ABSTRACT
We report two cases of solitary cerebral metastases from renal cell carcinoma 15 and 18 years after nephrectomy. In a review of the literature, only two cases of solitary brain metastasis from renal cell carcinoma with latency periods greater than 10 years have been documented. Our two cases represent the longest latency periods reported between nephrectomy and detection of a solitary cerebral metastasis. Histologic examination and immunohistochemical profile of the primary renal tumors and metastatic cranial tumors showed identical morphology and immunophenotype.
Subject(s)
Brain Neoplasms/secondary , Carcinoma, Renal Cell/secondary , Kidney Neoplasms/pathology , Aged , Brain Neoplasms/pathology , Carcinoma, Renal Cell/pathology , Female , Humans , Magnetic Resonance Imaging , Male , Middle AgedABSTRACT
The surgical approach to intrinsic lesions within the brain stem is undertaken by the surgeon knowing the potential for significant operative morbidity. We report the use of real-time intraoperative ultrasound and electrophysiological mapping techniques to aid in the localization and resection of an intrinsic brain-stem tumor in a child. These techniques permitted an aggressive surgical approach without encountering adverse postoperative neurological sequelae.
Subject(s)
Brain Mapping/instrumentation , Brain Stem/diagnostic imaging , Cerebral Ventricle Neoplasms/diagnostic imaging , Echoencephalography/instrumentation , Electromyography/instrumentation , Glioma/diagnostic imaging , Monitoring, Intraoperative/instrumentation , Brain Stem/physiopathology , Brain Stem/surgery , Cerebral Ventricle Neoplasms/physiopathology , Cerebral Ventricle Neoplasms/surgery , Child, Preschool , Cranial Nerves/physiopathology , Electric Stimulation/instrumentation , Facial Muscles/innervation , Female , Glioma/physiopathology , Glioma/surgery , Humans , Postoperative Complications/physiopathologyABSTRACT
The rare combination of spinal and intracranial meningeal hemangiopericytomas in the same patient is reported. The coexistence of cerebral and spinal meningiomas of all histological subtypes is distinctly uncommon with only nine cases found in the literature.
Subject(s)
Brain Neoplasms , Epidural Neoplasms , Hemangiopericytoma , Meningeal Neoplasms , Neoplasms, Multiple Primary , Adolescent , Brain Neoplasms/diagnostic imaging , Brain Neoplasms/pathology , Brain Neoplasms/radiotherapy , Brain Neoplasms/surgery , Combined Modality Therapy , Cranial Fossa, Posterior , Diagnostic Errors , Epidural Neoplasms/diagnostic imaging , Epidural Neoplasms/pathology , Epidural Neoplasms/surgery , Hemangiopericytoma/diagnostic imaging , Hemangiopericytoma/pathology , Hemangiopericytoma/radiotherapy , Hemangiopericytoma/surgery , Humans , Laminectomy , Magnetic Resonance Imaging , Male , Meningeal Neoplasms/diagnostic imaging , Meningeal Neoplasms/pathology , Meningeal Neoplasms/radiotherapy , Meningeal Neoplasms/surgery , Meningioma/classification , Meningioma/diagnosis , Meningioma/pathology , Neoplasm Recurrence, Local , Neoplasms, Multiple Primary/diagnostic imaging , Neoplasms, Multiple Primary/pathology , Neoplasms, Multiple Primary/surgery , Tomography, X-Ray ComputedABSTRACT
Meningiomas possess features indicative of epithelial differentiation. The present study further documents this finding by a multimodality approach on serial sections from 25 meningiomas of all histologic and clinical categories. Standard light microscopic examination, immunohistochemical staining with a variety of epithelial and nonepithelial markers, and histochemical staining for mucin were performed on each case. Directed electron microscopic examination was performed on selected examples of epithelial feature-positive and -negative cases. All cases were immunoreactive for vimentin and epithelial membrane antigen. Thirty-two percent were reactive for cytokeratin and 39% for S-100. Twenty percent showed mucin positivity by histochemistry. Electron microscopic examination of cytokeratin-positive cases showed either intracellular lumina (secretory areas) or cytoplasmic tonofibrils, whereas cytokeratin-negative tumors lacked lumina and tonofibrils. Previous studies showing epithelial features in meningiomas are reviewed with emphasis on the studies using immunohistochemistry. These histochemical, immunohistochemical, and ultrastructural characteristics are of utility in the examination of tumors of suspected meningeal origin, particularly when dealing with atypical presentations or histomorphologic features.
Subject(s)
Meningeal Neoplasms/pathology , Meningioma/pathology , Antigens, Neoplasm/analysis , Epithelium/analysis , Epithelium/pathology , Histocytochemistry , Humans , Immunohistochemistry , Keratins/analysis , Membrane Glycoproteins/analysis , Meningeal Neoplasms/analysis , Meningioma/analysis , Microscopy, Electron , Mucin-1 , S100 Proteins/analysis , Staining and Labeling , Vimentin/analysisABSTRACT
We conducted a voluntary cholesterol screening in a medical/occupational setting using the Eastman Kodak Ektachem (desk top) blood analyzer. In 10 hours, five technicians performed a finger-stick puncture on 1,081 screenees, 17.7 per cent of whom were classified as moderate-to-high risk. The cost per screenee was under $3; cost per moderate-to-high risk case was under $16. Turn-around time from check-in to report of result was under one hour. This project suggests the feasibility and acceptability of large-scale cholesterol blood screening.
