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Query: UMLS:C0018681 (headache)
 56,091 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We report the case of a 9-year-old boy clinically presenting with severe headache, vomiting, head retroflexion, nystagmus, and ataxia. Magnetic resonance imaging showed brainstem enlargement leading to the diagnosis of an inflammatory process. In addition, the clinical picture, a monocytic cerebrospinal fluid pleocytosis with elevated protein and lactate and serum IgM antibodies to Mycoplasma pneumoniae favored this diagnosis. Subsequently, corticosteroid treatment rapidly improved clinical symptoms, and lesions declined in subsequent neuroradiological examinations. However, 2 months later, fulminant disease progression led to brain death. Final neuroradiological examination favored meningoencephalitis. The autopsy revealed brain swelling and brainstem softening with a superficial gelatinous mass extending along the spinal cord. Finally, a disseminating anaplastic oligodendroglioma with allelic loss of the D19S246 tumor suppressor candidate locus of chromosome 19 was diagnosed. To our knowledge, this is the first case of a disseminating anaplastic brainstem oligodendroglioma associated with this specific allelic loss occurring in childhood.
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PMID:Disseminating anaplastic brainstem oligodendroglioma associated with allelic loss in the tumor suppressor candidate region D19S246 of chromosome 19 mimicking an inflammatory central nervous system disease in a 9-year-old boy. 1608 59

The authors describe an oligodendroglioma of the pineal region in a 59-year-old woman. The patient presented with intermittent confusion, memory disturbance, and headache associated with a cystic pineal region mass demonstrated on magnetic resonance imaging. Gross-total resection was performed via a suboccipital supratentorial approach. Pathological and genetic evaluation showed the tumor to be an anaplastic oligodendroglioma. Although the spectrum of tumors arising within the region of the pineal gland is broad, to the authors' knowledge this is the first report of an oligodendroglioma occurring in this area.
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PMID:Oligodendroglioma of the pineal region. Case report. 1696 Nov 43

Ependymomas account for 3-9% of all neuroepithelial tumors. A peculiar variant of ependymoma known as "giant cell ependymoma" ("GCE") is especially rarely reported, it may pose some difficulties for the diagnosing neuropathologist. Here we present a case of a giant cell ependymoma occuring in a 17-year-old patient with the history of 2-year recurrent headaches and a 1-month history of vision impairment. CT scanning demonstrated a mass in the left occipital lobe, arising from the occipital horn of the lateral ventricle. Histological, immunohistochemical and electron microscopic findings were consistent with high-grade ependymoma. Especially striking was the presence of bizzare pleomorphic giant cells which predominated in the tumor tissue. As a result the diagnosis of GCE was established. This type of neoplasm necessitates, at least in theory, differentiation with anaplastic oligodendroglioma, clear cell ependymoma, pleomorphic xanthoastrocytoma, giant cell glioblastoma, and subependymal giant cell astrocytoma. To date giant cell ependymomas (GCEs) were reported in seven cases in the literature. To the best of our knowledge this is the 8th case in the literature. In spite of apparently "worrisome" histology GCE seems to be a neoplasm with a relatively good prognosis.
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PMID:Giant cell ependymoma: a case report. 1800 20

Today, treatment recommendations for patients with all types of gliomas are based on light microscopic evaluation of tumor tissue with no allowance for genetic variability. Oligodendrogliomas are treated in a uniform manner with, as yet, no unique therapeutic approach or targeted therapy for those harboring a codeletion of chromosomes 1p and 19q. Surgical resection and radiotherapy are the standards-of-care for patients with oligodendrogliomas. Surgery improves symptoms, especially headache or seizures, and radiotherapy controls tumor growth for most patients. By extrapolation from randomized trials of glioblastoma, radiotherapy likely prolongs survival. Uncertainties persist about the timing of radiotherapy in the management of patients with low-grade oligodendrogliomas, but a superior antitumor treatment has yet to emerge. That said, the recognition that oligodendrogliomas with 1p/19q loss are sensitive to current therapies and slowly growing is already influencing our management of patients with this type of glioma, spawning trials in which patients are selected by molecular signature.
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PMID:Gliomas with 1p/19q codeletion: a.k.a. oligodendroglioma. 1906 May 98

Primary leptomeningeal oligodendrogliomas (PLOs) are rare intracranial malignancies where tumors grow in the subarachnoid space without an obvious connection to the brain or spinal cord parenchyma. Adding to the three previously reported cases of PLO with no parenchymal involvement we report a fourth case of the same in this paper in a 50-year-old woman presenting with unrelenting headaches. CT scan of her head revealed hydrocephalus and MRI revealed diffuse enhancement of her leptomeninges throughout her brain and spine, prominent over the basilar region. Biopsy obtained using a frameless stereotactic biopsy showed sharply defined cell borders, clear cytoplasm, and rounded nuclei consistent with an oligodendroglioma. Our case suggests that PLO can mimic diffuse forms of granulomatous meningitis and should be suspected in patients that clinically and radiographically present like granulomatous meningitis but without blood or CSF markers for the same.
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PMID:Primary leptomeningeal oligodendrogliomatosis. 1929 Apr 82

Oligodendroglioma of the spinal cord is a rare tumor that most often presents with spinal cord symptoms. The authors present a case of spinal cord oligodendroglioma that was associated with cerebral rather than spinal cord symptoms. A 30-year-old woman developed nausea, vomiting, and severe headaches. Magnetic resonance imaging of the brain showed meningeal enhancement. The patient underwent a craniotomy with biopsies of the meninges and brain. The biopsy findings revealed an abnormal arachnoid thickening without tumor cells. The patient later developed hydrocephalus and underwent shunt placement. Cerebrospinal fluid cytological findings were negative for tumor cells or infection. She was found to have a cervical cord lesion at C3-4 that was initially nonenhancing but later enhanced after Gd administration. Biopsy of the cord lesion with partial resection showed a WHO Grade II oligodendroglioma with 1p and 19q deletions determined by fluorescence in situ hybridization. Neurooncological treatment with tumor radiation and temozolomide (Temodor) resulted in improvement in radiographic findings, symptoms, and long-term survival. This paper presents an extensive review of the literature, which revealed only 2 other reported cases of cerebral symptoms in adults that preceded spinal cord symptoms in a patient with oligodendroglioma of the spinal cord. It is also the first reported case of oligodendrogliomatosis due to a cervical spinal cord oligodendroglioma with 1p and 19q deletions.
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PMID:Spinal cord oligodendroglioma with 1p and 19q deletions presenting with cerebral oligodendrogliomatosis. 1955 88

With the exception of oligoastrocytoma, mixed gliomas are rarely encountered, and the astrocytic component of mixed oligoastrocytoma is almost always fibrillary and diffusely infiltrative. Pleomorphic xanthoastrocytoma (PXA) has occasionally been described in conjunction with ganglioglioma, as well as in 1 case of oligodendroglioma. In this latter case, described by Perry et al., 1p/19q codeletions were not detected. The authors report on a 25-year-old woman with a combined PXA/oligodendroglioma in which concurrent 1p/19q codeletions were detected in the oligodendroglial component only. The patient presented with a 1-month history of headaches. Neuroimaging revealed a heterogeneous left temporal mass with focal enhancement, cystic changes, hemorrhage, and left-to-right midline shift. The patient underwent a craniotomy and gross-total resection. Pathological examination revealed a glial tumor composed of 2 apparently distinct components. The largest component exhibited a prominent fascicular, reticulin-rich, spindle cell arrangement admixed with areas of highly pleomorphic cells, with bizarre cytological features reminiscent of PXA. A smaller component was composed of cellular sheets and lobules of oligodendroglial cells. Both components were characterized by anaplastic features. Dual-color fluorescence in situ hybridization for 1p/19q codeletions was performed. Only the oligodendroglial component showed the combined 1p/19q deletions. This case represents the first instance in which PXA has been reported in conjunction with an oligodendroglioma exhibiting the "molecular signature" characteristic of oligodendroglial neoplasms. The different genetic alterations seen in the 2 components of this neoplasm argue in favor of a "collision tumor" rather than a mixed glioma of the same genotype.
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PMID:Pleomorphic xanthoastrocytoma and oligodendroglioma: collision of 2 morphologically and genetically distinct anaplastic components. 2121 37

A 42-year-old woman had suffered from headaches since April 2009. Computed tomography revealed a tumor with marked calcification in the left frontal lobe adjacent to the left anterior horn of the lateral ventricle. T1-weighted gadolinium-enhanced magnetic resonance imaging showed a well-enhanced tumor at the lesion. Dynamic methionine positron emission tomography showed no delayed methionine attenuation. Initial preoperative diagnosis was extraventricular neurocytoma (EVN). However, oligodendroglioma was determined upon a second diagnosis. The patient underwent total tumor removal. Hematoxylin and eosin staining showed the characteristic fried egg-like cells, round nuclei, and immunohistochemically, the tumor cells were positive for glial fibrillary acidic protein, synaptophysin, neuronal nuclear antigen, microtubule-associated protein 2 and Olig2. The MIB-1 labeling index was 20%, which suggested malignancy. Although these findings demonstrated that the tumor had glioneuronal character, it was difficult to differentiate between EVN and oligodendroglioma. There have been reports that Olig2 immunohistochemistry is generally positive in cases of oligodendroglioma, but not in cases of neurocytoma. We completed the diagnosis as oligodendroglioma. Subsequent electron microscopy results presented oligodendroglial but not neuronal characteristics. We concluded that Olig2 is useful in the differential diagnosis of oligodendrogliomas and EVNs.
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PMID:Olig2 is useful in the differential diagnosis of oligodendrogliomas and extraventricular neurocytomas. 2131 66

The primary brain tumors associated with cerebral aneurysms are rare in neurosurgical practice. The present article constitutes an evaluation of the management of coexistent primary brain tumor and cerebral aneurysm. A retrospective study of three cases of primary brain tumor with cerebral aneurysm was performed. We evaluated the complications and clinic outcomes by assessing the clinical and imaging findings. Case 1 presented with a subarachnoid hemorrhage from an aneurysm of the anterior communicating artery, with an incidental left frontal oligodendroglioma. Case 2 presented with chronic headache due to left frontal convexity meningioma, with proximal internal carotid artery aneurysm which was found incidentally during preoperative magnetic resonance angiography. Case 3 was admitted to our hospital complaining of headache, memory disturbance, and weakness in her left lower extremity. Magnetic resonance imaging revealed right frontal lymphoma and an unruptured aneurysm at the left middle cerebral artery. Preoperative magnetic resonance imaging revealed right frontal lymphoma and unruptured left middle cerebral artery. The frequency of primary brain tumor and cerebral aneurysm coexistence is increasing due to improvements in high-resolution imaging. In these complicated cases, the management will differ according to each pathology present, and this is an important problem for a neurosurgeon.
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PMID:Primary brain tumors associated with cerebral aneurysm: report of three cases. 2153 5

A case of anaplastic oligodendroglioma with femoral metastasis is presented in a 37-year old male with a 2-year history of progressive headaches and dizziness associated with a 2-month history of epilepsy and right hemiparesis. Magnetic resonance imaging (MRI) demonstrated a solid temporoparietal tumour and the patient underwent a left temporal craniotomy and subtotal resection followed by limited-field radiation therapy. The pathological diagnosis was anaplastic oligodendroglioma. The patient presented with left hip pain 3 years later. Radiography and computed tomography demonstrated osteosclerosis of the left proximal femur, and MRI revealed an intramedullary metastatic lesion. Total body (99m)Tc-methylene diphosphonate bone scan showed hyperactivity in the lesion and open biopsy confirmed it was a metastasis from the cerebral oligodendroglioma. The patient was treated with temozolomide and, to date, there is no sign of recurrence or progression in either the brain or the femur. Seven previously reported cases of extracranial skeletal metastasis from anaplastic oligodendroglioma are reviewed. Co-deletion of chromosome arms 1p and 19q and O(6)-methylguanine DNA methyltransferase status remain the most important prognostic and predictive markers.
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PMID:Extracranial skeletal metastasis in anaplastic oligodendroglioma: case report and review of the literature. 2181 30


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