Brain Tumors in Which Lactate and Lipid Have Been Detected: A Proton Magnetic Resonance Spectroscopy Study

To determine the spectral pattern of metabolites in 31 brain tumors in which the presence of lipids, lactate and additional intermediary metabolites had been detected, in vivo 1H-MR spectroscopy was performed. Metastasis (n=3), meningioma(n=7), astrocytic tumors of different grades(n=11), postop recurrent tumors(n=2) and other tumors(n=10) were examined using the stimulated echo(STEAM, TE=30ms) or double spin echo technique(PRESS, TE=272ms) with CHESS pulse for water suppression. The detection of lactate in astrocytic tumors correlated with a higher grade of malignancy, and lipid was observed in most glioblastomas. Elevated lactate levels in tumors do not simply originate in the necrotic region, but are related to the high glycolytic activity of adequately perfused, viable neoplastic cells. Lipid signals were detected in high grade, late stage brain tumors, indicating the need for enhanced phospholipid metabolism and membrane degradation, respectively. The absence of lactate and presence of alanine, glutamate/glutamine in most meningiomas distinguished them from schwannomas and other glial tumors. Observation of the spectral pattern of metabolites in brain tumors in which lipid and lactate has been detected might play an important prognostic role in the management and differentiation of metastasis, glial tumors, tumor recurrence, and other non-neoplastic diseases.

Central Neurocytoma: A Case Report

A rare case of intraventricular central neurocytoma in 17-year-old male is reported. The patient had diffuse headache and diplopia. Radiologic findings displayed obstructive hydrocephalus and a large, well-demarcated intraventricular mass lesion obstructing the foramen of Monroe. The tumor arouse from the splenium of corpus callosum. It was removed successfully using two different approaches after extraventricular drainage of the cerebrospinal fluid(CSF). Histologically, the tumor showed pathological features as that of oligodengroglioma on the light microscope. In immunohistochemical examination, glial fibrillary acidic protein(GFAP) was negative and synaptophysin, positive. Numerous neurosecretory granules were found and no typical synapsis was noticed on the electron microscope. No shunt operation was needed. Postoperative radiotherapy or chemotherapy was not performed and no tumor recurrence was detected during the one year follow-up period. We present the case together with a review of the literatures.

Growing Fracture of the Skull: A Case Report

The authors report a case of growing fracture of the skull, also called as leptomeningeal cyst, in a young boy who presented with symptoms of skull defect, headache, and pulsating mass on right posterior parietal area. Successful duroplasty and cranioplasty with autogenous bone were performed resulting in disappearance of all symptoms. The most significant factor contributing to the growing fracture is an underlying dura tear. A brief review of the relevant literature is also presented.

Growing Fracture of the Skull: A Case Report

The authors report a case of growing fracture of the skull, also called as leptomeningeal cyst, in a young boy who presented with symptoms of skull defect, headache, and pulsating mass on right posterior parietal area. Successful duroplasty and cranioplasty with autogenous bone were performed resulting in disappearance of all symptoms. The most significant factor contributing to the growing fracture is an underlying dura tear. A brief review of the relevant literature is also presented.