RESUMO
Intracranial hydatidosis is mainly a pediatric disease. Surgical evacuation of the mass in toto is the gold standard of therapy. No concise data related to the requirement of diversion procedures after uncomplicated hydatid cyst removal is encountered in the literature. The aim of this report is to focus on this idea and estimate the necessity of a diversion procedure beforehand. A 6-year-old girl both with intracranial and renal involvement of hydatidosis underwent surgery. Intact removal of the intracranial cyst harboring daughter vesicles was achieved. A persistent porencephalic cyst at the operative site required a shunt 6 months after surgery. Thick pericyst formation was blamed for this specific progress and the pathophysiology is discussed.
Assuntos
Encefalopatias/cirurgia , Derivações do Líquido Cefalorraquidiano , Equinococose/cirurgia , Criança , Feminino , Humanos , Hipertensão Intracraniana/parasitologia , Hipertensão Intracraniana/cirurgia , Nefropatias/cirurgia , RecidivaAssuntos
Neoplasias Encefálicas/diagnóstico , Helmintíase do Sistema Nervoso Central/diagnóstico , Erros de Diagnóstico/prevenção & controle , Equinococose/diagnóstico , Adolescente , Encefalopatias/diagnóstico , Encefalopatias/terapia , Neoplasias Encefálicas/terapia , Helmintíase do Sistema Nervoso Central/terapia , Criança , Pré-Escolar , Diagnóstico Diferencial , Equinococose/terapia , Feminino , Humanos , Imageamento por Ressonância Magnética/métodos , Masculino , Prognóstico , Medição de Risco , Tomografia Computadorizada por Raios X/métodosRESUMO
A 45-year-old woman presented with an extremely rare metastatic fibrosarcoma of the brain manifesting as persistent headache. She had undergone surgery for a fibrosarcoma of the soft tissue of the thigh 2 months earlier. She had a history of previous surgery and radiotherapy for this tumor. She was somnolent with papilledema and left hemiparesis. Magnetic resonance imaging of the brain revealed a right frontal lesion with mass effect and heterogeneous enhancement. Computed tomography and scintigraphy showed multiple metastatic lesions of the lung. Right frontal craniotomy was performed for gross total removal of the yellowish-white tumor. Histological examination showed signs of epithelioid transformation based on positive staining for epithelial membrane antigen compared to the primary tumor. Postoperatively the patient was alert and the left hemiparesis improved. She refused radiotherapy or chemotherapy. Follow-up computed tomography showed multiple intracranial metastases. She died 5 months after the surgery.
Assuntos
Neoplasias Encefálicas/secundário , Fibrossarcoma/secundário , Lobo Frontal/patologia , Neoplasias Encefálicas/cirurgia , Evolução Fatal , Feminino , Fibrossarcoma/cirurgia , Lobo Frontal/cirurgia , Humanos , Neoplasias Pulmonares/secundário , Neoplasias Pulmonares/cirurgia , Pessoa de Meia-Idade , Procedimentos Neurocirúrgicos/métodos , Neoplasias de Tecidos Moles/patologia , Neoplasias de Tecidos Moles/cirurgia , Tomografia Computadorizada por Raios XRESUMO
Although gliofibroma is a rare and incompletely characterized tumor, recent publications have revealed new aspects of this entity. The case of a 16-year-old boy who was diagnosed as having a gliofibroma is presented here, and the problems regarding nosology are discussed in the light of the recent literature.
