Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0018681 (headache)
 56,091 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Neuroenteric cysts of the CNS are uncommon benign lesions usually involving the spinal cord or rarely the cerebellopontine angle (CPA). We report a rare example of multiple neuroenteric cysts arising from the CPA and foramen magnum in a 20-year-old Caucasian woman who presented with headaches and dizziness. An MRI showed three separate lesions, not communicating with each other. The first lesion, within the left posterior lateral aspect of the CPA, demonstrated isointensity to gray matter on the fluid-attenuated inversion recovery (FLAIR) sequence. The second lesion, within the left foramen of Luschka at the level of the CPA, demonstrated hyperintensity on the T(2)-weighted sequences, intermediate to slightly hyperintense on T(1)-weighted sequence and hyperintensity on FLAIR. The third lesion, within the anterior/inferior left cerebellum at the level of the foramen magnum, followed CSF signal intensity throughout. None of the lesions demonstrated significant enhancement or bone lesions. Due to compression effect, surgery was performed. Pathologic examination revealed cystic structures lined by a single layer of non-ciliated well-differentiated mucin-producing columnar epithelium with eosinophilic to amphophilic cytoplasm and round to oval nuclei with focal pseudostratification. Immunohistochemical studies showed focal positivity for cytokeratin 7, CK 5/6, synaptophysin, and carcinoembryonic antigen (CEA), diffuse positive staining for epithelial membrane antigen (EMA) and BerEP4; and negative staining for cytokeratin 20, TTF-1, and GFAP. The MIB-1 proliferation index was < 1%. One-year follow-up has shown no recurrence. The differential diagnosis and a brief review of the literature are also presented.
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PMID:Multiple neuroenteric cysts at cerebello-pontine angle and foramen magnum: a case report and review of the literature. 1871 73

The cerebellopontine angle is an extremely rare site for the growth of a choroid plexus papilloma. The clinicoradiological diagnosis of this tumor in the cerebellopontine angle is difficult because of its rarity in addition to a nonspecific clinical presentation and radiological features. Herein, we report the case of a 49-year-old woman with complaints of headache and features of raised intracranial pressure, whose computerized tomography (CT) and magnetic resonance imaging (MRI) were suggestive of acoustic neuroma or meningioma with hydrocephalus. Histology revealed multiple arborizing papillae with a central fibrovascular core, lined by cubo-columnar cells. The cells showed diffuse immunoreactivity for pancytokeratin, S100 protein, synaptophysin, and vimentin, as well as focal expression of glial fibrillary acidic protein, epithelial membrane antigen, and cytokeratin 7. English medical literature is also reviewed.
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PMID:Choroid plexus papilloma of the cerebellopontine angle. 2103 14

We present to our knowledge the first patient with histopathologically proven brain metastasis from extramammary Paget's disease (EMPD) and discuss the effect of brain radiation therapy for this condition. A 68-year-old man presented to our hospital with headache and gait disturbance. Brain MRI showed multiple enhancing mass lesions, and two large cystic lesions in the left cerebellum. The patient had been diagnosed with scrotal Paget's disease 3 months previously but no further management had been performed due to his refusal. The patient underwent stereotactic aspiration and biopsy of the two large cystic lesions. A histopathological examination revealed that the tumor was a metastatic adenocarcinoma. Immunohistochemical staining revealed that the tumor cells were strongly positive for cytokeratin 7 and moderately positive for carcinoembryonic antigen and gross cystic disease fluid protein 15. These findings were similar to those of his scrotal skin lesions and were consistent with metastatic EMPD. The patient underwent brain radiation therapy with a total radiation dose of 30 Gy in 10 fractions. The patient improved neurologically so as to be self-ambulatory, and a mild improvement in the metastatic tumors was found on follow-up MRI. We had planned systemic chemotherapy, but the patient died of acute respiratory failure 2 months after radiation therapy.
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PMID:Brain metastasis from extramammary Paget's disease of the scrotum. 2421 Aug 6

We report a case of a 35-year-old female patient who presented with worsening headaches, vertigo, and vision changes. MRI of the brain showed an enhancing lesion in the pineal region. The patient was taken for resection of the lesion which was classified as neuroendocrine carcinoma of the pineal parenchyma, intermediate grade. Histologically, the neoplasm was cellular, mitotically active, and composed of tightly packed cells with high nuclear cytoplasmic ratio, scant cytoplasm, and ill-defined cell borders. Immunohistochemically the tumor cells were positive for chromogranin, synaptophysin and AE1/AE3, and negative for CK-7, CK-20, and TTF1. Possible metastasis from any other primary sites was ruled out clinically. This represents the first reported case of neuroendocrine carcinoma of the pineal parenchyma.
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PMID:Neuroendocrine carcinoma of the pineal parenchyma. The first reported case. 2774 68

The metastasis of cancer to the pituitary gland is uncommon but may mimic a typical pituitary adenoma. Such cancers often derive from the breasts or the lungs, or very rarely from thyroid carcinoma. We described the case of a 60-year-old woman who presented with headaches and pain to the right eye. CT and MRI scans of the head revealed a sellar mass compressing the optic chiasm and invading the cavernous sinus. Her serum prolactin level was 1720 mIU/L. The preoperative diagnosis was pituitary adenoma. An endoscopic endonasal transsphenoidal approach was used to remove the tumor. Immunohistochemistry revealed immunoreactivity for thyroid transcription factor-1, CK-7, TG, supporting the diagnosis of a metastatic thyroid carcinoma. The rechecked thyroid ultrasonography showed a nodus with calcification on the left side. A total thyroidectomy was performed with a final histopathological diagnosis of minimally invasive follicular thyroid carcinoma. She was advised to take 131I treatment. The relevant literature is reviewed in light of this unusual case, illustrating the problems in the diagnosis and management of this type of patient.
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PMID:Minimally invasive follicular thyroid carcinoma mimicking pituitary adenoma: a case report. 3193 88