ABSTRACT
Portal vein aneurysm is a rare clinical entity, with only 41 published cases in the English-language literature. Twenty-five of them were congenital. We present the case of a 50-year-old woman who was incidentally diagnosed with a congenital extrahepatic portal vein aneurysm during an investigation for dyspepsia. Ultrasonographic features are described with correlation of computed tomographic and magnetic resonance findings. Etiology, clinical significance, and management strategies for these lesions are discussed and a review of the literature regarding this entity is presented.
Subject(s)
Aneurysm/diagnosis , Portal Vein/diagnostic imaging , Aneurysm/congenital , Diagnosis, Differential , Dyspepsia/complications , Female , Follow-Up Studies , Humans , Liver/blood supply , Magnetic Resonance Angiography , Magnetic Resonance Spectroscopy , Middle Aged , Portal Vein/pathology , Rare Diseases , Tomography, X-Ray Computed , Ultrasonography, Doppler, ColorABSTRACT
Although the coincidence of multiple sclerosis (MS) and central nervous system (CNS) tumors has been reported in over 30 cases in English literature, meningioma growth was associated with interferon-beta (INF-b) treated MS only in two of them. We report the case of a 19-year-old woman with clinically possible, laboratory supported MS, and a concomitant right intraventricular tumor with magnetic resonance imaging (MRI) characteristics consistent with meningioma (similar signal with grey matter on T1 and T2-weighted images and homogenous, intense enhancement). Two years after initiation of INF-b treatment, follow-up brain MRI revealed enlargement of the intraventricular mass and relative increase in the number of white matter lesions without significant clinical deterioration. She underwent almost total resection of the mass and histology confirmed the diagnosis of papillary meningioma. Based on the immunohistochemistry results, we speculate that INF-b resulted in meningioma growth by enhancing platelet derived growth factor (PDGF) receptors or/and down-regulating transforming growth factor receptors on the tumor itself.
Subject(s)
Adjuvants, Immunologic/adverse effects , Cerebral Ventricle Neoplasms/diagnosis , Interferon-beta/adverse effects , Magnetic Resonance Imaging , Meningeal Neoplasms/diagnosis , Meningioma/diagnosis , Multiple Sclerosis/drug therapy , Adjuvants, Immunologic/therapeutic use , Adult , Cerebral Ventricle Neoplasms/complications , Cerebral Ventricle Neoplasms/metabolism , Female , Humans , Immunohistochemistry , Interferon beta-1b , Interferon-beta/therapeutic use , Meningeal Neoplasms/complications , Meningeal Neoplasms/metabolism , Meningioma/complications , Meningioma/metabolism , Multiple Sclerosis/complications , Receptors, Platelet-Derived Growth Factor/metabolismABSTRACT
We report serial MR findings in a 54-year-old woman with eosinophilic meningoencephalitis due to Toxocara canis infection, a parasitic disease contracted through exposure with soil contaminated by the eggs of the roundworm. MR imaging revealed several enhancing subcortical and white matter lesions in both lobes. Antihelminthic chemotherapy yielded marked improvement of the neurologic deficits and cerebral lesions. The specific MR findings-low signal intensity on T1-weighted images, high signal intensity on T2-weighted images, and contrast enhancement-and the clinical and epidemiologic features of CNS involvement are herein reviewed.
