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

The case is described of a 23-year-old female patient presenting with unilateral proptosis, headaches, and transient epiphora. Surgery revealed an encapsulated tumour composed exclusively of spindle-shaped cells within a richly vascularised myxoid stroma. Immunohistochemical staining showed focal positivity for smooth muscle actin, vimentin, and glial fibrillary acidic protein. These combined findings are interpreted as providing evidence of a myoepithelioma, which may be regarded as a monomorphic adenoma consisting solely of myoepithelial cells. To our knowledge this is only the second report of such a tumour in the lacrimal gland.
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PMID:Myoepithelioma of the lacrimal gland: report of a case with spindle cell morphology. 132 39

The authors present a case of central neurocytoma in a 34-year-old female who had experienced intermittent headaches over a 10-year period. On computed tomographic (CT) scans and magnetic resonance images, the tumor appeared as a large, calcified mass occupying both lateral ventricles. A right parieto-occipital craniotomy was performed and the tumor was totally removed. While the light microscopic findings suggested a diagnosis of oligodendroglioma, electron microscopic examination demonstrated clear vesicles, microtubules, and synaptic structures within the abundant cytoplasmic processes of the tumor cells. Immunohistochemical examination showed the tumor cells to be strongly positive for neuron-specific enolase, sparsely positive for S-100 protein, and negative for glial fibrillary acidic protein. The final histological diagnosis was central neurocytoma. The postoperative course was uneventful and no further treatment was administered. She has no neurological deficits and CT has shown no evidence of recurrence during the 2 years since her surgery. Central neurocytoma is a rare tumor arising in the lateral ventricle, and the diagnosis is mainly based on electron microscopic findings. Since central neurocytoma appears to have a good prognosis following total removal alone, it is very important to distinguish between this and other ventricular tumors.
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PMID:Central neurocytoma--case report. 169 45

This is the first report of extraneural metastasis of malignant glioma through V-P shunt tube and growth in peritoneal cavity as ascitic form. The patient was a 43-year-old man who was admitted to our hospital with occipital headache. CT scan showed enhanced cystic tumor mass at left temporal lobe. Craniotomy and partial excision of the tumor was done and the histology of tumor tissue showed a malignant astrocytoma. Following this treatment, the patient received the adjuvant therapies of radiation, chemotherapy and immunotherapy with interferon, and also recraniotomy three times. In the mean time, a ventriculo-peritoneal shunt was set up for internal hydrocephalus. One month later, abdominal bulging appeared and yellowish ascites could be obtained with peritoneal tap. In the ascite, tumor cells with glial fibrillary acidic protein were observed at the concentration of 5-10 x 10(4) cells/ml. The patient died three months after extraneural metastasis to the abdominal cavity as ascitic form. At autopsy, solid metastatic mass lesion was not found in extraneural region include abdomen.
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PMID:[Extraneural metastasis of malignant glioma through a ventriculo-peritoneal shunt: growth in peritoneal cavity as ascitic form]. 299 92

A case of cerebellar ganglioglioma is reported. A 22-year-old female was admitted to the Kurume University Hospital on August 19, 1985, suffering from headache, vomiting and gait disturbance. On admission, neurological examination revealed staggering gait and the right cerebellar ataxia showing dysmetria and dysdiadochokinesis. Mild choked disc in the right fundus was also noted. Plain CT scan showed the low-density area involving the right cerebellar hemisphere and the part of the vermis with internal hydrocephalus. Enhanced CT scan showed the high-density area adjacent to the low-density area suggesting a mural nodule. A vertebral angiogram in the arterial phase showed an expansive lesion in the posterior fossa and the tumor stain, which was also visualized in the venous phase. An emergency suboccipital craniectomy was then performed. With opening the tense dura mater, the cyst formation was noted and 30 ml of xanthochromic fluid was then aspirated. A well demarcated mural nodule was noted in the lateral wall of the cyst. The nodule was then extirpated in toto. The hypertrophy of the cerebellar cortex was not observed. Histologically, the tumor was consisted of nerve fiber, glial fiber and neuronal cells. Its architecture was differed distinctly from that of hamartomatous diffuse hypertrophy of the cerebellar cortex (Lhermitte-Duclos' disease). Immunohistochemically, the neuronal cells revealed positive staining for NSE and S-100, and the glial cells displayed positive staining for GFAP, S-100. The authors reviewed previously reported eleven cases of cerebellar ganglioglioma including the present case. These results showed that cerebellar gangliogliomas have some characteristic clinical features among general intracranial gangliogliomas.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Cerebellar ganglioglioma: a case report]. 304 1

We report a case of Rathke's cleft cyst in pituitary tumor. A 31-year-old woman admitted to our hospital complained of visual disturbance, headache, amenorrhea and galactorrhea. Serum prolactin level was 3,060 ng/ml. By means of CT scan and MRI, we found suprasellar-extending tumor to have cystic component in the center of the tumor. Transsphenoidal surgery revealed grayish jelly-like content in the cyst. Histologically tumor cells were composed of chromophobic, basophilic and eosinophilic cells. The cyst wall in the pituitary adenoma was composed of ciliated or non-ciliated columnar epithelium intermingled with goblet cells, being similar to Rathke's cleft cyst. Except for the cells of the cyst wall, most of the tumor cells were immunoreactive for prolactin. As for intermediate filament, tumor cells in both solid and cystic portions showed positive immunoreactivity for cytokeratin and GFAP, and not for vimentin and neurofilament. These results suggest that the nature of the intracytoplasmic filament in the pituitary tumor with Rathke's cleft cyst may be not only keratin but also GFAP.
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PMID:[A case of prolactinoma in close association with Rathke's cleft cyst]. 332 Aug 6

A three-year-old boy with a progressive history of headache, vomiting and ataxia in the course of 2 months, was admitted on August 1983, when he was lethargic. Neurological examination revealed dysphagia, scanning speech and tremor in the bilateral hand. CT scan showed a very large enhanced mass in the center of posterior fossa with central necrosis in it and the dilatation of whole ventricular system. Suboccipital craniectomy was immediately performed and the tumor that occupied the vermis and invaded into both cerebellar hemisphere was subtotally removed. Postoperative irradiation was well performed: 4140 rads to the whole brain and 3162 rads to the spinal cord. However, 5 months later, facial palsy in the left side and progressive ataxia became prominent. CT scan showed multiple enhanced masses in the left trigonum and right anterior horn of the lateral ventricles and in the left cerebellopontine angle. In spite of chemotherapy, the patient had a down-hill course, especially after the ventricular hemorrhage, and died on June 9th, 1984. Histologically, the tumor had a lobulated appearance with an aggregation of tumor cells encircled by vascular septae. The cells within lobules generally had vesicular nuclei, which were arranged in parallel row. Occasionally smaller hyperchromatic cells with scant cytoplasm were present along the vascular septae. Reticulin was present within the septa, but was not observed within the lobules. Scattered astrocytic cells and processes were identified within the lobules by the immunoperoxidase technique for GFAP. The fibrillary cytoplasmic processes within the lobules were stained by immunoperoxidase technique for neurofilament (68K).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[A case of cerebellar neuroblastoma]. 361 40

Ganglion cell tumours are mostly seen in children and young people, but they are extremely rare, accounting for 0.1-0.5% of all brain tumours. It usually occurs in the floor of the third ventricle and the temporal lobe. Recently we have experienced a pineal gangliocytoma, probably the first ever seen in Japan and the fourth case in the world, and have succeeded in a total removal of it. The case concerns a 51-year-old man who suffered from intermittent blurred vision and headache of 3 years' duration. CT showed, together with severe hydrocephalus, positive contrast medium enhancement and a somewhat irregular but sharply circumscribed high density lesion suggestive of a meningioma. But the brain scintiscan revealed a badly and irregularly demarcated region of warm activity and having little change with time mainly in the pineal region, which was strongly suspicious of gliomas. Hence this scan was thought to be important in diagnosing this tumour. As an operative procedure, biparieto-occipital craniotomy was successfully performed in the "sea lion" position to remove the tumour totally. Pathological findings indicated a mixture of dispersion and concentration of giant cells possessing prominent nucleoli, abundant chromatin and a prominent nucleus or several nuclei of varying sizes and process-like cell bodies polygonal or irregular in shape. GFAP stain showing no glial fibres and the tumour was thought to be a gangliocytoma.
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PMID:Gangliocytoma of the pineal body. A case report and review of the literature. 387 55

Two cases of pleomorphic xanthoastrocytoma (P X A) of young subjects (Kepes et al., 1979) are reported. Case 1 arose in 15-year-old boy admitted to the hospital with the complaint of severe headaches associated with nausea and vomiting of 1 month's duration. Computed tomographic scans showed a large well-defined low density area in the left temporo-parietal region of which an anterior portion was enhanced by contrast medium. Craniotomy revealed a large superficial and cystic tumor with a mural nodule. Histological and immunohistochemical features were those of a P X A confirmed by an electron microscopic study. No radiotherapy was given. The patient made a complete recovery, and 32 months later was asymptomatic. Case 2, a 17-year-old boy was admitted to the hospital in 1977. He presented with seizures that started 18 months prior to surgery. Carotid and humeral angiograms and air studies indicated the presence of a right, internal temporal mass with herniation. The craniotomy revealed a firm superficial tumor with an infratentorial, extraparenchymal extension. The histological diagnosis was giant cell glioblastoma or gliosarcoma. The patient received post-operative radiation of 5.500 rads and chemotherapy (CCNU and VM 26). He died on the 7th post-operative month. In this 2nd case, the diagnosis of P X A was made retrospectively based upon histological and immunohistochemical observations similar to case 1. We are aware of 24 P X A in the literature. In their clinical and histological features these neoplasms resemble closely each other. P X A are superficial, supratentorial astrocytomas occurring in youngs subjects (ages 3 to 32). Their typical microscopic structure include a marked cellular pleomorphism with bizarre giant cells, some mitotic figures and no necrosis. Many cells contain lipid and hyalin droplets in their cytoplasm. Characteristically, the tumoral stroma contain a very rich reticulin fiber network. Immunoperoxidase technique reveal glial fibrillary acidic protein in the tumor cells. Electron microscopic studies demonstrate abundant intracytoplasmic glial filaments. Individual cells or group of cells are surrounded by a prominent basal lamina. Some hemidesmosomes or primitive attachments are seen at the margins of the tumor cells. The biological behaviour of PXA with or without radiotherapy is relatively favorable. Long survival times (up to 25 years) are reported but in 5 cases, P X A follow a less favorable course with malignant transformation and death. Morphologic and immunohistochemical studies support the subpial astrocytic origin of P X A.
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PMID:[Xanthoastrocytoma inf young subjects. Review of the literature apropos of 2 cases with discordant courses]. 389 48

A review of the literature on primary diffuse meningeal gliomatosis (DMG) yielded three cases and we report a fourth. DMG is a syndrome characterized by extensive basal and spinal chronic meningitis with mental confusion, headaches, diplopia, papilledema and cranial nerve palsies. The cerebrospinal fluid (CSF) has a markedly elevated protein content, moderate mononuclear pleocytosis and a normal or low glucose. This picture invariably leads to the diagnosis and treatment of tuberculous or fungal meningitis despite persistently negative cerebrospinal fluid (CSF) cultures. Reaction of exfoliated CSF cells with glial fibrillary acidic protein (GFAP) immunoperoxidase labelled antibody is suggested as a diagnostic tool. A basal meningeal biopsy appears to be the only alternative diagnostic approach.
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PMID:Primary diffuse leptomeningeal gliomatosis. 405 90

The clinical and pathological data of ten patients with gliomatosis cerebri are compared with 48 well documented cases from the literature. The most striking clinical findings were behavioural and mental changes, seizures, motor weakness and headaches. Though diagnostic techniques have gained in sophistication, the clinical diagnosis of gliomatosis cerebri remains difficult. Laboratory and radiograph tests are mostly unconclusive. Expectations that computed tomography might lead to an accurate diagnosis were not fulfilled. Histological examination disclosed a diffuse proliferation of glial elements infiltrating normal nervous tissue with destruction of myelin sheaths, but only slight damage to neurons and axons. In two cases, areas typical of oligodendroglioma were also present. Glial fibrillary acidic protein staining showed in seven cases that most of the neoplastic cells were of astrocytic origin. In addition, GFAP negative neoplastic cells with the appearance of oligodendroglia and intermediate elements between astroglia and oligodendroglia and irregularly shaped naked nuclei of unidentified nature were found. On the basis of the two-stage theory of carcinogenesis, it is suggested that this disease might be the result of propagation of initiated glial elements which have not yet undergone the process of tumor conversion.
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PMID:Gliomatosis cerebri: clinical and histological findings. 405 56


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