Glioblastoma Multiforme with Subcutaneous Metastases, Case Report and Literature Review

Glioblastoma multiforme (GBM) is the most common primary brain tumor and the most malignant astrocytoma in adults, with rare extra-cranial metastases, especially for subcutaneous metastases. It could be easily misdiagnosed as primary subcutaneous tumor. In this report, we describe a patient with pontine GBM who developed a subcutaneous swelling at the ipsilateral posterior cervical region 8 months after operation, and the pathological and immunocytochemical examination carry the same characteristics as the primary intracranial GBM cells, which defined it as subcutaneous metastasis. GBM with subcutaneous metastasis is extremely rare, and knowledge of a prior intracranial GBM, pathological examinations and immunocytochemical tests with markers typically expressed by GBM are of vital importance for the diagnosis of GBM metastasis. Surgical resection of subcutaneous swelling, followed by chemotherapy and radiotherapy, could be the best strategy of treatment for the patients with GBM subcutaneous metastasis.

Abnormal expressions of Nav1.1 and Nav1.2 in hippocampus following traumatic brain injury in rats / 中华创伤杂志

Objective To investigate the mRNA and protein expressions of Nav 1.1 and Nav 1.2 in hippocampus following traumatic brain injury ( TBI) in rats.Methods After the lateral fluid percussion model was established in adult male Sprague Dawley rats,the rats were sacrificed at 2,12,24 and 72 hours after percussion and collected ipsilateral hippocampus for detecting mRNA and protein expressions of Nav 1.1 and Nav 1.2 by means of fluorescent quantitation RT-PCR,Western blot and immunofluo rescence staining.Results The mRNA expressions of Nav 1.1 and Nav 1.2 were significantly down-regulated (P<0.01) in hippocampus and reached the lowest level at 2 hours following TBI.The protein expression of Nav 1.1 was significantly down-regulated (P<0.01) but recovered near to level of control group at 72 hours after TBI.While there was no statistical difference on protein expression of Nav 1.2 in hippocampus after TBI compared with control group (P>0.05).Conclusion TBI induces significant down-regulated mRNA and protein expressions of Nav 1.1 in the hippocampus,which may be one of molecular mechanisms for functional alternation of sodium channels and excitotoxic action following TBI.

Preliminary investigation into clinical values of intravascular ultrasound in carotid artery narrowing of transient ischemia attack / 中华超声影像学杂志

ObjectiveTo investigate preliminary applic ation values of intravascular ultrasound(IVUS)in the carotid artery narrowing of transient ischemia attack (TIA) patients. MethodsIVUS has been used to 4 TIA patients with carotid artery narrowing identified by carotid artery echo, following carotid stenting and completion angiogram to detect evidence of inappropriate stent deployment. ResultsIVUS revealed the vessel wall structure, plaque morphology, measured accurately the narrowing degree of carotid artery. The narrowing percent identified by IVUS was larger than angiogram, and IVUS was more sensitive in detecting plaque than digital subtraction angiography(DSA). Four patients accepted stent deployment successfully.ConclusionsDSA underestimated the severity of the lesion. IVUS more accurately evaluates the extent and characteristics of the lesions than DSA, it is an important and useful component of carotid artery stent procedures.