RESUMO
BACKGROUND: Hemangioblastoma (HBL) in the suprasellar region is extremely rare. CASE DESCRIPTION: A suprasellar mass was found in a 33-year-old woman with retinal HBL and bilateral adrenal pheochromocytomas. The diagnosis of von Hippel-Lindau (VHL) disease was confirmed preoperatively not only by these clinical manifestations but also by germline mutation study. The existence of VHL disease indicated a diagnosis of HBL for the suprasellar mass. The results of our mutation study indicated that this patient had type II VHL disease, suggesting that careful follow-up is essential for the early detection of renal cell carcinoma, which is often associated with type II VHL disease. Here, we summarize the previously reported features of sellar and suprasellar HBLs. CONCLUSIONS: HBLs in this region may be one manifestation of VHL disease. Genetic testing of the VHL gene of our patient could provide useful information to determine appropriate medical care and management.
Assuntos
Mutação em Linhagem Germinativa/genética , Hemangioblastoma/genética , Neoplasias Hipofisárias/genética , Proteínas Supressoras de Tumor , Ubiquitina-Proteína Ligases , Doença de von Hippel-Lindau/genética , Adulto , Sequência de Bases/genética , Análise Mutacional de DNA , Feminino , Hemangioblastoma/patologia , Hemangioblastoma/cirurgia , Humanos , Ligases/genética , Imageamento por Ressonância Magnética , Mutação de Sentido Incorreto/genética , Neoplasias Hipofisárias/patologia , Neoplasias Hipofisárias/cirurgia , Proteína Supressora de Tumor Von Hippel-Lindau , Doença de von Hippel-Lindau/patologia , Doença de von Hippel-Lindau/cirurgiaRESUMO
We report a patient with hemichorea following subthalamic hemorrhage. Vo-complex thalamotomy abolished the choreic movements for over 4 years of follow-up.
Assuntos
Hemorragia Cerebral/cirurgia , Coreia/cirurgia , Dominância Cerebral/fisiologia , Acidente Vascular Cerebral/cirurgia , Núcleos Ventrais do Tálamo/cirurgia , Idoso , Mapeamento Encefálico , Hemorragia Cerebral/fisiopatologia , Coreia/fisiopatologia , Humanos , Imageamento por Ressonância Magnética , Masculino , Exame Neurológico , Acidente Vascular Cerebral/fisiopatologia , Resultado do Tratamento , Núcleos Ventrais do Tálamo/fisiopatologiaRESUMO
A 73-year-old female weighing 41 kg who had undergone ilecolostomy under general anesthesia showed extremely prolonged apnea. Despite only 7 mg of vecuronium, she needed postoperative mechanical ventilation for more than 24 hours. A postoperative examination revealed hypermagnesemia, which probably potentiated the effect of vecuronium. Her hypermagnesemia might be caused by chronic renal failure with hypocalcemia and administration of magnesium sulfate as a cathartic. Plasma magnesium concentration should be measured perioperatively in all surgical cases.
Assuntos
Anestesia Geral/métodos , Apneia/induzido quimicamente , Magnésio/sangue , Brometo de Vecurônio/efeitos adversos , Idoso , Neoplasias do Colo/complicações , Neoplasias do Colo/cirurgia , Colostomia , Sinergismo Farmacológico , Feminino , Humanos , Falência Renal Crônica/complicações , Respiração ArtificialRESUMO
The authors report on two cases of pineal germinomas with granulomatous inflammation (granulomatous germinomas). Macroscopically, both tumors were relatively hard and grayish in color. Histological examination revealed a germinoma with multinucleated giant cells and Schaumann bodies in one case, and a germinoma with the background of acellular fibrillated matrix in the other. On immunohistochemical analysis, the granulomatous germinomas were shown to contain many macrophages, T- and B-lymphocytes, and glial fibrillary acid protein-positive cells infiltrating the specimens, compared to nongranulomatous germinomas. Analysis of Masson's trichrome staining tests showed that large areas of the granulomatous germinomas were occupied by a collagenous component; this was not the case in cases of nongranulomatous germinomas. Analysis of monoclonal anti-human Ki-67 results showed that the granulomatous germinomas had a lower score than nongranulomatous germinomas (p < 0.05, unpaired t-test), indicating that germinomas with granulomatous inflammation may have a better prognosis.
