Falx chondroma with hyperostosis of the scull: a case report.

INTRODUCION: Intracranial chondroma is a very rare, slow growing, benign cartilaginous tumor that arises usually from the base of the scull. Chondroma located at the falx is extremely rare. According to our best knowledge 15 cases of falx chondromas have been reported in the literature. CASE OUTLINE: This is the first case report of falx chondroma located in the parietal area associated with hyperostosis. Magnetic resonance imaging of the brain revealed a 3x4x4 cm solid, calcified, ring-shaped, well-defined tumor at the posterior falx.The patient underwent surgery and complete resection was performed. Histological examination confirmed chondroma of the falx. Postoperative CT scan showed no residual of tumor and the patient was discharged. CONCLUSION: The long-term prognosis is good after a total excision of the tumor. Awareness of this rare pathology in the differential diagnosis of falx mass could facilitate the diagnosis.

Spinal metastasis of medulloblastoma in adults: a case report.

INTRODUCTION: Medulloblastoma is a primitive neuro-ectodermal malignant tumor most commonly seen in childhood and rarely and uncommonly in adult age. Treatment consists of surgery followed by radiotherapy. In the case of a relapse there is no overall accepted treatment. Tumor metastasis can be seen along the neural axis, lymph nodes, soft tissues, bones and distant organs. CASE OUTLINE: In this paper we present a 45-year-old female patient with a thoraco-spinal extramedullary metastatic medulloblastoma and progressive neurological deterioration seen 11 months after the first operation and description of magnetic resonance and intraoperative finding. CONCLUSION: Although rare, the presence of metastasis is a poor prognostic factor. The treatment options for patients with metastases are limited and their prognosis continues to remain poor.

[Epidemiological features of brain tumors].

Brain tumors account for 1.4% of all cancers and 2.4% of all cancer-related deaths. The incidence of brain tumors varies and it is higher in developed countries of Western Europe, North America, Australia and New Zealand. In Serbia, according to data from 2009, malignant brain tumors account for 2.2 of all tumors, and from all cancer-related deaths, 3.2% is caused by malignant brain tumors. According to recent statistical reports, an overall incidence of brain tumors for benign and malignant tumors combined is 18.71 per 100,000 persons/year. The most common benign brain tumor in adults is meningioma, which is most present in women, and the most common malignant tumor is glioblastoma, which is most present in adult men. Due to high mortality, especially in patients diagnosed with glioblastoma and significant brain tumor morbidity, there is a constant interest in understanding its etiology in order to possibly prevent tumor occurrence in future and enable more efficient treatment strategies for this fatal brain disease. Despite the continuously growing number of epidemiological studies on possible factors of tumor incidence, the etiology remains unclear. The only established environmental risk factor of gliomas is ionizing radiation exposure. Exposure to radiofrequency electromagnetic fields via cell phone use has gained a lot of attention as a potential risk factor of brain tumor development. However, studies have been inconsistent and inconclusive, so more definite results are still expected.

[Surgical treatment of Arnold-Chiari malformation type I in an adult patient].

BACKGROUND: Herniation of the cerebellar tonsils through the foramen magnum into the cervical spinal canal with obliteration of the cerebellomedullary cistern is the primary feature of Arnold-Chiari type I malformation (ACM I). It is considered to be congenital malformation, although there have been reported cases of an acquired form. CASE REPORT: We presented a female patient, 45-year old, with ACM I without syringomyelia as a rare and unusual clinical image, as well as the effect of decompressive surgery in the treatment of this malformation. The patient was admitted to the Department of Neurosurgery with clinical signs of truncal ataxia worsening during the last six years. Moderate quadriparesis with predominant lower extremity involvement and the signs of the cranial nerves damages occured during the last seven months before admission, with progressive clinical course up to the date of admission. Neurosurgical treatment that included suboccipital medial craniectomy with resection of posterior arch C1 vertebrae and C2 laminectomy resulted in a significant clinical improvement and a much better quality of life. CONCLUSION: Posterior craniovertebral decompression with microsurgical reduction of the cerebellar tonsils and placement of an artificial dural graft is a treatment of choice in severe forms of ACM I without syringomyelia.

Cyclin D1 immunoreactivity in meningiomas.

OBJECTIVE: Cyclin D1 is an important nuclear protein required for progression of cells through the G1 phase of the cell cycle. The proliferative potential of meningiomas has been studied using various proliferative markers. However, there have been only few published studies evaluating Cyclin D1 immunoreactivity in meningiomas. PURPOSE OF THE STUDY: The aim of our study was to analyze the Cyclin D1 expression in meningiomas and correlate it both with proliferation markers Ki67 and PCNA, and with meningiomas of WHO grade. MATERIAL AND METHODS: We evaluated immunoreactivity for proliferative markers (Cyclin D1, Ki-67, and PCNA) in a consecutive series of 64 meningioma samples obtained from patients who underwent surgical resection because of cerebral or spinal meningiomas. Immunohistochemical staining with Ki-67, PCNA, and Cyclin D1 was performed using the microwave processing procedure and LSAB+ methodology. The number of positive cells for each antibody has been determined and shown in percentage in relation to 1000 counted cells. RESULTS: All meningioma samples showed immunostaining for Ki-67, PCNA, and Cyclin D1 antibodies. The Cyclin D1 scores exhibited a close correlation with Ki-67 and PCNA immunostaining (P < 0.01). Some meningiomas (15 cases) showed a combination of nuclear and cytoplasmatic (fine granular) Cyclin D1 immunoreactivity. All proliferative indexes have been in positive correlation with meningioma grade. CONCLUSION: Our comparative study of proliferative markers in meningiomas demonstrated Cyclin D1 as a very useful proliferative marker in meningiomas.

Huge extracranial asymptomatic frontal invasive meningioma: a case report.

Meningioma is a well-recognized tumor of the central nervous system, but it rarely appears as an extracranial tumor secondarily extended into the paranasal sinuses. Meningiomas arise from arachnoid cap cells that form the external membrane of the brain. Most meningiomas are slow growing and are usually not associated with substantial underlying brain edema; they cause symptoms by the compression of adjacent neural structures. An interesting natural history of a neglected meningioma with extracranial extension is described. The diagnosis of meningioma was established by CT imaging, finally based on the histopathology and immunochemistry. The meningioma cells in our male patient were positive for progesterone receptors. The patient underwent surgical treatment and recovered without complications. On follow-up 1 year later there were no signs of process expansion.