ABSTRACT
We report two cases of posterior third ventricular choroid plexus papilloma, one in an 8-month-old infant and another in a two-year-old child. These cases presented with features of obstructive hydrocephalus. Both these patients underwent a ventriculo-peritoneal (VP) shunt surgery prior to the tumor excision. Following the VP shunt surgery both patients developed ascitis requiring exteriorization of the abdominal end of the shunt. There was a clear proof of CSF overproduction: 1400-1500 ml/day in the eight-month-old infant and 900-1200 ml/day in the two-year-old child. In the former it was transient and could be treated with revision of the VP shunt whereas in the second case a ventriculo-arterial shunt had to be done. In the second case a staged reduction cranioplasty was also performed for an enormously enlarged head (head circumference--74 cm). Interesting clinical and radiological findings and useful management strategies are described.
Subject(s)
Cerebral Ventricle Neoplasms/complications , Child, Preschool , Female , Humans , Hydrocephalus/etiology , Infant , Male , Papilloma, Choroid Plexus/complications , Third Ventricle , Ventriculoperitoneal ShuntABSTRACT
O neurocitoma central foi descrito pela primeira vez na literatura em 1982 por Hassoun e colaboradores como tumor bem diferenciado de origem neuronal. O tumor geralmente localiza-se no sistema ventricular, afetando adultos jovens e geralmente cursando com hipertensão intracraniana secundária à hidrocefalia obstrutiva. O diagnóstico diferencial com outros processos intraventriculares como oligodendroglioma é realizado através de métodos imuno-histoquímicos. Raros casos de neurocitoma central associados com hemorragia têm sido descritos na literatura. Descrevemos um caso de neurocitoma central de uma paciente de 35 anos com apresentação atípica. A paciente havia procurado o hospital com quadro súbito de cefaléia, vômitos e rigidez de nuca, sugerindo a presença de hemorragia subaracnóidea. A ressonância magnética demonstrou volumosa massa no ventrículo lateral direito cujos perfis histológico e imuno-histoquímico eram condizentes com neurocitoma central, a ressecção cirúrgica foi realizada com sucesso, embora a paciente tenha evoluído para um quadro de ventriculite no pós-operatório. Salientamos a importância do estabelecimento do neurocitoma central como diagnóstico diferencial de pacientes com hemorragia intraventricular e discutimos as opções de tratamento para este tumor incomum.
Subject(s)
Humans , Female , Adult , Cerebral Hemorrhage/diagnosis , Cerebral Ventricle Neoplasms/diagnosis , Cerebral Ventricles , Neurocytoma/diagnosis , Cerebral Hemorrhage/etiology , Cerebral Ventricle Neoplasms/complications , Cerebral Ventricle Neoplasms/surgery , Diagnosis, Differential , Hydrocephalus/diagnosis , Hydrocephalus/etiology , Hydrocephalus/surgery , Neurocytoma/complications , Neurocytoma/surgeryABSTRACT
O caso de um menino com esclerose tuberosa, apresentando o quadro clínico típico e que morreu com hemorragia intratumoral maciça, é estudado. A autópsia parcial de crânio revelou hemorragia cerebral maciça à esquerda, no interior da qual se identificou um tumor que, à microscopia, mostrou se tratar de astrocitoma subependimário de celulas gigantes. Este é o segundo caso, na literatura, no qual um paciente com esclerose tuberosa morre de hemorragia maciça intratumoral, com inundaçäo ventricular
Subject(s)
Humans , Male , Adolescent , Astrocytoma/complications , Cerebral Hemorrhage/etiology , Cerebral Ventricle Neoplasms/complications , Scalp Dermatoses/complications , Tuberous Sclerosis/complications , Astrocytoma/pathology , Cerebral Hemorrhage/pathology , Cerebral Ventricle Neoplasms/pathology , Electroencephalography , Follow-Up Studies , Scalp Dermatoses/pathology , Tomography, X-Ray Computed , Tuberous Sclerosis/pathologyABSTRACT
We report a case of tuberous sclerosis in an 8 year old girl presenting for the first time with features of raised intracranial pressure due to a large intraventricular tumour. Occurrence of these tumours in children with tuberous sclerosis justifies cranial computerised tomography as a screening procedure to detect these tumours early.