Cases reported "Brain Stem Neoplasms"

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1/7. Histiocytic lesion mimicking intrinsic brainstem neoplasm. Case report.

    This 10-year-old girl presented with a 1-month history of progressive bulbar palsy and a solitary enhancing mass originating within the floor of the fourth ventricle. Results of initial imaging studies and presentation were suggestive of neoplasia. Subtotal resection was performed and pathological examination revealed the mass to be a histiocytic lesion, with no evidence of a glioma. The patient had no other stigmata of histiocytosis and was treated with steroid medications, resulting in prolonged resolution of the lesion. This case demonstrates that for discrete brainstem lesions the differential diagnosis includes entities other than glioma for which treatment is available. biopsy sampling should be considered when technically feasible.
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ranking = 1
keywords = neoplasm
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2/7. Sudden and unexpected infant death due to an hemangioendothelioma located in the medulla oblongata.

    Herein, we report the case of a 4-month-old male infant dying suddenly and unexpectedly. Post mortem examination was requested with clinical diagnosis of sudden infant death syndrome (SIDS). Histological examination showed instead the presence of an hemangioendothelioma located in the medulla oblongata. Sudden unexpected death is the commonest form of death among babies between 1 month and 1 year of age. Although the vast majority of these fatalities are related to SIDS, a very small percentage is due to primary neoplasm. Necroscopy studies of sudden infant death should always include an accurate histological examination of the medulla oblongata on serial sections but seldom do.
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ranking = 0.25
keywords = neoplasm
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3/7. A new homeopathic approach to neoplastic diseases: from cell destruction to carcinogen-induced apoptosis.

    Neoplastic diseases are now among the most commonly seen conditions. Orthodox, non-surgical approaches, including chemotherapy and radiotherapy, have variable results, but many adverse affects that limit their use. These are sometimes the direct cause of death. More patients are choosing alternative treatments, mainly the homeopathic and herbal-nutrition approach. homeopathy does not have highly effective remedies for cancer in its literature, and has been limited to palliating the adverse effects of chemo/radiotherapy. research into substances that can produce neoplastic diseases (carcinogens), may lead to them being used to treat the cancer they cause, according to the principle of similarity. I have used ultra-low doses (1 x 10(-10) to 10(-12) molar) of chemical carcinogens for 3-24 months, which have been given to cancer patients, usually in conjunction with conventional treatment. Using this procedure, complete remission or life extension has been achieved for some cancer cases. Three clinical cases are presented: a man with undifferentiated lung cancer; a child with an astrocytoma and a woman with leiomyosarcoma.
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ranking = 0.010611095735292
keywords = cancer
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4/7. MKM-guided resection of diffuse brainstem neoplasms.

    OBJECTIVES: Some primary brainstem tumors, when extensive, are considered inoperable. We wanted to assess the value of robotic image-guided microscopic surgery in the resection of these tumors and to improve survival and quality of life for these patients. methods: Two patients with extensive brainstem tumors were evaluated at our center. They previously underwent several biopsies, attempted partial resections, radiotherapy and shunting. They presented with progressive neurological deterioration, 'coma vigil' for several months, and required life-supporting measures prior to surgery. Both patients underwent frameless stereotactic craniotomy using a MKM robotic microscope, intraoperative neurophysiological monitoring, and extensive resection of their recurrent brainstem tumors. RESULTS: In the immediate weeks after surgery, both patients became interactive and regained major motor and cranial nerve deficits present prior to surgery. Nine months after surgery, 1 patient succumbed to pneumonia. At 2 years after the operation, 1 patient has maintained his neurological status and showed no recurrence on imaging studies. CONCLUSIONS: Image-guided surgery with an MKM microscope allows surgical outlines to be injected in the microscope viewer and facilitates resection of extensive brainstem tumors previously considered inoperable.
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ranking = 1
keywords = neoplasm
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5/7. Malignant glioma as a secondary malignant neoplasm after radiation therapy for craniopharyngioma: report of a case and review of reported cases.

    BACKGROUND: The development of a secondary neoplasm in childhood cancer survivors attains growing importance due to the reported excellent survival and therefore the long exposure to potentially carcinogenic effects of treatment. CASE REPORT: We report a 14-year-old girl in whom a large craniopharyngioma (CP) was diagnosed. After surgery, radiation therapy (RT) was given for residual tumour. Discrete progression necessitated further surgery, resulting in permanent tumour control. Soon after the second surgery hypothalamic-pituitary dysfunction developed together with obesity. Supportive hormone therapy was initiated. growth hormone (GH) therapy was also given for 15 months. Four years after the diagnosis, a cerebropontine anaplastic astrocytoma WHO grade III was detected, with the main lesion being at the dorsal edge of the irradiated area. The girl died 1 month later from this secondary presumably radiation-induced tumour. Only recently a second child with RT for a CP was diagnosed with malignant glioma in our hospital. case reports IN THE literature: 12 other cases of malignant glioma have been reported after RT for CP. Including our present cases, the mean latency period was 10.7 years (median 9.6 years). However, the shortest latency periods were found in patients who had received GH therapy. In numerous cases, the secondary tumour was seen at the edge of the irradiated volume, and not in the region with the highest absorbed dose. CONCLUSIONS: Therapy-induced secondary gliomas after treatment of CP or other intracranial tumours are rare but dramatic late events with a very poor prognosis. Including our own 2 patients, we reviewed 14 cases of CP with occurrence of a secondary, probably radiation-induced malignant glioma. The short latency periods for patients treated with GH is remarkable. We therefore suspect that GH therapy may accelerate the development of a secondary brain tumour. We are reluctant to recommend GH therapy in conventionally irradiated CP patients. In order to seriously answer the questions about therapy-induced secondary neoplasms, a life-long follow-up is mandatory for all patients who are survivors of childhood cancer.
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ranking = 13.236484124285
keywords = radiation-induced, neoplasm, cancer
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6/7. The causes of dysphagia in carcinoma of the lung.

    Dysphagia occurs in only a small percentage of patients with lung cancer, but the frequency of this cancer means that large numbers are affected. Non-quantitative analysis of a large Scottish series of lung cancer cases indicates the following eight broad categories of dysphagia according to underlying mechanisms: mediastinal disease; cervical lymphadenopathy; brainstem lesions; gastrointestinal tract metastases; associated systemic disorders; second primaries; oropharyngeal and oesophageal infections; and radiation-induced oesophageal toxicity.
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ranking = 5.8724865004366
keywords = radiation-induced, cancer
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7/7. Gamma knife radiosurgery for metastatic tumours in the brain stem.

    BACKGROUND: Stereotactic radiosurgery has become important in the treatment of metastatic brain tumours and is often the first choice modality for eloquent or deep locations such as the brain stem. This study evaluated the efficacy of gamma knife radiosurgery (GKS) for the treatment of brain stem metastases. methods: The medical records of 25 patients with 31 tumours, 11 men and 14 women aged 42 to 78 years (mean 57.1 years), who underwent GKS for metastatic tumours in the brain stem were retrospectively reviewed. The results of GKS were evaluated according to the change in tumour size on neuro-imaging. FINDINGS: The most common location of the primary malignancy was the lung followed by the breast. adenocarcinoma was found in 19 patients (24 lesions). No case of squamous cell carcinoma was found. The mean calculated tumour volume was 2.1 cm(3) and the mean prescription dose to the tumour margin was 13.0 Gy. Mean duration of neuro-imaging follow up was 5.2 months and the overall tumour control rate was 77.4%. There was a significant correlation between the marginal dose delivered and the effect on neuro-imaging. New radiation-induced injury in the surrounding brain occurred in only 2 patients. INTERPRETATION: GKS for brain stem metastases using a marginal dose of 15 Gy or less is effective and relatively safe. Accurate targeting of the tumour and safe dose planning are essential to obtain satisfactory results with GKS for brain stem metastases.
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ranking = 5.8661198429954
keywords = radiation-induced
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