1/124. akinetic mutism after fourth ventricle choroid plexus papilloma: treatment with a dopamine agonist.BACKGROUND: akinetic mutism is a behavioral state wherein a patient seems to be awake but does not move or speak. Several patients are reported to have developed mutism after posterior fossa surgery. We present a patient who developed akinetic mutism after total excision of a choroid plexus papilloma of the fourth ventricle, and who was treated with bromocriptine. CASE DESCRIPTION: An 18-year-old woman was admitted with akinetic mutism, which had developed 6 days after posterior fossa surgery. She had had no neurologic deficit in the first 5 days after surgery and could communicate with her family. Despite antioedematous therapy and daily lumbar punctures to drain cerebrospinal fluid, there was no clinical improvement after she entered the akinetic mute state. Brain magnetic resonance revealed ventriculomegaly; brain single photon emission computed tomography revealed bilateral reduction of perfusion in the frontal region. Because daily lumbar drainage did not result in clinical improvement, shunt placement was not considered. bromocriptine therapy was begun at a dose of 2x2.5 mg; 24 hours later, the patient started to speak and move her upper extremities. Further improvement occurred over the following week when the dose was increased to 3x2.5 mg. bromocriptine was replaced with a placebo to determine whether the neurologic improvement was caused by the medicine. The patient's neurologic status deteriorated progressively; therefore, bromocriptine was restarted and she was discharged from the hospital. During the 6 months of follow-up, the patient has remained in good health. CONCLUSIONS: The etiology of akinetic mutism is not clear. Monoaminergic pathways, particularly dopaminergic cell groups, are most probably involved in this syndrome, because bromocriptine has a dramatic effect on these patients, as demonstrated in our case.- - - - - - - - - - ranking = 1keywords = choroid plexus, choroid, plexus (Clic here for more details about this article) |
2/124. choroid plexus papilloma. I. Proof of cerebrospinal fluid overproduction.Utilizing a ventricular perfusion technique, the rate of CSF formation was determined in a 2-year-old child before and after removal of a 74 g choroid plexus papilloma from the left lateral ventricle. Preoperatively, the CSF formation rate was 1.05 /- SD 0.01 ml/min (1,656 ml/day). Postoperatively, the CSF formation rate was reduced fivefold to 0.20 /- SD 0.01 ml/min (288 ml/day). Whereas these data are regarded as conclusive evidence of CSF overproduction by a choroid plexus papilloma, the pathogenesis of generalized ventricular enlargement in this case was due to part to obstruction of the subarachnoid pathways.- - - - - - - - - - ranking = 0.41111196664344keywords = choroid plexus, choroid, plexus (Clic here for more details about this article) |
3/124. choroid plexus papilloma of cerebellopontine angle with extension to foramen magnum.A case of choroid plexus papilloma resembling meningioma of cerebellopontine (CP) angle with its extension to foramen magnum is presented. Occurrence of this tumour in CP angle is very rare. Its extension towards foramen magnum is further rare. It was a real diagnostic enigma preoperatively as the tumour was resembling meningioma upto some extent on radiological study. Retromastoid craniectomy with microsurgical excision of tumour and its extension was achieved in toto. Tumour was attached to few rootlets of lower cranial nerves which were preserved. Attachment of the tumour with lower cranial nerves again caused diagnostic confusion with neurofibroma intraoperatively.- - - - - - - - - - ranking = 0.21111196664344keywords = choroid plexus, choroid, plexus (Clic here for more details about this article) |
4/124. Endoscopically assisted anterior cranial skull base resection of sinonasal tumors.The traditional approach to sinonasal tumors involving the base of skull has been the anterior craniofacial resection. Endoscopic techniques have created the potential to approach the intranasal aspect of skull base lesions without external incisions and still develop an en bloc resection when removed. We report our initial experience with skull base neoplasms in which the otolaryngic portion of the standard resection was accomplished instead through an endoscopic approach. The nature of lesions favorable for this approach and associated technical issues are discussed. Although we do not consider this approach a replacement for the traditional anterior craniofacial resection, it is an important adjunct in the skull base surgeon's armamentarium.- - - - - - - - - - ranking = 3.3567507725368E-5keywords = neoplasm (Clic here for more details about this article) |
5/124. Recurrent lacrimal sac papilloma: case report.Tumors of the lacrimal sac are rare. Benign papillomas comprise approximately 40% of all neoplasms of the lacrimal drainage system. They often present insidiously with symptoms of dacryostenosis or dacryocystitis. Recurrent bouts of dacryocystitis and nasolacrimal duct obstruction were reported in a 35-year-old man over a period of 13 years. A medial canthal mass was noted in the 6th year after the onset of symptoms. A tumor was discovered incidentally during surgical intervention for presumed dacryostenosis. Surgical removal of the tumor and dacryocystorhinostomy were performed. The histopathologic report turned out to be benign papiloma. Local recurrences occurred during the follow-up period. In addition to surgical excision, we applied cryotherapy and CO2 laser to prevent further recurrence. This case we presented the characteristic recurrence of lacrimal sac papilloma and implied the possibility of tumor occurrence in a patient with recurrent dacryocystitis. We must bear in mind that a recurrent dacryocystitis may be a presentation of a lacrimal sac tumor, because early diagnosis and aggressive treatment can prevent recurrence and result in a cure.- - - - - - - - - - ranking = 3.3567507725368E-5keywords = neoplasm (Clic here for more details about this article) |
6/124. Primary choroid plexus papilloma of the cerebellopontine angle presenting as brain stem tumor in child.A case of a primary choroid plexus papilloma of the cerebellopontine angle in an 8-year-old female is presented. The clinical features of progressive cranial nerve palsies and cerebellar signs in the absence of intracranial hypertension initially suggested an intrinsic brain stem lesion. Whereas a radionuclide brain scan demonstrated abnormal uptake in the region of the pons, vertebral angiography and pneumoencephalography were diagnostic of an angle mass. At surgery, the tumor proved to be a choroid plexus papilloma that was totally confined to the cerebellopontine angle. This patient represents the thirteenth reported case of a primary cerebellopontine angle papilloma and the first such case occurring in a child.- - - - - - - - - - ranking = 1.2keywords = choroid plexus, choroid, plexus (Clic here for more details about this article) |
7/124. choroid plexus papilloma with osseous and adipose metaplasia.Rare cases of osseous and chondroid metaplasia in choroid plexus papillomas have been described. We report a case of left lateral ventricular choroid plexus papilloma presenting in a 25-year-old man. The tumor demonstrates prominent calcification with associated osseous metaplasia and a region of adipose metaplasia, which has not been previously described in these tumors. There is no evidence of mucin in the papilloma on mucicarmine and alcian blue stains. A MIB-1 labeling index (marker of cell proliferation) of 0.1% was noted. P53 immunoreactivity was not observed in the papilloma. Ann Diagn Pathol 5:43-47, 2001.- - - - - - - - - - ranking = 0.41111196664344keywords = choroid plexus, choroid, plexus (Clic here for more details about this article) |
8/124. Evidence of therapeutic efficacy of CCNU in recurrent choroid plexus papilloma.A pregnant 33-year old woman developed nystagmus and cerebellar ataxia. A tumor in the roof of the fourth ventricle was diagnosed. The tumor was subtotally removed using microneurosurgical techniques. The histopathological diagnosis was choroid plexus papilloma (CPP). Twenty-one months later, the tumor recurred and was reoperated. Histologically the tumor displayed now increased mitotic activity and pleomorphism. radiation therapy of the neuroaxis was performed. Within 59 months, the CPP recurred 3 more times with neuroradiological evidence of extensive spinal seeding. After several palliative irradiations, including 2 gamma-knife boosts, the patient was referred to chemotherapy. She was treated with CCNU (Lomustin) 100 mg/m2 orally (12 cycles, cumulative dosis 1440 mg/m2). Within 42 months, there was no new local recurrence and spinal seeding showed significant regression. Clinically the patient improved and stabilized, but needs continuous support because of persisting severe gait ataxia. The course of disease in our patient provides evidence for therapeutic efficacy of CCNU in recurrent CPP.- - - - - - - - - - ranking = 1keywords = choroid plexus, choroid, plexus (Clic here for more details about this article) |
9/124. choroid plexus papilloma diagnosed by crush cytology.In a 32-yr-old man, an infratentorial cystic lesion with a mural nodule was interpreted to be either a hemangioblastoma or a cystic astrocytoma on CT scan. Intraoperative crush cytology revealed it to be a choroid plexus papilloma (CPP). The utility of crush cytology in the rapid diagnosis of central nervous system (CNS) tumors and the differential diagnosis of CNS papillary lesions are highlighted in this report.- - - - - - - - - - ranking = 0.21111196664344keywords = choroid plexus, choroid, plexus (Clic here for more details about this article) |
10/124. biliary tract papillomatosis.Papillomatosis of the biliary tract is characterised by multicentric papillary lesions of intra and extrahepatic biliary epithelium. It's a rare benign neoplasm of the biliary tract that causes obstructive jaundice with a high rate of malignant transformation. We described a case of papillomatosis of the biliary tract in a woman of 75-years-old, who came to our observation with jaundice, pruritus and fever. The surgical treatment consisted of cholecystectomy, choledochotomy and positioning a definitive T-Tube. We described our experience and the evolution of this disease.- - - - - - - - - - ranking = 3.3567507725368E-5keywords = neoplasm (Clic here for more details about this article) |
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