ABSTRACT
Gliomatosis cerebri is a rare entity with non-specific clinical and conventional magnetic resonance imaging (MRI) findings; accurate diagnosis is a differential diagnostic challenge. MR spectroscopy has recently been introduced as a useful diagnostic tool for detection of this entity. We present a gliomatosis cerebri case in which we made the radiological diagnosis using the MR spectroscopy findings; the diagnosis was confirmed by subsequent biopsy and histopathologic evaluation. Multivoxel spectroscopy (CSI, PRESS, 1500/135) shows a marked increase in Cho/NAA (6.6), normal to mild increase in Cho/Cr (1.2), and marked decrease in NAA/Cr (0.2) compared with the normally appearing contralateral side (Cho/NAA: 0.8, Cho/Cr: 0.9, NAA/Cr: 1.2).
Subject(s)
Brain Neoplasms/diagnosis , Magnetic Resonance Spectroscopy/methods , Neoplasms, Neuroepithelial/diagnosis , Adult , Aspartic Acid/analogs & derivatives , Aspartic Acid/analysis , Biopsy , Brain Chemistry , Choline/analysis , Creatine/analysis , Humans , Male , Stereotaxic TechniquesABSTRACT
Primary or secondary involvement of the breast is a rare form of extranodal lymphoma. Most reported primary non-Hodgkin lymphomas of the breast have a B-cell phenotype, those of T-cell phenotype are even more rare. Bilateral breast involvement at diagnosis also is very rare. We herein report a young female patient with bilateral breast involvement by low-grade T-cell malignant lymphoma.
Subject(s)
Breast Neoplasms/diagnosis , Lymphoma, T-Cell/diagnosis , Adult , Breast Neoplasms/pathology , Female , Humans , Lymphoma, Non-Hodgkin/diagnosis , Lymphoma, Non-Hodgkin/pathology , Lymphoma, T-Cell/pathology , Magnetic Resonance Imaging , MammographyABSTRACT
A 40-year-old female was admitted to the hospital with complaints of headache worsening gradually over a 1-month duration. Her past history included surgery to treat a left cerebellar cystic lesion 3 years before, and an untreated small solid right supracerebellar lesion of 1 cm diameter. On admission, magnetic resonance imaging showed that the right cerebellar lesion had grown to approximately 4 cm diameter abutting the tentorium and causing obstructive hydrocephalus. She also had two more small lesions, a right supratentorial solid lesion with cystic component near the splenium and an intramedullary cystic lesion at the C-2 level. Right suboccipital craniectomy was done. The vascular attachments between the superior aspect of the tumor and the tentorium were coagulated and the tumor was totally removed. C1-2 laminectomy was also performed to drain the intramedullary cyst. The patient deteriorated and lost consciousness with respiratory arrest 6 hours postoperatively and was reoperated for intracerebellar hematoma due to oozing from the tentorial vessels. Histological investigation revealed hemangioblastoma. Dural tentorial vascular attachments in solid hemangioblastomas located subjacent to the tentorium may cause early postoperative complications of hematoma at the site of vascular attachment following the resection. Computed tomography study in the early postoperative period is helpful to identify this problem.
Subject(s)
Brain/pathology , Cerebellar Neoplasms/surgery , Craniotomy , Hemangioblastoma/surgery , Postoperative Hemorrhage/surgery , Adult , Brain/surgery , Cerebellar Neoplasms/blood supply , Cerebellar Neoplasms/diagnosis , Cerebellar Neoplasms/pathology , Diagnosis, Differential , Female , Hemangioblastoma/blood supply , Hemangioblastoma/diagnosis , Hemangioblastoma/pathology , Humans , Magnetic Resonance Imaging , Postoperative Hemorrhage/etiology , Tomography, X-Ray Computed , Treatment Outcome , von Hippel-Lindau Disease/diagnosisABSTRACT
A 38-year-old female presented with sudden neurological deterioration 6 years after an operation and chemotherapy for uterine leiomyosarcoma. An extremely rare metastasis of the uterine leiomyosarcoma to the brain was identified and totally resected. Whole brain irradiation (50 Gy) was given. A recurrence of the metastasis was resected 10 weeks later. She ultimately died of a second recurrence. Aggressive surgical management of cerebral metastasis of uterine leiomyosarcoma may achieve an improved outcome.
