ABSTRACT
We present here a rare complication of ventriculoatrial shunt: migration of the distal catheter into both pulmonary arteries. The patient showed no cardiorespiratory symptoms. The catheter was removed by endovascular technic, the most usual procedure in these cases.
Subject(s)
Cerebrospinal Fluid Shunts , Hydrocephalus , Humans , Cerebrospinal Fluid Shunts/adverse effects , Pulmonary Artery/diagnostic imaging , Pulmonary Artery/surgery , Catheters , Prostheses and Implants , Hydrocephalus/surgery , Ventriculoperitoneal ShuntABSTRACT
Dural metastases are uncommon findings and at diagnosis normally appear in disseminated stages of malignant tumors. Usually clinically silent, these could become symptomatic due to mass effect or after developing subdural collections. We present the case of a young woman recently operated from gastric cancer who presented consciousness deterioration and hemiparesis caused by subdural collection. During examination, the patient drastically worsens his neurological status due to an acute subdural bleeding within the subdural collection, which after pathological analysis was diagnosed of dural metastasis of gastric cancer. In malignancies associated with subdural collections it is important to suspect the coexistence of dural metastases and performing a contrast enhanced CT scan or Magnetic Resonance Imaging (MRI) may help in the diagnosis. If surgery is indicated, it is mandatory to evacuate the tumor and involved dura which causes the accumulation of fluid and to coagulate the external tumor membrane to avoid re-bleeding (AU)
Las metástasis durales son hallazgos infrecuentes, y al diagnosticarse, normalmente se encuentran en estadios diseminados de tumores malignos. Generalmente, son clínicamente silentes, pero pueden dar síntomas debido al efecto de masa o tras desarrollar colecciones subdurales. Presentamos el caso de una mujer joven, recientemente intervenida de cáncer gástrico, que presentó deterioro de la conciencia y hemiparesia por colección subdural. Durante la exploración, la paciente empeoró neurológicamente debido a un sangrado subdural agudo dentro de la colección subdural, que tras análisis patológico fue diagnosticada de metástasis dural de cáncer gástrico. En las neoplasias asociadas con colecciones subdurales es importante sospechar la coexistencia de metástasis durales y realizar una tomografía computarizada con contraste o una resonancia magnética puede ayudar en el diagnóstico. Si está indicada la cirugía es obligatorio evacuar el tumor y la duramadre afectada que provoca la acumulación de líquido y coagular la membrana tumoral externa para evitar el resangrado (AU)
Subject(s)
Humans , Female , Adult , Stomach Neoplasms/pathology , Meningeal Neoplasms/complications , Meningeal Neoplasms/secondary , Hematoma, Subdural/etiology , Subdural Effusion/etiology , Tomography, X-Ray Computed , Magnetic Resonance Imaging , Meningeal Neoplasms/diagnostic imagingABSTRACT
Dural metastases are uncommon findings and at diagnosis normally appear in disseminated stages of malignant tumors. Usually clinically silent, these could become symptomatic due to mass effect or after developing subdural collections. We present the case of a young woman recently operated from gastric cancer who presented consciousness deterioration and hemiparesis caused by subdural collection. During examination, the patient drastically worsens his neurological status due to an acute subdural bleeding within the subdural collection, which after pathological analysis was diagnosed of dural metastasis of gastric cancer. In malignancies associated with subdural collections it is important to suspect the coexistence of dural metastases and performing a contrast enhanced CT scan or Magnetic Resonance Imaging (MRI) may help in the diagnosis. If surgery is indicated, it is mandatory to evacuate the tumor and involved dura which causes the accumulation of fluid and to coagulate the external tumor membrane to avoid re-bleeding.
Subject(s)
Meningeal Neoplasms , Stomach Neoplasms , Subdural Effusion , Female , Humans , Stomach Neoplasms/complications , Stomach Neoplasms/pathology , Subdural Effusion/etiology , Meningeal Neoplasms/complications , Dura Mater/diagnostic imaging , HemorrhageABSTRACT
Dural metastases are uncommon findings and at diagnosis normally appear in disseminated stages of malignant tumors. Usually clinically silent, these could become symptomatic due to mass effect or after developing subdural collections. We present the case of a young woman recently operated from gastric cancer who presented consciousness deterioration and hemiparesis caused by subdural collection. During examination, the patient drastically worsens his neurological status due to an acute subdural bleeding within the subdural collection, which after pathological analysis was diagnosed of dural metastasis of gastric cancer. In malignancies associated with subdural collections it is important to suspect the coexistence of dural metastases and performing a contrast enhanced CT scan or Magnetic Resonance Imaging (MRI) may help in the diagnosis. If surgery is indicated, it is mandatory to evacuate the tumor and involved dura which causes the accumulation of fluid and to coagulate the external tumor membrane to avoid re-bleeding.
ABSTRACT
Una masa intramedular pigmentada es un hallazgo muy raro en la práctica diaria, y supone un reto diagnóstico. Se deben considerar tumores que contienen melanina (ependimoma melanótico y schwannoma melanótico) y los tumores que contienen melanocitos (melanocitoma, melanoma primario, melanoma metastásico). Describimos el caso de un hombre de 47 años con una lesión intramedular a nivel de T7-T8. Las imágenes de resonancia magnética (RM) revelaban una lesión hiperintensa en T1 e hipointensa en T2. El tumor fue resecado parcialmente y tratado con radioterapia adyuvante. La histología y la ausencia de lesiones fuera del sistema nervioso central (SNC) permitieron establecer el diagnóstico de melanoma primario intramedular (MPI). Se realizó una revisión de la literatura de los 26 casos de MPI reportados. Los MPI son tumores extremadamente raros, pero son la causa más frecuente de tumores intramedulares pigmentados. La primera opción de tratamiento es la resección quirúrgica completa, seguida de radioterapia complementaria
A dark pigmented intramedullary mass is very rarely encountered in daily practice, and poses a diagnostic challenge. Several entities have to be considered, including melanin-containing tumours (melanotic ependymoma and melanotic schwannoma) and melanocyte-containing tumours (melanocytoma, primary melanoma and melanoma metastases). The case is presented of a 47 year-old male with a pigmented intramedullary tumour located at T7-T8 level. Magnetic resonance images (MRI) revealed a tumour with hyperintensity on T1 and hypointensity on T2. The tumour was resected partially and treated with adjuvant radiotherapy. The diagnosis of primary intramedullary melanoma (PIM) was established based on histology and the absence of other lesions outside of the CNS. A literature review is presented on the other 26 PIM cases reported. PIM are extremely rare tumours, but are the most frequent cause of pigmented intramedullary tumour. Complete surgical resection is the treatment of choice whenever possible, followed by radiotherapy
Subject(s)
Humans , Male , Middle Aged , Melanoma/surgery , Spinal Cord Neoplasms/surgery , Melanocytes/pathology , Neoplasm Metastasis/pathology , Brain Neoplasms/secondary , Magnetic Resonance ImagingABSTRACT
A dark pigmented intramedullary mass is very rarely encountered in daily practice, and poses a diagnostic challenge. Several entities have to be considered, including melanin-containing tumours (melanotic ependymoma and melanotic schwannoma) and melanocyte-containing tumours (melanocytoma, primary melanoma and melanoma metastases). The case is presented of a 47 year-old male with a pigmented intramedullary tumour located at T7-T8 level. Magnetic resonance images (MRI) revealed a tumour with hyperintensity on T1 and hypointensity on T2. The tumour was resected partially and treated with adjuvant radiotherapy. The diagnosis of primary intramedullary melanoma (PIM) was established based on histology and the absence of other lesions outside of the CNS. A literature review is presented on the other 26 PIM cases reported. PIM are extremely rare tumours, but are the most frequent cause of pigmented intramedullary tumour. Complete surgical resection is the treatment of choice whenever possible, followed by radiotherapy.
