypertension. Neuroimaging studies showed supratentorial lesions in 9 patients, being single in 8. One case had infratentorial and supratentorial lesions. Low CD4+ cell counts were observed in all the cases and in 6 of them CTLAT was the first manifestation of acquired immunodeficiency syndrome. Serological tests for Chagas' disease were positive in 6 of 8 patients. Trypanosoma cruzi was identified in all brain specimens and in three cerebrospinal fluid samples. CTLAT should be considered in the differential diagnosis of intracranial mass lesions in human immunodeficiency virus-positive patients and should be added to the list of acquired immunodeficiency syndrome-defining illnesses.
Assuntos
Síndrome da Imunodeficiência Adquirida/parasitologia , Córtex Cerebral/patologia , Tripanossomíase/etiologia , Síndrome da Imunodeficiência Adquirida/complicações , Síndrome da Imunodeficiência Adquirida/patologia , Adulto , Feminino , Humanos , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Tripanossomíase/patologiaRESUMO
Trigeminal nucleotomy is a relatively simple, straightforward stereotactic procedure, acting at the deafferentation site, i.e., at the nucleus caudalis. Patients were operated on in a seated position, by a posterior suboccipital approach. Out of a series of 196 patients, 143 underwent trigeminal nucleotomy for deafferentation. Clinical diagnoses were 52 cases of postherpetic pain dysesthesia, 35 of anesthesia dolorosa, 46 of dysesthetic state with superimposed tic-like sequelae of trigeminal surgery performed elsewhere and 9 of posttraumatic neuropathy. Abolition of allodynia or marked reduction in, or disappearance of deep background pain was achieved in 72.0% of the cases overall. Results are analyzed for each clinical category. There were no side effects of any kind. Follow-up ranged from 4 to 17 years. This seems to be the procedure of choice for deafferentation facial pain.