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

Malignant meningiomas are rarely encountered neoplasms. Few studies have examined MIB1 (marker of cell proliferation) or p53 (tumor suppressor gene) immunoreactivity in these tumors. This study retrospectively examines 23 malignant meningiomas (defined by the presence of either unequivocal brain invasion or metastasis) including MIB1 and p53 immunohistochemistry. The patients included 13 women and 10 men who ranged in age from 22 to 82 years (mean 63 years). Initial clinical presentation included weakness or numbness in 10 patients, visual signs or symptoms in 7 patients, and headaches in 6 patients. Histologically, nuclear pleomorphism was present in 23 of 23 tumors, disorganized architecture in 22 of 22, necrosis in 20 of 23, prominent nucleoli in 17 of 23, and hypervascularity in 4 of 23. One to 18 mitotic figures per 10 high power fields (HPF) (mean 6.1) were observed. Metastases were present in six patients (bone: 3 patients; lung: 2 patients; skin: 2 patients; kidney: 1 patient; and liver: 1 patient). MIB1 indices (positive tumor cells per 1,000 tumor cells evaluated x 100) in 20 tumors ranged from 1.3 to 24.2 (mean 11.7). p53 nuclear staining was observed in only 2 of 20 tumors. Follow-up information was available in 21 patients: 6 died of tumor (mean 27 months); 9 are alive with residual tumor (mean 35 months); 5 are alive with no evidence of tumor (mean 12 months); and 1 died 13 days postoperatively. There was no obvious correlation of the MIB1 index and tumor behavior. The majority of malignant meningiomas are characterized by nuclear pleomorphism, architectural disorganization, necrosis, prominent nucleoli, and increased mitoses. MIB1 labeling in most malignant meningiomas was high, consistent with the generally rapid growth of these tumors. Only a rare malignant meningioma demonstrated p53 alteration by immunostaining.
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PMID:Malignant meningioma: a clinicopathologic study of 23 patients including MIB1 and p53 immunohistochemistry. 865 46

A case of metastatic desmoplastic malignant melanoma is reported. The patient presented initially with a lung mass and subsequently developed facial swelling and numbness secondary to tumor involvement of the maxillary division of the trigeminal nerve. The pleomorphism, histochemistry, and schwannoid differentiation of these tumors is discussed.
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PMID:Desmoplastic malignant melanoma presenting as a lung mass. 869 71

The nationwide epidemiological survey of syringomyelia was carried out in Japan by sending inquiries to neurologists, child neurologists, neurosurgeons and orthopedic surgeons for the period of 1991 and 1992. A total of 1,243 cases of syringomyelia were ascertained. Among them, 622 were men and 619 women, and the average age of onset was 28 years old. The classification by Barnett et al was used, presenting syringomyelia with Chiari malformation in 684 cases (51.2%), dysraphism in 47 (3.7%), post traumatic syringomyelia in 139 (11%), post-spinal arachnoiditis in 76 (6%), spinal cord tumor in 132 (10.5%) and others in 204. Its predominant clinical course was slowly progressive, but 202 cases (17.9%) showed rather stable course including spontaneous resolution in 29 cases. The main initial symptoms were numbness in 522 cases (42%), motor disturbance in 504 (40.5%), and pain in 296 (23.8%). Neurologic signs noted in the abnormality of deep tendon reflexes in 836 cases (67.3%), motor disturbance in 763 (60.4%) and positive pathological reflexes in 383 (30.1%). Sensory disturbance was found in 942 cases (75.8%) and the dissociated type were 559 out of them (59.3%). It is noteworthy that 982 out of 1,243 were documented by MRI and surgical operations such as foramen magnum decompression, syringo-subarachnoid shunt and others were performed in 829 cases. Syringobulbia was confirmed on MRI in 101 cases of syringomyelia in which spinal cord tumors were most frequently associated.
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PMID:[Epidemiology of syringomyelia in Japan--the nationwide survey]. 875 8

Dural arteriovenous fistula is an uncommon cause of myelopathy. The nidus of the malformation is on or within the dura and results in a mass of serpentine vessels on the dorsal surface of the spinal cord, usually at low thoracic or lumbar levels. Onset is usually between ages 40 and 70 years. Male to female ratio is 4:1. Symptoms include pain, progressive proximal weakness of lower limbs, saddle area numbness, claudication, and difficulty with urination. Course may be fluctuating or slowly progressive. Signs include upper and lower motor neuron abnormalities and nondermatomal sensory loss. Spinal bruit is rare. Magnetic resonance imaging may show an enlarged cord or abnormalities on its dorsal surface. Myelography (patient prone and supine) is the procedure of choice. Motor neuron disease, disc disease, spinal cord tumor, and multiple sclerosis are differential considerations. Untreated patients have a poor prognosis. Excision of the nidus, ligation of the draining vein, and endovascular embolization may be helpful even in patients with severe deficits.
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PMID:Dural arteriovenous fistula of the spinal cord: an uncommon cause of myelopathy. 887 54

A case of right trigeminal neurinoma extending from the cavernous sinus to the cerebellopontine angle in a 48-year-old male is reported. The patient first noticed right facial numbness in June 1993. Six months later, he experienced headaches with occasional nausea, diplopia, ataxic gait, tinnitus and dysphagia and was referred to our department on January 21, 1994. Neurological examination on admission showed multiple cranial nerve palsy from the 4th to 11th nerve on the right, and the cerebellar sign on the right. Initial CT and MRI revealed a large mass lesion extending from the right cavernous sinus to the right cerebellopontine angle. On February 16, 1994, radical resection of the tumor, except the lesion invading the cavernous sinus, was performed via a combined retroauricular and preauricular transpetrosal transtentorial approach. The histological diagnosis was neurinoma. The patient's postoperative course was uneventful and there was good clinical improvement, although the right facial numbness and mild diplopia persisted. On April 6, 1994, radiosurgery was performed with a maximum dose of 28 Gy and a marginal dose to 14 Gy to the remaining cavernous sinus lesion. Two weeks after radiosurgery, the patient achieved a complete return to his daily routine. Two-year follow-up CT and MRI showed a small residual les on in the right cavernous sinus alone. There was no evidence of tumor growth. No new neurological deficits had developed, and the patient's the double vision had resolved. Thus, the patient has been able to maintain a satisfactory level of activities of daily living. We wound like to emphasize the clinical value of the strategy used to treat this patient which combined microsurgery with subsequent radiosurgery.
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PMID:[Therapeutic effectiveness of combined microsurgery and radiosurgery in a patient with a huge trigeminal neurinoma]. 888 34

Cystic hemangioblastoma of the brain stem is an extremely rare clinical entity. Only eight cases have been reported in the literature. This is a report of a case of successful extirpation of a cystic hemangioblastoma of the medulla oblongata. A 47-year-old man was admitted to our clinic with the complaint of progressive numbness on his left upper limb since January 1995. Neurological examination revealed numbness and decreased vibration sensation on his left upper limb. MRI showed a cystic 1.5 x 2.0 cm lesion on the medulla oblongata, and with administration of Gd-DTPA, a small mass lesion on the dorsolateral side of the medulla oblongata. Left vertebral angiogram revealed a tumor fed directly from the left vertebral artery. An operation was performed using a suboccipital approach. The dorsal surface of the medulla was swollen edematously, suggesting the site of a cyst, which emptied by means of opening the wall. The reddish tumor was embedded on the left dorsolateral surface of the medulla oblongate. A total extirpation of the tumor was carried out under microscopic procedure. Histologically, the tumor was diagnosed as a hemangioblastoma. The patient was free from his distressing numbness immediately after the operation, and discharged without neurological deficit.
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PMID:[A case of cystic hemangioblastoma of the medulla oblongata]. 891 56

We report here a case of paraplegia following coeliac plexus block by anterior approach under direct vision. Laparotomy was performed in a 62-year-old male patient with pancreatic cancer. Coeliac plexus block was undertaken in order to control his back pain, since the tumor was unresectable. The patient complained of numbness and weakness of his legs 14 hours later. The consequence of neurological events was diagnosed as ischemic infarct of the spinal cord by myelo-CT and MRI. He died of pancreatic cancer without recovery of neurological disturbances 4 months after the surgery. As demonstrated in this case, even when coeliac plexus block was performed by open anterior approach under direct vision, paraplegia might be a possible complication due to the anatomical proximity of coeliac plexus to the Adamkiewicz's artery.
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PMID:[Paraplegia following coeliac plexus block by anterior approach under direct vision]. 893 21

A 42-year-old male presented with the complaint of mild left facial numbness. Magnetic resonance imaging demonstrated a solid tumor in the interpeduncular cistern and a huge arachnoid cyst in the left middle cranial fossa. The tumor appeared isointense to the surrounding cerebral gray matter on T1-weighted images and hyperintense to that on T2-weighted images. The tumor was partially resected. Histological findings were characteristic of hamartoma. The mild left facial numbness was probably due to compression of the left trigeminal nerve by the arachnoid cyst. Asymptomatic hypothalamic hamartomas may occur in adults with atypical clinical presentations.
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PMID:Asymptomatic hypothalamic hamartoma associated with an arachnoid cyst--case report. 893 95

Pancoast's syndrome is almost exclusively caused by a malignant apical lung tumor invading the structures of the thoracic outlet. We report a case of thoracic actinomycosis as a cause of Pancoast's syndrome. A 65 y/o bm presented with a 6 month history of nonproductive cough, weight loss, a left upper lobe infiltrate, and a positive PPD of 20 mm. He failed to improve with triple antituberculous therapy for 3 months with worsening of left upper lobe disease. CT scan of the chest showed a mass lesion of the left upper lobe. Bronchoscopy with BAL and biopsy as well as percutaneous fine needle aspiration failed to reveal a diagnosis. Patient developed Pancoast's syndrome characterized by reflex sympathetic dystrophy with pain, swelling, and numbness of left shoulder, arm, and hand. A thoracoscopic left upper lung biopsy was performed and histologic examination revealed sulfur granules containing filamentous organisms characteristic of Actinomyces species. All sections were negative for malignancy. AFB stain and culture were negative. Patient was clinically cured following a 6-month course of penicillin with resolution of the left upper lobe mass. Although rare, thoracic actinomycosis must be considered in the differential diagnosis of Pancoast's syndrome. This case emphasizes the importance of obtaining a precise etiologic diagnosis before a treatment decision is made.
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PMID:Pancoast's syndrome secondary to thoracic actinomycosis. 897 81

A 61-year-old female presented with an abducens nerve neurinoma manifesting as diplopia and facial numbness. The tumor was totally removed, and the exact origin was confirmed intraoperatively. Neuroradiological imaging and clinical history are frequently insufficient to obtain an accurate preoperative diagnosis of intracranial neurinoma.
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PMID:Abducens nerve neurinoma--case report. 905 46


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