ABSTRACT
We report a case of isolated myxopapillary ependymoma (MPE) of the fourth ventricle. This is the thirteenth reported case of primary intracranial MPE and the fourth reported case of MPE originating from the fourth ventricle. We suggest that exhaustive clinical and radiological investigation of a spinal ependymoma must be undertaken in all cases of intracranial ependymoma.
Subject(s)
Brain Neoplasms , Ependymoma , Spinal Cord Neoplasms , Ependymoma/diagnostic imaging , Ependymoma/surgery , Fourth Ventricle/diagnostic imaging , Fourth Ventricle/surgery , Humans , Spinal Cord Neoplasms/diagnostic imaging , Spinal Cord Neoplasms/surgeryABSTRACT
Malignant transformation of intracranial epidermoid cysts to squamous cell carcinoma is a rare occurrence and only a small number have been reported to date. MRI recurrence in combination with neurological decline should prompt surgery to exclude malignant transformation. Herein, we describe our experience of such a case and contribute to the evolving series within the literature.
Subject(s)
Carcinoma, Squamous Cell/pathology , Cerebellar Diseases/pathology , Cerebellopontine Angle/pathology , Epidermal Cyst/pathology , Cell Transformation, Neoplastic/pathology , Cranial Fossa, Posterior , Epidermal Cyst/surgery , Humans , Magnetic Resonance Imaging , Male , Middle Aged , Neoplasm Recurrence, Local/pathology , Trigeminal Neuralgia/etiologyABSTRACT
A rare case of supratentorial intraventricular schwannoma is described. A 16-year-old male with asymptomatic papilloedema was found to have a 5-cm intraventricular tumour arising from the trigone of the right lateral ventricle. A craniotomy and total macroscopic excision was performed.
Subject(s)
Cerebral Ventricle Neoplasms/diagnosis , Neurilemmoma/diagnosis , Supratentorial Neoplasms/diagnosis , Adolescent , Cerebral Ventricle Neoplasms/surgery , Craniotomy , Humans , Magnetic Resonance Imaging , Male , Neurilemmoma/surgery , Supratentorial Neoplasms/surgeryABSTRACT
Solid haemangioblastomas can be difficult to treat surgically because of their hypervascularity and requirement for circumferential dissection. We report two cases of large solid cerebellopontine angle haemangioblastomas that were safely resected utilizing wide transtemporal posterolateral skull-base exposures. In both cases, good tumour exposure was achieved with trans-cochlear approaches and division of the sigmoid sinus. These were large tumours and we felt that the added complexity of the approach was justified by providing panoramic exposure to allow safe resection.
Subject(s)
Cerebellar Neoplasms/surgery , Cerebellopontine Angle/surgery , Hemangioblastoma/surgery , Cerebellar Neoplasms/diagnosis , Female , Hemangioblastoma/diagnosis , Humans , Magnetic Resonance Imaging , Middle Aged , Neurosurgical Procedures/methodsABSTRACT
We report the case of a middle aged woman who developed refractory complex partial seizures in her early twenties. She had a right coloboma and neurological examination was normal. Neuropsychological assessments revealed mild impairments of non-verbal memory, and visuospatial and constructional difficulties. Serial CT and MRI showed multiple nodular abnormalities in her mid-brain, diencephalon, subependymal region and both mesial temporal lobes. EEG recording revealed a right medial temporal focus. She underwent en bloc temporal lobectomy. The surgical pathology revealed mesial temporal dysembryoplastic neuroepithelial tumour (DNET) in association with extensive, contiguous neocortical dysplasia. The proliferation marker MIB-1 revealed up to 2% labelling in tumour areas resembling conventional oligodendroglioma. In the two years since surgery she has been seizure free and the remaining MR brain abnormalities have not changed. The very unusual centripetal MRI pattern of discrete multifocal lesions with the characteristic T1 and T2 features of DNET would support the dysembyroplastic germinal origin that was proposed by Daumas-Duport et al. (1988) in their original description of the lesion. The neuroradiological, neuropathological and clinical features of this case are compared with the two previous cases of multifocal DNET.
