ABSTRACT
We report a case of multiple cerebral infarcts, which developed after intra-arterial(IA) carboplatin therapy in a patient with glioblastoma who had received surgery with conventional and intraoperative radiation therapy (IORT). A 31-year-old male patient presented with one-month history of worsening headaches and visual dimness. Seven years previously, he had been subjected to a subtotal resection of anaplastic astrocytoma in the right occipital lobe, followed by external radiation therapy with a total dose of 5580cGy. Carboplatin was given at an initial dose of 300mg/m2. Before and after the infusion of carboplatin, solumedrol(500mg/day) was given for seven days, with the dosage being gradually reduced over the next five days. In addition, 20% mannitol(100ml) was infused over a 15-minute period before chemotherapy, and the fluid volume of electrolyte was adjusted to maintain an optimal urine output. The patient underwent five cycles of IA carboplatin therapy. Careful attention should be given during IA carboplatin chemotherapy to patients who are also being treated with IORT.
Subject(s)
Adult , Humans , Male , Astrocytoma , Carboplatin , Drug Therapy , Glioblastoma , Headache , Occipital LobeABSTRACT
The authors present a statistical survey of the general incidence, age distribution, and preferential site of 631 tumors of the brain which have been surgically treated at Korea university medical center, department of neurosurgery over the last period of 10 years from 1985 to 1994. Among them 269 cases were males and 362 were females. Of the 631 intracranial neoplasms verified histologically, tumors of neuroepithelial tissue comprised 34%(212 cases), tumors of meninges 23%(148 cases), pituitary adenoma 18%(114 cases), metastatic tumors 8%(50 cases), neurilemmomas 8%(49 cases), germ cell tumors 3%(13 cases), cyst and tumor like lesions 3%(16 cases), and lymphomas 1%(5 cases). Of the 178 gliomas, astrocytic tumors comprised 83%(148 cases), oligodendroglial tumors 11%(20 cases), ependymal tumors 3%(6 cases) and mixed gliomas 1.7%(3 cases). Brain tumors occurred most frequently in the age group of 45-50 years, as seen by an incidence of 63 cases(10%). The male to female ratio was 0.74: 1. Tumors that showed a definitive preponderance of females over males were meningiomas, neurilemmomas, and pituitary adenomas. Supratentoral and infratenorial cases were 73%(461 cases) and 26%(162 cases), respectively and the remaining cases involved both sites. Of the 114 cases of childhood and adolescent tumors, 60 were male and 54 were female. Supratentorial tumors were 56% and infratentorial were 44%. The tumors in order of frequency were astrocytomas(28%), primitive neuroectodermal tumors(21%), craniopharyngioma(10%) and so on. Meningiomas occurred most frequently in parasagittal/falx area(25%), followed by cerebral convexity 23%, sphenoid 14%, posterior fossa 13%. Among pituitary adenomas, prolactinomas(32%) were the most common and followed by null cell adenomas 31%, growth hormone cell adenomas 15%, mixed GH-PRL cell adenomas 11%.
Subject(s)
Adolescent , Female , Humans , Male , Academic Medical Centers , Adenoma , Age Distribution , Astrocytoma , Brain Neoplasms , Brain , Glioma , Growth Hormone , Incidence , Korea , Lymphocytes, Null , Lymphoma , Meninges , Meningioma , Neoplasms, Germ Cell and Embryonal , Neural Plate , Neurilemmoma , Neurosurgery , Pituitary Neoplasms , Supratentorial NeoplasmsABSTRACT
Neuroendocrine tumors are heterogeneous and potentially aggressive, and they must be distinguished from classic carcinoid tumors as the tumors share histologic features with their counterparts that occur in the lung, such as oat cell and intermediate cell carcinomas. Histopathologically, the oat cell neuroendocrine carcinoma displays itself in sheets, cord and rib-bons of small hyperchromatic, undifferentiated cells with very scanty cytoplasm. The intermediate cell is slightly larger than the oat cell and has more abundant cytoplasm. The authors report a case of a 52-year old patient with neuroendocrine carcinoma that occurred at the anterior cranial fossa extending into the nasal cavity. The patient presented with recurrent meningitis and seizure. Histological examination of the nasal biopsy tumor specimen confirmed neuroendocrine carcinoma, afterwhich the patient treated with a 4300 rad radiation therapy. Magnetic resonance imaging taken 2 years later showed an enlargement of the tumor mass at the anterior cranial fossa, and the patient was operated for removal of the intracranial tumor. The nasal cavity defect was reconstructed using rotation galeal flap technique.