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Query: UMLS:C0027651 (tumor)
 685,946 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Using a retrospective diagnostic approach based upon an analysis of the clinical data found in biographical documents, the author explores the medical peculiarities apparent in the life of Emmanuel Kant. The clinical history is globally dominated by neurological and ophthalmological symptoms. From a neurological standpoint, the philosopher started to manifest around the age of fifty a subtle deterioration of his mental powers. This disorder gradually impaired his intelligence and judgement, progressing slowly toward dementia. He also manifested signs of raised intracranial pressure, and later, frontal symptoms such as a slackening of social inhibitions, stereotypies and affective disinterest. An anosmia is also reported and several episodes of loss of consciousness are highly reminiscent of late-onset epileptic fits. Ophthalmological findings include transient visual obscurations, a bout of diplopia, and a progressive loss of vision in his left eye. Various diagnostic hypotheses found in the literature are then reviewed. These hypotheses are confronted with the clinical data and the reasons for their inadequacy are assessed. The nature of the clinical features, in conjunction with the similarity underlying the evolution of the neuro-ophthalmological symptoms and the philosopher's psychological profile, leads us to propose a diagnosis of frontal tumor, possibly of meningiomatous origin. This aetiology makes it possible to account for more biographical data than has been the case with other hypotheses presented to date.
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PMID:[Was Emmanuel Kant's dementia symptomatic of a frontal tumor?]. 929 54

Olfactory neuroblastoma is a rare tumor originating in the upper nasal cavity. It rarely extends intracranially. We report a clinical case of olfactory neuroblastoma with intracranial extension and distant metastasis. A 35-year-old man complained of nasal stuffiness and bleeding, headache and vomiting. Neurological examination showed anosmia and papilledema. MRI showed a huge mass that occupied the right nasal and paranasal cavities, and extended into the right frontal base. The tumor was removed totally and was histologically diagnosed as olfactory neuroblastoma. About two months after surgery, however, MRI demonstrated a rapid recurrence of the tumor in the nasal and paranasal cavities and the frontal lobe. Metastatic lesions were also seen in the right cervical lymph nodes. Chemotherapy was administered using cisplatin and etoposide. The tumor in the frontal lobe shrunk markedly but the other lesion persisted. Whole brain irradiation and local irradiation of the cervical lymph nodes were performed. The tumors became smaller but did not disappear. MRI demonstrated spinal dissemination. Irradiation of the whole spinal cord was performed. The metastatic lesions disappeared. The patient was discharged without neurological deficits, but died of pneumonia 15 months after surgery. Olfactory neuroblastoma is a slow-growing tumor and is highly radiosensitive, but it rarely extends or develops multiple distant metastases and seldom shows a short survival time, as in our case. A review of the literature documented responses in patients treated with a cisplatin-based drug combination. We recommend systemic control using cisplatin-based chemotherapy in addition to irradiation to prevent local recurrence in cases of advanced or metastatic olfactory neuroblastoma.
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PMID:[A case of olfactory neuroblastoma with intracranial extension and distant metastasis]. 1106 69

We report a case of an atypical bronchial carcinoid showing sestamibi uptake. A 27-year-old man with Kallmann's syndrome and hyperparathyroidism had parathyroid scintigraphy with 99mTc-sestamibi. A focal uptake was observed on the right perihilar region, and this right perihilar mass was demonstrated on computed tomography and proved histologically to be an atypical bronchial carcinoid tumor. Factors which may explain the tumoral avidity for sestamibi are increased blood flow, transmembrane potentials of plasma and mitochondrial membranes and the relative number of mitochondria present in the cells of this carcinoid tumor. The importance of this case is the coincidence of an atypical carcinoid in a patient with significant failure of secondary sexual characteristics, right renal agenesis and bilateral anosmia associated with Kallmann's syndrome.
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PMID:Coincidental visualization of an atypical bronchial carcinoid on Tc-99m-sestamibi scan in Kallmann's syndrome. 1192 10

In 1998 to 2001, the Academician N. N. Burdenko Research Institute of Neurosurgery operated on 15 patients aged 20 to 65 years who had bulky processes in the base of the skull and paranasal sinuses by applying an access through the frontal sinus. Most patients (n = 7) had meningiomas. The others had osteoma of the base of anterior cranial fossa (n = 2), chondroma (n = 2), angiofibroma (n = 1), fibroma (n = 1), esthesioneuroepithelioma (n = 1), and neurinoma (n = 1). The main criteria for choosing this access were the site and extent of a process, the sizes of the frontal sinus, and no signs of acute or chronic rhinosinusitis. The length of frontal sinuses in the most measurement was 3.5 to 5.0 cm, their width was 7 to 10 cm. All patients showed no progression of neurological symptoms. Three patients had a decrease in visual acuity from 1.0 to 0.8; with vascular therapy, visual disorders regressed during 2 months. Olfaction became worse in 4 cases, there was anosmia in 2 cases. Nasal liquorrhea was not observed. When there were tumors in the anterior cranial fossa, an access through the anterior wall of the frontal sinus permits radical removal of both intra- and extracranial parts of a tumor with closure of the defect with a periostal flap.
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PMID:[Access to the anterior cranial fossa through the frontal sinus]. 1221 4

A case of an 11-year-old female with cementifying fibroma in the ethmoidal sinus extending to the anterior cranial base was presented. She complained of slowly progressive nasal obstruction and anosmia. Magnetic resonance imaging (MRI) revealed a tumor in both ethmoidal and sphenoidal sinuses and nasal cavity. Although a tumor reduction surgery was attempted through a transnasal approach, tumor size increased gradually and right exophthalmos subsequently appeared. The pathological diagnosis was cementifying fibroma of the nose. Total tumor removal was consequently accomplished through the intracranial anterior transbasal approach. The surgical approach should be selected according to the site and expansion of the lesion in individual patients.
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PMID:Cementifying fibroma in the ethmoidal sinus extending to the anterior cranial base in an 11-year-old girl: a case report. 1254 76

Intracranial schwannoma not related to cranial nerves are unusual and rarely found in the subfrontal region. We report a case of olfactory groove schwannoma in a 27-year-old male, who presented with anosmia and headache initiated one year ago. At admission, bilateral papilledema was noted with absense of motor deficits or cranial nerves abnormalities. Cranial computed tomography (CT) revealed a bifrontal multicystic isodense enhancing mass lesion causing a frontal ventricular horn compression. Radiological features resembled that of a cystic olfactory groove meningioma. Decompressive bifrontal craniotomy was done. One month later, CT demonstrated a homogeneously contrast-enhancing mass in the olfactory groove region who extended into the left nasal cavity. Magnetic resonance imaging did not add more informations. A second surgical procedure was done through a nasoethmoidal approach with incomplete resection of the lesion. The complete tumor resection was only possible in a third surgery through another bifrontal approach. The hystopathological diagnosis of schwannoma was performed by conventional methods and confirmed by immunohistoquemical staining for S-100 protein. The rarity of this tumor and his clinical, radiological and histological aspects justify this publication.
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PMID:[Olfactory groove schwannoma: case report]. 1271 36

The technical approach for anterior skull base tumors has progressed considerably during the last decade. In the classical combined craniofacial resection (CFR) technique, anterior skull base lesions have been approached through bi-frontal craniotomy coupled with Weber-Ferguson and related modifications incisions. The purpose of this work is to present our experience with the subcranial approach for treatment of anterior skull base tumors. During the years 1994-2002, 64 patients underwent 72 procedures of anterior skull base tumor resection via the subcranial approach. The ages of the patients ranged from 2 to 81 years (mean 42 years). Twenty-nine cases involved malignant tumors (40%), and 43 cases involved benign tumors (60%). The most common benign pathology was meningioma (n = 12) and the most common malignant tumor was squamous cell carcinoma (n = 8). The principle skull base reconstruction procedure was performed using a multi-layered fascia: limited defects of the dura were reconstructed with the use of temporalis fascia, whereas reconstruction of large dural defects was performed using a multi-layered fascia lata sheath. Reconstruction of significant bony defects was achieved by utilizing a split calvarial bone graft, posterior sinus wall, or titanium mash covered with pericranial flap. Postoperative follow-up (26 months in average) revealed that 76% of the patients are without evidence of disease, 14% are alive with disease, 3% died of their diseases and 7% died of unrelated causes. Twenty-seven patients (44%) have suffered from anosmia following the operation. The rate of severe complications was 5.6%, and included meningitis (n = 2), cerebrospinal fluid rhinorrhea (n = 1) and tension pneumocephalus (n = 1). We conclude that the extirpation of anterior skull base tumors via the subcranial approach is simple, reproducible and reliable, and is associated with reasonable complication rates.
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PMID:[The subcranial approach for tumors involving the anterior skull base]. 1285 24

We report a five-year-old girl with a sinonasal cementoossifying fibroma with CT findings that reveal the invasion of all paranasal sinuses and the remodeling of facial bones. It was possibly a congenital lesion and caused a slowly progressive nasal obstruction and anosmia. Tumor removal with transnasal endoscopic approach was applied and total removal of the mass was accomplished. It was found out to be the cementoossifying fibroma of the paranasal sinuses when the results of the pathological examinations were obtained.
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PMID:Endoscope assisted removal of cementoossifying fibroma in the paranasal sinuses in a five-year-old girl. 1501 18

A 69-year-old woman presented with a transethmoidal meningoencephalocele manifesting as gradually developing anosmia. Examinations revealed a mass in the nasal cavity associated with multiple angiomas in her lip and orbit. Neuroimaging showed meningoencephalocele extending via the ethmoid sinus to the nasal cavity. She had no history of craniofacial trauma and intranasal or intracranial operation, and no skull base tumor was detected. Frontal base reconstruction was performed with a two-layer vascularized flap to prevent cerebrospinal fluid leakage. The dural defect was repaired with the pericranial flap, and the bony defect of the cribriform plate was reconstructed using the reversed U-shaped split temporalis musculofascial flap. Transethmoidal meningoencephalocele is a rare congenital malformation and almost half of the cases are identified in the first year of life. We should be aware of this clinical pathology and avoid unexpected rhinorrhea in elderly patients. The most important aspect of the operation is watertight closure of the patent passage to the intracranial compartment. The reversed U-shaped split temporalis musculofascial flap is useful to reconstruct the midline frontal base defect.
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PMID:Transethmoidal meningoencephalocele in an elderly woman. Case report. 1597 68

The nasal septum is a particularly rare site of origin of a chondrosarcoma. A 55-year-old man presented with complaints of nasal obstruction and anosmia of one year duration. A fragile mass was detected in the left nasal cavity. Computed tomography showed a large hypodense mass with scattered calcifications, eroding both ethmoid sinuses and extending to the left orbit. Following a biopsy, the tumor was resected via a lateral rhinotomy approach. No evidence for recurrent disease was detected during a three-year follow-up period. Although unusual in the nasal septum, chondrosarcoma must be considered in the differential diagnosis of calcified intranasal masses.
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PMID:Chondrosarcoma of the nasal septum: a case report. 1601 96


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