The Status of Central Nervous System Tumors in Daegu City and Kyungbook Province

The authors analized statistically 403 cases of C.N.S. tumors confirmed by pathology in the boundary of Daegu city and Kyungbook province from January 1984 to December 1986. The results were as follows: 1) The each cases of male and female were 220(54.6%) and 183(45.4%). 2) Intracranial tumors were 288 cases(71.5%), spinal tumors 75(18.6%), and others 40(9.9%). 3) Numbers of C.N.S. tumors were 8.7/100,000 population in city and 6.3/100,000 in country. 4) Among the intracranial tumors, glioma(30.9%) was the most common and followed by meningioma(16.3%) and metastatic tumor(8.7%). Among the spinal tumors, metastatic tumors was 34.6%, neurofibroma 30.7%, and meningioma 5.3%. 5) The majority of intracranial tumors were found in supratentorial region(76.3%), in which area frequency of tumor incidence were as follows; glioma, meningioma, metastatic tumor. Among the infratentorial area(22.6%), the sequence of tumor incidence were glioma, medulloblastoma, and neurilemmoma, 6) Tumors predominantly in male were oligodendroglioma(2:1), metastatic tumor(1.8:1), and medulloblastoma(1.7:1), and in female were meningioma(1:2), neurilemmoma(1:1.7), and pituitary tumor(1:1.5). 7) Peak age incidence of glioma, meningioma, and neurilemmoma were from 40 to 60 years, pituitary tumor and oligodendroglioma were 30 to 50 years, craniopharyngioma and ependymoma were around 10 years old, and metastatic tumor was 50 to 70 years old. 8) In the spinal tumors, the most favorable site of longitudinal axis was thoracic area(62.7%) and transverse location was epidural space(45.3%). 9) The most common site of metastatic tumor were came from lung(29.1%) in brain metastasis and prostate(19.2%) in spine.

A Case of Malignant Schwannoma in the Sacrum

Malignant schwannoma is a relatively rare malignant neoplasm arising from schwann cell of neuroectodermal origin that infiltrate locally and widely, and metastases. Inreaosseous bone involvement or retroperitoneal location of this tumor is extremely rare. A rare case of solitary malignant schwannoma which originated in the sacrum and extended to the retroperitoneal space in a 34 year-old male without neurofibromatosis reported. Simple X-ray showed not sclerotic, smooth marginated lytic defect in the right sacral bone. Computed tomography(CT) of sacrum revealed homogenous soft mass with intraosseous and dumbel shaped retroperitoneal extension without enhancement after were appeared in serial iliac artery angiogram. We could remove the tumor mass without specific technical difficulty with the help of CT and angiographic findings.

Diagnostic Value of Computed Tomography for Intracranial Suppuration

The authors report their experience with 22 cases of intracranial suppuration : 18 with brain abscess and four with subdural empyema. A small series of nine consecutive cases of intracranial suppuraion with one death is presented since Computed Tomographic brain scanning become a routine diagnostic procedure. These patient have been compared to 13 consecutive cases treated without benefit of CT analysis in order to determine the factors responsible for the recently improved prognosis. The mortality rate was 30.8% for al operated patients treated before availability of CT and 22.7% for the patient since advent of CT scan. Among the factors that may have contributed to the improved results for patients diagnosed with CT are : fewer patients with poor preperative clinical status, and a great incidence of total abscess removal. In addition, CT scanning provided more accurate diagnosis and localization of abscess and aided in the rapid detection of postoperative complication.

A Case of Large Chondroblastoma Occupying Middle Cranial Fossa

Chondroblastoma is a benign occurrence bone tumor arising most often in the epiphyses of long bone and its occurance in skull is rare. The authors recently encountered a case of large chondroblastoma occupying middle cranial fossa. The clinical presentation, reoentgenographic appearance, gross and microscopic characteristics, surgical treatment, differential diagnosis, and the rapeutic result are presented. A 27 year old male patient was admitted to the Department of Neurosurgery, Keimyung University Hospital because of progressive diffuse swelling in right temporal area of 4 months duration. In physical examination, nontender, firm, nonmovable diffuse mass in right temporal area and bean sized polypoid mass in the anterior and superior wall of the right external auditory canal were noted. Plain skull X-rays showed lytic defect in the right temporal squama, base of middle cranial fossa, sphenoid ridge, a part of petrous bone and anterior fossa with rather sharp, but not sclerotic margin. Brain CT scan showed a lentiform nonhomogeneous slight high density mass with scattered calcification in the entire middle cranial fossa, and the tumor enhanced slightly. Selective external carotid serial angiogram revealed complete obstruction of external carotid artery just behind the origin of lingual artery without tumor staining. Right temporal craniectomy was performed with nearly total curetting of tumor mass grossly. The histological diagnosis was chondroblastoma. The patient was discharged with good result.