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

A 58-year-old female presented with a rare case of intracranial solitary fibrous tumor (SFT) manifesting as progressive ataxic gait and hearing loss on the left persisting for 6 months with recent symptoms of increased intracranial pressure. Computed tomography demonstrated a large isodense irregular-shaped mass in the left posterior cranial fossa. T2-weighted magnetic resonance imaging showed two components appearing as very low intensity and high intensity. Extreme-lateral suboccipital craniotomy was performed. Gross total resection was achieved except for some dural attachment in the jugular foramen. All symptoms and signs subsided after surgery. Histological, immunohistochemical, and electron microscopic examinations led to a diagnosis of SFT. The strongly hypointense areas on the T2-weighted images were hypocellular region characterized by disorganized spindle cells and thick bands of collagen. The hyperintense areas on the T2-weighted images were hypercellular region mimicking hemangiopericytoma. Strong immunoreactivity for CD34 was also helpful in the diagnosis. Electron microscopy revealed absence of pinocytic vesicles and dense laminae which are characteristic of hemangiopericytoma. The magnetic resonance imaging appearance of SFT seems to be pathognomonic.
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PMID:Solitary fibrous tumor of the meninges in the posterior cranial fossa: magnetic resonance imaging and histological correlation--case report. 1097 68

A case of Lambert-Eaton myasthenic syndrome (LEMS) and subacute cerebellar degeneration (SCD) was associated with small-cell lung cancer (SCLC). The patient, a 52-year-old man, who had noticed impotence one year previously, began to have ataxic gait, scanning speech and thirst progressing for 3 months, followed by weakness of the lower limbs, bilateral blepharoptosis, and double vision. Electromyographic studies showed low amplitude of compound muscle action potential (CMAP) and waxing phenomenon in high frequency stimulation of the ulnar nerve. A chest x-ray showed a mass lesion in the left hilar region, and small cell lung cancer was diagnosed on the basis of biopsy specimens. Anti-voltage-gated calcium channel (VGCC) antibody was positive. Anti-Yo and anti-Hu antibodies were negative. The patient was treated by lobectomy and chemotherapy, which resulted in improvement in the LEMS and SCD. Anti-VGCC antibody, the CMAP amplitude, and waxing phenomenon were improved. Operable cases of SCLC are rare. But we propose that anti-neoplastic treatment including resection of the tumor is the first choice for the treatment of paraneoplastic syndrome associated with SCLC.
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PMID:[A Lambert-Faton myasthenic syndrome and subacute cerebellar degeneration with a favorable clinical course after resection of small-cell lung cancer]. 1129 68

Differentiation among various non Langerhans cell histiocytoses granulomatous in adults is often difficult. Patients, moreover, may not have endocrinologic abnormalities. A 53-yr-old patient was admitted owing to central diabetes insipidus and partial hypopituitarism. Magnetic resonance imaging revealed a space-occupying lesion near the hypophyseal stalk, along with diffuse signal uptake in the cerebellar region. Laboratory chemistry showed monoclonal gammopathy of IgGkappa, and hormone tests disclosed insufficiency in the gonadotropic and somatotropic axes. The clinical picture was marked by multiple cutaneous xanthogranulomas, ataxic gait with blurred speech, compatible with pseudobulbar pontocerebellar symptomatology. Stereotactic pituitary biopsy was histologically classified as nonspecific granulomatous disease. Supplemental biopsies taken from the cutaneous periorbital xanthogranulomas were histologically and immunohistochemically consistent with non Langerhans cell histiocytosis. Systemic cortisone treatment as well as local radiotherapy to the pituitary lesion with a total of 18.0 gy had no impact on the progression of disease-growing tumor and progressing neurologic symptoms. Systemic granulomatoses cannot always be classified according to specific defined diseases. Differential diagnosis in the current patient should include the possibility of Erdheim-Chester disease, necrobiotic xanthogranuloma, and adult disseminated xanthoma.
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PMID:Problems in differential diagnosis of non Langerhans cell histiocytosis with pituitary involvement: case report and review of literature. 1266 54

Ancient change in a schwannoma is a histological variant typically found in longstanding tumors. Histologically, the tumor has biphasic features typical of a schwannoma with evidence of degenerative changes that may complicate diagnosis. The authors report on a 23-year-old man with no features of neurofibromatosis who presented with headaches, blurred vision, and ataxic gait. Magnetic resonance imaging demonstrated a rim-enhancing lesion in the cerebellopontine angle with displacement of brainstem structures and no supratentorial hydrocephalus. Using a lateral suboccipital approach together with image guidance and intraoperative neurophysiological monitoring, a gross-total macroscopic excision was performed. At surgery, the tumor was found to arise from the inferior division of the trigeminal nerve. The final histological diagnosis was schwannoma with ancient change. Note that ancient change in schwannomas is a histological variant thought to result from degenerative changes in longstanding tumors. To the authors' knowledge, this is the first independent report of this histological variant in an intracranial schwannoma.
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PMID:Trigeminal nerve schwannoma with ancient change. Case report and review of the literature. 1602 82

A 50-year-old woman developed gait disturbance and hypersomnia over a period of a month. General physical examination revealed axillary lymph node swelling. On neurological examinations she was fully orientated but hypersomnic; short term memory disturbance, horizontal gaze evoked nystagmus and ataxic gait were observed. Electroencephalography disclosed a tendency for easily decreasing vigilance with delta activities but normal dominant rhythm. Cerebrospinal fluid examinations showed increased protein amounts (109 mg/dl) without either pleocytosis or atypical cells. An echogram of the breasts revealed a tiny mass in the left side. Pathological studies on a biopsied lymph node and the mass in her left breast showed a mammillary duct carcinoma. Brain MRI was normal, and no anti-neuronal antibody was detected in sera by two dimensional immunoblotting using human brain crude antigens. She was diagnosed as having paraneoplastic limbic encephalitis (PLE) associated with breast cancer. Over 42 hours polysomnography showed long total sleep time (TST) with a high ratio of sleep stage 1/TST and no REM sleep abnormalities; this resembled a thalamic-hypothalamic damaged sleep pattern. At first she was treated with plasma exchanges, but no improvement was observed. Hormonal and chemotherapies produced partial resolution of her neurologic symptoms and there were signs of reduction of the breast mass. Most reported PLE cases with hypersomnia have been associated with testicular cancer and anti-Ma antibodies. The present case is an extremely rare example manifesting hypersomnia without either testicular cancer or anti-Ma antibody. Since anti-tumor therapy successfully ameliorated her neurologic symptoms, cell-mediated immunity against a common tumor and neuronal antigens rather than hormonal immunity may have played a role in the development of her PLE.
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PMID:[A patient with paraneoplastic limbic encephalitis induced by breast cancer presenting with hypersomnia]. 1618 Jul 5

A 67-year-old male presented with a clear cell ependymoma with symptoms of ataxic gait and dizziness. Magnetic resonance imaging showed a ring enhanced and circumscribed mass lesion with some cysts in the left cerebellar hemisphere, and the vertebral artery angiogram showed the vascurality of the tumor fed by both the left posterior inferior cerebellar artery and the left superior cerebellar artery mainly. They demonstrated suspicious finding of metastatic tumor, glioblastoma, or cystic meningioma. Surgery via the left suboccipital approach revealed a whitish and solid tumor, which was demarcated from the cerebellar parenchyma and had no continuity with the 4th ventricle. Total resection of the tumor was successfully performed. The hematoxilyn-eosin staining of the surgical specimen was similar to hemangioblastoma or oligodendroglioma, however, immunohistochemical findings for glial fibrillary acidic protein, vimentin, epithelial membrane antigen, and factor VIII were compatible with clear cell ependymoma. The patient's postoperative course was uneventful, and his symptoms improved. Clear cell ependymoma is known as a variant of ependymoma, which is usually located at the foramen of Monro. We think that the immunohistochemical study is highly helpful for the diagnosis of the cerebellar tumor with atypical presentation such as our case.
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PMID:[Immunohistochemical study is helpful for the diagnosis of cerebellar clear cell ependymoma with atypical radiological findings--case report]. 1627 26

A 27-year-old female was admitted to our department due to gait disturbance and disorientation. Computed tomography (CT) scan revealed symmetrical ventricular dilatation. She was pregnant at 25 weeks of gestation. At the age of 16 years, she had received a ventriculo-peritoneal (VP) shunt for hydrocephalus, induced by a cerebellar medulloblastoma. Neurological examination at the current admission showed that she was disoriented with ataxic gait and convergence nystagmus. Analysis of the cerebrospinal fluid showed normal cell composition. Magnetic resonance images (MRI) and Thalium-single photon emission tomography (CI-SPECT) revealed no recurrence of the tumor. The radio-isotope shunt flow study showed there was no obstruction of the shunt tube or retardation of intraabdominal diffusion. The patient was diagnosed as having shunt malfunction without obstruction of the shunt tube. We performed pumping of a flushing device for the shunt system. As a result her symptom was gradually improved. The follow-up MRI, 20 days after the using, showed complete disappearance of hydrocephalus. She was discharged from our hospital 1 month later. She continued pumping of the flushing device by herself at home. Three months later, she delivered a healthy infant by vaginal labor. She has not need to do pumping after that. And MRI showed no sign of hydrocephalus.
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PMID:[Ventriculoperitoneal shunt malfunction due to pregnancy]. 1648 64

This report is a retrospective analysis of the surgical outcome of 15 patients (8 females, 7 males; mean age, 37.8 years) with residual or recurrent vestibular schwannomas operated on between 1987 and 2005. These 15 patients were part of a larger series of 252 consecutive vestibular schwannoma excisions. Tumors were classified as large (10) when their diameter exceeded 3.5 cm and giant (5) when their diameter exceeded 4.5 cm. All patients had previously undergone surgery. Hearing was lost in all cases, 8 had complete facial nerve palsy, 6 had trigeminal nerve deficits, 5 had cranial nerve IX and X palsy, and 10 had ataxic gait. Twelve patients had hydrocephalus. The tumors were reoperated through the retrosigmoid-transmeatal approach. The mean postoperative follow-up was 4.9 years. Complete resection was achieved in all patients. The facial nerve was preserved in 6 of the 7 patients with preoperative facial function. Transient worsening of bulbar cranial nerves palsy occurred in 2 cases. Cerebrospinal fluid leakage occurred in 3 patients. There were no deaths, and the tumors were histologically benign. Surgical removal is the only treatment for these lesions. Total resection associated with a low morbidity rate is possible. Preservation of the facial nerve is difficult due to severe scar tissue.
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PMID:Treatment of large and giant residual and recurrent vestibular schwannomas. 1776 40

We report a case of jugular foramen schwannoma associated with tuberous sclerosis. A 28-year-old female with tuberous sclerosis presented to Hikone Municipal Hospital with subacute onset of somnolence, ataxic gait and frequent vomiting. Her tuberous sclerosis was diagnosed at the age of 9, when she developed hydrocephalus caused by subependymal giant cell astrocytoma near the foramen of Monro, which was treated by surgical resection and VP shunt placement followed by radiation and chemotherapy. Brain MR images revealed a 3 cm enhancing mass extending from the left jugular foramen to the cerebellopontine cistern, accompanied by perifocal edema of the brain stem and cerebellar hemisphere. The tumor was partially removed via suboccipital craniotomy and histologically diagnosed as a schwannoma. After surgery her symptoms promptly improved and 4 months later she underwent additional stereotactic radiosurgery. No tumor regrowth has been observed at 94 months. Intracranial schwannoma complicating tuberous sclerosis is very rare. Only one other case has been reported in the literature.
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PMID:[Case of jugular foramen schwannoma associated with tuberous sclerosis]. 1796 37

A 65-year-old man presented with a rare case of cavernous malformation with hemorrhage located within vestibular schwannoma. He had suffered hearing impairment for 20 years, and was admitted to our hospital with vertigo and ataxic gait. Neurological examination revealed hearing loss, facial nerve paresis, and left cerebellar ataxia. Magnetic resonance imaging demonstrated a left vestibular schwannoma 35 mm in diameter, as well as a heterogeneous area associated with hypointense rim within the tumor, indicating intratumoral hemorrhage. Subtotal removal of the tumor together with the fibrously encapsulated hematoma was performed through a left retrosigmoid craniotomy. Histological examination of the surgical specimen revealed cavernous malformation within vestibular schwannoma. Immunohistochemistry for matrix metalloproteinase (MMP)-2 and -9, and tissue inhibitors of metalloproteinase-2 showed strong expression in the endothelial cells of the cavernous malformation, but not in the interstitial structures. His symptoms significantly improved after surgery and he underwent gamma-knife therapy for the residual tumor. Cavernous malformations may show dynamic characteristics such as repeated hemorrhage and de novo formation. MMP-2 and -9, which are implicated in angiogenesis and hemorrhage, may be upregulated in such tumors.
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PMID:Association of cavernous malformation within vestibular schwannoma: immunohistochemical analysis of matrix metalloproteinase-2 and -9. 1803 6


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