ABSTRACT
Glioblastoma Multiforme frequently metastasises from their original location by for example infiltration along white matter tracts [1]. GBM metastasis outside the central nervous system is distinctly rare though there are previous reports of spread to various organs [2-5]. We add an unusual case of a patient with aggressive cerebral GBM metastasis to the parotid gland and the lungs.
Subject(s)
Brain Neoplasms/pathology , Glioblastoma/secondary , Parotid Neoplasms/secondary , Brain Neoplasms/therapy , Fatal Outcome , Female , Glioblastoma/therapy , Humans , Lung Neoplasms/secondary , Lung Neoplasms/therapy , Magnetic Resonance Imaging , Middle Aged , Parotid Neoplasms/therapy , Tomography, X-Ray ComputedABSTRACT
The objective of this study was to review published reports on the epidemiology of primary brain tumours in adults and present the body of knowledge related to these tumours in Great Britain and Ireland. A literature search of all published epidemiological data on brain tumours was conducted in Pre-Medline, Medline, Embase and the Cochrane databases from 1966 to the present. A hand search of all the references alluded to was conducted and older studies identified. The articles were reviewed and tabulated. The papers were subjected to descriptive analysis. Information available to the public and held with the Cancer Registries was reviewed, and cross-referenced with published evidence. To our knowledge, only seven papers have discussed the epidemiology of primary brain tumours in adults. The different methodology of the population-based studies of brain tumours and the different time periods they investigated makes them incomparable. Two papers with comprehensive and detailed strategies for case ascertainment have both recorded tumour incidences of 21 per 100,000 person years. The results of the better studies are at variance with reports from the Cancer Registries. On the basis of the current studies, Cancer Registries appear to under-estimate the incidence of such tumours in adults. It is apparent that a significant number of tumours especially benign varieties are not recorded by some Cancer Registries. The previous estimates, patterns of incidence, prevalence, and survival of brain tumours in Great Britain and Ireland, may thus be incorrect. Patterns of primary brain tumours in adults have not been widely reported in GB and Ireland and the aetiology remains largely unknown. The need for current estimation of geographical and secular variations was identified. This demands closer co-operation between medical and allied staff, and the Cancer Registries. Prospective regional studies of incidence patterns and up to date epidemiological appraisal is deemed necessary. Meanwhile, Cancer Registries should seriously consider the inclusion of all primary brain tumours in their database.
Subject(s)
Brain Neoplasms/epidemiology , Adolescent , Adult , Brain Neoplasms/classification , Female , Humans , Incidence , Ireland/epidemiology , Male , Middle Aged , Registries , United Kingdom/epidemiologyABSTRACT
Intramedullary cervical spinal cord schwannomas are rare tumours and complete excision is often an elusive goal. The use of the KTP laser to accomplish complete excision has not been reported previously. Postoperatively, our patient had no additional deficit and after 1 year has made a good recovery. This case further highlights the difficulty in interpretation of intraoperative biopsy specimens.
Subject(s)
Laser Therapy/methods , Neurilemmoma/surgery , Spinal Cord Neoplasms/surgery , Adult , Cervical Vertebrae , Humans , Magnetic Resonance Imaging , Male , Neurilemmoma/diagnosis , Spinal Cord Neoplasms/diagnosisABSTRACT
Microvascular decompression (MVD) is now recognized as an effective operation for the cure of trigeminal neuralgia (TN), and is far superior to the other surgical procedures utilized in the treatment of TN. TN is common in the elderly, but there is debate concerning MVD in 'elderly' patients. Some clinicians have a policy of not offering patients over a certain age the choice of MVD, yet the recurrence rate is inversely related to the age of the patient. Previous failed procedures and a long period of pain before MVD, also affect the outcome negatively. This study is a retrospective review of the outcome in elderly patients following MVD. Forty-two patients over the age of 65 years are reviewed after undergoing MVD for TN. The results indicate that there was no serious morbidity or mortality that could be ascribed to old age and the length of stay in the hospital was not influenced by the age of the patient. The results are compared with the outcome in a younger age group and the literature on MVD for TN reviewed.
Subject(s)
Cerebellum/blood supply , Decompression, Surgical/methods , Trigeminal Neuralgia/surgery , Adult , Age Factors , Aged , Aged, 80 and over , Decompression, Surgical/adverse effects , Female , Humans , Length of Stay , Male , Microcirculation , Middle Aged , Retrospective Studies , Treatment OutcomeABSTRACT
The authors describe a simple technique used to achieve a water-tight closure of the dura mater during suboccipital craniectomy.
