| A case of leptomeningeal metastasis from lung adenocarcinoma is reported. In this case, we evaluated the feasibility of reverse transcriptased polymerase chain reaction (RT-PCR) methods to detect cancer cells in cerebrospinal fluids (CSF). Messenger rna of carcinoembryonic antigen (CEA) was clearly demonstrated in CSF by reverse RT-PCR methods. An immunohistochemical study also demonstrated that tumor cells were stained positive with anti-CEA antibody. This case suggests that RT-PCR for CEA was a sensitive and useful method to diagnose leptomeningeal metastasis from lung adenocarcinoma. ( info) |
2/2429. Intracranial Castleman's disease of solitary form. Case report. This 62-year-old woman presented with clumsiness in her right hand. magnetic resonance imaging demonstrated a small lesion mimicking a meningioma, which had arisen from the tentorium and contained notable edema. Full recovery was achieved by total removal of the lesion, which was diagnosed as a lymphoid mass resembling giant lymph node hyperplasia on histological examination. The lack of notable findings on whole-body and laboratory studies was compatible with a rare case of intracranial Castleman's disease of solitary form. The authors document clinical, neuroradiological, and pathological features of this rare disease. ( info) |
| amyotrophic lateral sclerosis (ALS) is a progressive, degenerative disease of the nervous system. It affects adults in all age groups and leads to death few years after the diagnosis. The etiology is unknown, and there no convincing medical or surgical therapy Some diseases can mimic ALS. If diagnosed early these may be treatable, but if misdiagnosed as ALS and left untreated they may be fatal. We present a case of foramen magnum meningioma presenting clinically as ALS. After surgery, the symptoms disappeared and the neurological deficits improved. ( info) |
4/2429. Ectopic dural osteolytic meningiomas. Intracranial meningiomas usually originate from the arachnoidal cells of the internal dural layer: meningiomas that originate from different sites are ectopic. The authors describe the case of a small meningioma adhering to the external dural layer without involvement of the internal layer, accompanied by osteolysis of the internal surface of the skull. A review of the literature on cranial ectopic meningiomas yielded only four cases described as originating from the external dural layer. osteolysis of the skull was always present and was not found to have prognostic significance. The authors suggest that these four primary ectopic meningiomas originating from the external dural layer should be differentiated from intraosseous meningiomas of the skull. ( info) |
5/2429. Meningeal chondrosarcomas, a review of 31 patients. We reviewed the literature to study the clinical features, the management and the outcome of meningeal chondrosarcomas. We included 31 patients in this review: 22 were mesenchymal and nine were non-mesenchymal. The mean age was 27 years and 64% arose from the cranial meninges. The treatment was mainly total surgical excision. Adjuvant therapy was given to 36% of patients. Spinal meningeal chondrosarcomas had a better prognosis (81% 1-year survival and 45% 3-year survival). There were no pathognomonic clinical or radiological features. We concluded that the best management of meningeal chondrosarcomas is total surgical excision whenever possible, followed by combined course of radiotherapy and chemotherapy as soon as possible. ( info) |
6/2429. aneurysm occurring within a meningioma: case report. Aneurysms can be expected to be found in approximately 0.5% of patients with brain tumours; nevertheless, the real incidence is difficult to assess because angiography is now seldom performed for brain tumours. In the literature, 42 cases of meningioma associated with aneurysms are reported, but in none was the aneurysm intratumoural. We describe a case of intracranial meningioma with an intratumoural aneurysm in a 48-year-old woman. ( info) |
| BACKGROUND: Total microsurgical resection is the procedure of choice for growing and symptomatic foramen magnum meningiomas. We hypothesized that for patients with advanced age, complicating medical conditions, or residual or recurrent meningiomas at the foramen magnum, stereotactic radiosurgery would be a useful adjunctive (n = 2) or alternative (n = 3) treatment. methods: We report our experience in five elderly patients (73-84 years) who underwent gamma knife radiosurgery. The median tumor volume was 10.5 ml and the tumor margin dose varied from 10 to 16 Gy. Because of the irregular tumor volumes along the inferior clivus, multiple isocenters of irradiation were required (range, 2-8; mean 4.4). RESULTS: During the follow-up interval of 1-5 years (median, 3 years), one patient died of an intercurrent illness, and all remaining patients were stable without any further deterioration in their clinical condition. Follow-up imaging studies revealed a reduction in tumor volume in one patient and no further growth in the remaining four. CONCLUSION: We believe that stereotactic radiosurgery provides safe and effective management for patients who are poor candidates for resection of their foramen magnum meningiomas. ( info) |
| BACKGROUND: The incidence of multiple skull base meningiomas varies from 1 to 3% in different series. skull base meningiomas are rare. The pathogenetic role of low-dose radiation seems to be fairly well established in the oncogenesis of meningiomas. Calvarial location and multiplicity seem to be among the distinctive features of radiation-induced meningiomas. skull base location is a very rare occurrence, mainly because the path of irradiation does not significantly involve this region. CASE REPORT: We describe a rare case of simultaneous occurrence of two skull base meningiomas in a 66-year-old female. This patient underwent low-dose irradiation for tinea capitis when she was 8 years old. The patient complained of nuchal pain, paresthesias in both hands, and progressive weakness on her right side. She was admitted to the hospital in September 1994. An MRI showed two masses, one located at the level of the tuberculum sellae and the other at the foramen magnum. These seemed very likely to be multiple meningiomas. The latter lesion, which was more symptomatic and dangerous, was operated on first. Six months later, elective treatment of the suprasellar meningioma was performed with success. CONCLUSION: The actual role of previous head irradiation in the oncogenesis of the present meningiomas remains somewhat unclear. Proper management and judicious use of skull base surgery techniques were key factors in the successful treatment of the patient. ( info) |
9/2429. Clear cell meningioma of the lumbo-sacral spine with chordoid features. Clear cell meningioma (CCM) is a peculiar variant that differs from conventional meningioma in affecting younger patients, arising more often in spinal or cerebellopontine locations, and showing a higher recurrence rate. Classical meningothelial areas are scarce in these tumors and the differential diagnosis with other neoplasms, particularly metastatic carcinoma, is often difficult. We report a case of clear cell meningioma from the lumbosacral spine in which location, radiologic presentation, light microscopic appearance in initial sampling, and some of the ultrastructural findings were reminiscent of chordoma. The tumor cells were diffusely positive for vimentin and very focally positive for epithelial membrane antigen. Ultrastructural demonstration of interdigitating cell processes joined by numerous desmosomes confirmed the diagnosis of CCM. ( info) |
| We describe four patients infected with the human immunodeficiency virus (hiv) who had development of meningiomas. In contrast to those in the general population who have meningiomas, all our patients were young men; the mean age was 40 years (range, 32 to 50). Their risk behavior for hiv was homosexuality (three patients) and intravenous drug use (one patient). The CD4 cell count in each of the three homosexual men was less than 50/microL and was 280/microL in the drug user. Imaging studies showed enhancing lesions in three of the patients. Although each of these meningiomas could have occurred in otherwise normal young to middle-aged men, we speculate that the meningiomas may have grown in these hiv-infected hosts because of either loss of immune function or dysregulation of cytokines. ( info) |