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1.
J Surg Case Rep ; 2024(6): rjae413, 2024 Jun.
Article in English | MEDLINE | ID: mdl-38915342

ABSTRACT

Mucoepidermoid carcinoma, a salivary gland tumor, rarely occurs in bronchial mucous glands. Brain metastases are rarely seen which makes for a challenging diagnosis and treatment approach. A 40-year-old woman presented with confusion, and ataxia, accompanied by a declining Glasgow Coma Score. Brain computerized tomography revealed two hyperdense, postcontrast-enhanced infra- and supratentorial lesions with perifocal edema. First causing obstructive hydrocephalus. The initial surgery involved external ventricular drainage system placement leading to the patient's clinical improvement. After radiological diagnostics, both lesions were resected without complications. Histopathological analysis revealed solid clusters of atypical, polygonal epithelial cells exhibiting mucin production, classified as a poorly differentiated mucoepidermoid carcinoma metastasis which originated from the upper lobe's apicoposterior segment and left lung. The correct treatment approach remains elusive due to the infrequent occurrence and challenging diagnosis. While new oncological and radiosurgery options promise improved overall survival rates, radical resection remains the preferred initial option.

2.
Surg Neurol Int ; 12: 469, 2021.
Article in English | MEDLINE | ID: mdl-34621584

ABSTRACT

BACKGROUND: Pleomorphic xanthoastrocytoma (PXA) is a rare astrocytic tumor, accounting for <1% of astrocytic tumors. Due to its rarity, etiology, natural history, and biologic behavior is not completely explained. We present a case of malignant transformation of a PXA to glioblastoma in pregnant patient 6 month after tumor biopsy. CASE DESCRIPTION: A 28-year-old female patient was presented with a newly onset of headache, nausea, and right-sided hemiparesis at 21st week of pregnancy. Magnetic resonance imaging (MRI) revealed cystic mass in the left frontal region. Patient underwent biopsy to confirm pathohistological analysis; the tumor tissue corresponded to an anaplastic PXA. Two weeks after initial biopsy, open surgery along with gross total tumor removal was performed confirming pathohistological analysis. Six months later, after childbirth, and control MRI revealed a recurrent tumor mass: the patient underwent surgical resection and the tumor tissue corresponded to a glioblastoma. The patients were further treated with radiation and chemotherapy according to oncologist. CONCLUSION: Distinguishing between PXA patients who have a good prognosis and those at risk for early progression is very important for the PXA clinical management. Despite cellular pleomorphism, mitotic index and the extent of resection are shown to be the main predictors for recurrence-free survival and overall survival rates. The standard therapy management is not yet established. Our patient treatment was associated with a significant ethical dilemma. Respecting patient's wishes to deliver a baby, nor radio or chemo treatments were done. Further studies are necessary to provide factors responsible for malignant transformation of PXA. In addition, in ethically sensitive situation, such as tumor in pregnant patient, good communication, respecting patient's wishes, and a multidisciplinary teamwork is the key for better outcome.

3.
Croat Med J ; 62(4): 376-386, 2021 Aug 31.
Article in English | MEDLINE | ID: mdl-34472741

ABSTRACT

Malignant brain tumors are among the most aggressive human neoplasms. One of the most common and severe symptoms that patients with these malignancies experience is sleep disruption. Disrupted sleep is known to have significant systemic pro-tumor effects, both in patients with other types of cancer and those with malignant brain lesions. We therefore provide a review of the current knowledge on disrupted sleep in malignant diseases, with an emphasis on malignant brain tumors. More specifically, we review the known ways in which disrupted sleep enables further malignant progression. In the second part of the article, we also provide a theoretical framework of the reverse process. Namely, we argue that due to the several possible pathophysiological mechanisms, patients with malignant brain tumors are especially susceptible to their sleep being disrupted and compromised. Thus, we further argue that addressing the issue of disrupted sleep in patients with malignant brain tumors can, not just improve their quality of life, but also have at least some potential of actively suppressing the devastating disease, especially when other treatment modalities have been exhausted. Future research is therefore desperately needed.


Subject(s)
Brain Neoplasms , Quality of Life , Brain Neoplasms/complications , Humans , Sleep
5.
World J Surg Oncol ; 9: 53, 2011 May 19.
Article in English | MEDLINE | ID: mdl-21595882

ABSTRACT

BACKGROUND: Glioblastoma multiforme is a highly malignant primary brain tumor that shows marked local aggressiveness, but extracranial spread is not a common occurrence. We present an unusual case of recurrent glioblastoma in 54-year old male that spread through the scull base to the ethmoid and sphenoid sinuses, to the orbita, pterygomaxillar fossa, and to the neck. METHODS: A 54-year old male underwent left temporal resection because of brain tumor of his left temporal lobe. Operation was followed by external beam radiation combined with temozolomide. The tumor recurred eight months after first surgery. The patient developed swelling of left temporal region, difficult swallowing and headache. MRI of head showed recurrent tumor, which invaded orbita, ethmoid and sphenoid sinuses, nasal cavity, pterygomaxillar fossa. RESULTS: The patient died ten months after initial diagnosis of glioblastoma multiforme, and two months after his second operation. CONCLUSIONS: The aggressive surgical operation helped to downsize the tumor mass as much as possible, but did not prolonged significantly the life or improved the life quality of the patient. The current literature is reviewed, and the diagnostic approaches as well as therapeutic options are discussed.


Subject(s)
Brain Neoplasms/pathology , Glioblastoma/secondary , Neoplasm Recurrence, Local/surgery , Skull Neoplasms/secondary , Brain Neoplasms/surgery , Fatal Outcome , Glioblastoma/surgery , Humans , Male , Middle Aged , Skull Neoplasms/surgery
6.
Acta Neurochir (Wien) ; 151(6): 653-7, 2009 Jun.
Article in English | MEDLINE | ID: mdl-19319469

ABSTRACT

Glioblastoma multiforme usually affects the cerebral hemispheres with the peak age of onset in the sixth or seventh decade, while cerebellar glioblastoma multiforme is a rare tumour especially in younger patients. Most result from de-differentiation from low grade astrocytoma (secondary glioblastoma) or can develop de novo (primary glioblastoma). Primary glioblastomas develop in older patients while secondary glioblastomas develop in younger patients and contain TP53 mutations as the earliest detectable change. We report a 28 year old patient with primary multi-focal cerebellar glioblastoma multiforme and review the pathophysiology, clinical presentation, diagnosis and treatment of cerebellar glioblastomas.


Subject(s)
Cerebellar Neoplasms/pathology , Genetic Predisposition to Disease/genetics , Glioblastoma/pathology , Mutation/genetics , Tumor Suppressor Protein p53/genetics , Adult , Biomarkers, Tumor/analysis , Biomarkers, Tumor/metabolism , Cerebellar Neoplasms/genetics , Cerebellar Neoplasms/physiopathology , Cerebellum/diagnostic imaging , Cerebellum/pathology , Cerebellum/surgery , Fatal Outcome , Female , Fourth Ventricle/pathology , Fourth Ventricle/surgery , Glioblastoma/genetics , Glioblastoma/physiopathology , Headache/etiology , Humans , Hydrocephalus/etiology , Intracranial Hypertension/etiology , Magnetic Resonance Imaging , Neoplasm Recurrence, Local , Neurosurgical Procedures/methods , Reoperation , Tomography, X-Ray Computed , Vomiting/etiology
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