Spinal paragangliomas: Surgical treatment and follow-up outcomes in eight cases.

Paragangliomas are neuro-endocrine tumors originating from the adrenal gland. They are usually benign and nonfunctioning, rarely seen in central nervous system. More than 90% of central nervous system paragangliomas are manifested as carotid and glomus jugulare tumors. Spinal paragangliomas are quite rare.The study was conducted through retrospective analysis of the files of the patients who had undergone surgery with pre-diagnosis of spinal intradural tumor between 2011 and 2017 and diagnosed with paraganglioma.A total of 8 patients (4 females and 4 males) were included in the study. Mean age of the patients was 51.1 years (28-64). Time to admission was mean 6.5 months (3 weeks-24 months). Recurrence was not observed in 7 patients, 1 patient is being followed up due to residual tumor.Treatment may be achieved through recognizing malignant transformation in patients who were not diagnosed histopathologically. We consider that quality of life of the patients may be improved through this way.

Biomarkers of connective tissue disease in patients with intracranial aneurysms.

Connective tissue defects may play a significant role in the development of intracranial aneurysms (IAs). Multiorgan connective tissue disorders may, therefore, indicate a risk of IA development. We investigated biomarkers of connective tissue disease in patients with IAs. A series of 62 patients with IAs was studied by physical examination, echocardiography, ultrasound examination of the kidneys and abdomen, and microscopic examination of skin tissue (temporal area) and superficial temporal artery taken at operation. Patients with IAs had a higher incidence of biomarkers of systemic connective tissue disease than controls and identification of these markers may be important for screening for IAs. Microscopic investigation of biopsies of the skin and superficial temporal artery from patients and their relatives may become valuable for clinical diagnosis, identification of people at risk and basic studies of the pathogenesis of this vascular disease.

Magnetic resonance spectroscopic imaging associated with analysis of fluid in cystic brain tumors.

OBJECTIVE: There is a growing interest in cystic lesions of the brain. Examining the cyst content of brain tumors may contribute in determining the malignancy of the given tumor accompanied by a cyst. METHODS: In this work, samples of cyst fluid from 18 patients with brain tumor were collected and studied biochemically regarding their protein, lactate contents and pH values; magnetic resonance spectroscopic images of these patients were also compared. We investigated the relation between the grade of malignancy and the lactate concentration and the discrepancy between the high levels of lactate in cysts and their alkaline environment. RESULTS: There appears to be a positive relation between the grade of malignancy and the concentration of lactate in the cysts' fluid. A significant two-fold increase in lactate concentration in malignant tumors cysts has been found as compared with the more benign tumor cysts (p<0.001). This increase in lactate level is probably because of aerobic glycolysis, which causes lactate production by the tumor. DISCUSSION: High lactate levels found through magnetic resonance spectroscopy are positively related to the grade of tumor malignancy. The pH values in the cyst fluids were above normal, resulting to a discrepancy in high levels of lactate in the cyst and the alkaline environment. This suggests efflux of H+ ions by a Na/H exchange mechanism to compensate for the change of pH.