RESUMO
Objetivo: El presente artículo describe las características clínicas e imagenológicas de seis pacientes en edad pediátrica con diagnóstico de tumor cerebral atendidos en dos instituciones privadas de Lima durante la pandemia del COVID-19. Material y métodos: Estudio descriptivo de casos de tumor cerebral en pacientes menores de 18 años, atendidos en dos clínicas privadas de Lima, desde marzo 2020 a diciembre 2021. Resultados: Seis casos consecutivos de tumores intracraneales fueron detectados durante la mayor parte del primer año de la pandemia COVID-19 (periodo de octubre del 2020 a marzo del 2021), todos ellos con el diagnóstico de sarcoma intracraneal primario. Antes de la pandemia, el último sarcoma intracraneal primario en niños operado en las instituciones mencionadas ocurrió en junio del 2018 y fue el único caso de este tipo de tumor en el año. Conclusiones: Durante la pandemia de COVID-19, se encontró una inusual frecuencia de sarcoma intracraneal primario en niños en dos instituciones privadas de Lima.
SUMMARY Objective: The article describes the clinical and neuroimaging characteristics of six children with the diagnosis of brain tumor attended in two private institutions from Lima, during the COVID-19 pandemic. Material and methods: Descriptive study of cases of brain tumor in patients aged 18 and younger, followed at two private institutions in in Lima, from March 2020 to December 2021. Results: Six consecutive cases of intracranial tumors were detected during a large part of the COVID-19 pandemic's first year (October 2020 to March 2021), all of them with diagnosis of primary intracranial sarcoma. Before the pandemic, the last primary intracranial sarcoma in children, operated in the mentioned institutions, occurred in June 2018 and was the only case that year. Conclusions: During the COVID-19 pandemic, an unusual frequency of primary intracranial sarcoma in children was found in two private institutions from Lima.
Assuntos
Humanos , Criança , Pediatria , Sarcoma , Neoplasias Encefálicas , Relatos de Casos , Sistema Nervoso Central , Pacientes , COVID-19RESUMO
La Enfermedad de Rosai-Dorfman es un trastorno infrecuente y de etiología desconocida. La presentación intracraneal es aún más rara y suele imitar la apariencia de un meningioma en las imágenes del encéfalo. Se presenta el caso de un paciente varón de 38 años que ingresa por una tumoración intracraneal, extra-axial y supratentorial asociada a déficit neurológico leve; con diagnóstico presuntivo de meningioma de la convexidad. Después de la intervención quirúrgica, el diagnóstico histológico definitivo fue de Enfermedad de Rosai-Dorfman intracraneal. Se debe considerar la Enfermedad de Rosai-Dorfman intracraneal dentro del diagnóstico diferencial de una lesión intracraneal extra-axial sugestiva de un meningioma debido a la similitud en las neuroimágenes y la presentación clínica entre ambas patologías.
Rosai-Dorfman disease is an infrequent condition with no known etiology. The intracranial presentation is even rarer, and it resembles the appearance of a meningioma in image studies. We present the case of a 38-year-old male patient who was admitted because of an extra-axial supratentorial cranial tumor, associated to mild neurological deficit. The presumptive diagnosis was convexity meningioma. After surgery, the definitive histologic diagnosis was intracranial Rosai-Dorfman disease. This condition should be considered in the differential diagnosis of an extra-axial intracranial lesion suggesting meningioma, because of similar neuroimaging results and the similar clinical picture.
RESUMO
Los procedimientos de revascularización cerebral se utilizan en el manejo quirúrgico de aneurismas en los que hay gran riesgo de generar isquemia al intentar el tratamiento quirúrgico o endovascular. Además se usan en el tratamiento de tumores de base craneal que engloban e infiltran la pared de la arteria carótida interna o sus ramas principales, en la enfermedad oclusiva vascular con riesgo de producir infarto de tipo hemodinámico y en la enfermedad de moyamoya.
Cerebral revascularization procedures are used in the surgical management of cerebral aneurysms in which there is agreat risk of generating ischemia, in the attempt for surgical or endovascular treatment. Besides this, these procedures are utilized en the treatment of cranial base tumors that encase and infiltrate the trunk of the internal carotid artery orits main branches, in the vascular occlusive disease with risk of producing hemodynamic type stroke and, in the moyamoya disease. These techniques have the aim of restoring the blood supply of the brain and with it, the nutrient loading in order to avoid ischemia in territories already affected or in risk. To obtain an effective revascularization, with good clinical outcome , the patient should be chosen adequately with cerebral blood flow studies and vascular reserve, to perform a meticulous technique and the correct graft should be elected.
Assuntos
Humanos , Anastomose Cirúrgica , Aneurisma Intracraniano/cirurgia , Aneurisma Intracraniano/terapia , Oclusão com Balão , Revascularização Cerebral , Revascularização CerebralRESUMO
A 30-yr-old woman was admitted with acute headache, right hypesthesia and hemiparesis, right quadrantanoptic defect and neck stiffness. CT imaging study revealed left temporal hematoma and angio CT and cerebral digital angiography revealed and aneurysm of the left posterior cerebral artery. The patient was treated surgically. Surprisingly the clot was very firm and consistent with a mixture of tumor tissue and blood debris and in the pathological examination turned to be a glioblastoma multiforme. The aneurysm was clipped. The partner gradually improved and was treated with linear accelerator radiotherapy. This rare case is consistent with the association of malignant tumor with an aneurysm of neoplasm type.