RESUMO
El papiloma del plexo coroideo es un tumor poco frecuente del sistema nervioso central, que representa menos del 1% de todas las neoplasias intracraneales. Las ubicaciones habituales son el ventrículo lateral en bebés y niños y el cuarto ventrículo en adultos. El tercer ventrículo es una localización inhabitual, con pocos casos recogidos en la bibliografía. Describimos el caso de un niño de 3 meses que ingresó en nuestro centro con signos de aumento de la presión intracraneal. Los estudios de neuroimagen mostraron una lesión en el tercer ventrículo, con hidrocefalia asociada. Al paciente se le extirpó completamente el tumor mediante abordaje transfrontal y cirugía de derivación ventriculoperitoneal. El curso postoperatorio del niño transcurrió sin incidentes y la imagen de resonancia magnética de seguimiento no reveló tumor residual. La histopatología de la lesión resecada confirmó el diagnóstico de papiloma del plexo coroideo. Discutimos las características clínicas, radiológicas e histológicas de este tipo infrecuente de tumores
Choroid plexus papilloma is an uncommon tumour of the central nervous system, accounting for less than 1% of all intracranial neoplasm. The usual locations are the lateral ventricle in infants and children and the fourth ventricle in adults. The third ventricle is a rare location, with few cases reported in the literature. We describe the case of a 3-month-old boy who was admitted to our centre with signs of raised intracranial pressure. Neuroimaging studies showed a third ventricular mass with associated hydrocephalus. The patient underwent complete tumour removal through a transfrontal approach and ventriculo-peritoneal shunt surgery. Postoperative course of the child was uneventful and follow-up magnetic resonance imaging revealed no residual tumour. Histopathology of the resected lesion confirmed the diagnosis of choroid plexus papilloma. We discuss the clinical, radiological and histological features of this infrequent type of tumours
Assuntos
Humanos , Masculino , Lactente , Papiloma do Plexo Corióideo/diagnóstico por imagem , Papiloma do Plexo Corióideo/cirurgia , Terceiro Ventrículo/cirurgia , Neuroendoscopia/métodos , Terceiro Ventrículo/patologia , Derivação Ventriculoperitoneal/métodos , Ultrassonografia , Cérebro/diagnóstico por imagem , Cérebro/patologiaRESUMO
Los ganglioneuromas lipomatosos son una variante poco frecuente de los ganglioneuromas, que se caracterizan por presentar un componente adipocítico maduro entremezclado con un componente convencional de ganglioneuroma. Presentamos el caso de un paciente de 34 años con una lesión paravertebral L1-L4 derecha con extensión intraespinal y con déficit neurológico secundario, que fue intervenido en nuestro centro. La anatomía patológica confirmó la presencia de una neoplasia encapsulada amarillenta, que al microscopio presentaba áreas de ganglioneuroma mezcladas con áreas de grasa madura. En el seguimiento, el paciente se encontraba asintomático, con la paresia en la extremidad inferior derecha recuperada. En el último control de imagen no presentaba datos de recidiva de la lesión. Existen menos de 10 casos de ganglioneuroma lipomatoso descritos en la bibliografía. Este es el primero a nivel paravertebral con extensión intraespinal y con déficit neurológico, de ahí el interés de este trabajo
Lipomatous ganglioneuromas are a rare variant of ganglioneuromas characterized by a mature adipocytic component admixed with a conventional ganglioneuroma component. We present the case of a 34 year old patient with a paravertebral right lesion L1-L4 with intraspinal extension and secondary neurological deficit, who underwent surgery in our hospital. The pathological anatomy showed a yellowish encapsulated neoplasm, which under microscopic evaluation showed areas of ganglioneuroma admixed with areas of mature fat. In the follow up, the patient was asymptomatic, had recovered paresis in the right lower extremity and in the last image control did not present data of lesion recurrence. Fewer than 10 cases of lipomatous ganglioneuromas have been reported in the literature, being this the first paravertebral case wih intraspinal extension and with neurological deficit, hence the interest of this work
Assuntos
Humanos , Masculino , Adulto , Ganglioneuroma/cirurgia , Vértebras Lombares/cirurgia , Monitorização Neurofisiológica Intraoperatória , Ganglioneuroma/diagnóstico por imagem , Vértebras Lombares/diagnóstico por imagem , Paresia/complicações , Hipestesia/complicações , Espectroscopia de Ressonância Magnética , Tomografia Computadorizada por Raios X , Proteínas de Neurofilamentos/análise , Diagnóstico DiferencialRESUMO
Lipomatous ganglioneuromas are a rare variant of ganglioneuromas characterized by a mature adipocytic component admixed with a conventional ganglioneuroma component. We present the case of a 34 year old patient with a paravertebral right lesion L1-L4 with intraspinal extension and secondary neurological deficit, who underwent surgery in our hospital. The pathological anatomy showed a yellowish encapsulated neoplasm, which under microscopic evaluation showed areas of ganglioneuroma admixed with areas of mature fat. In the follow up, the patient was asymptomatic, had recovered paresis in the right lower extremity and in the last image control did not present data of lesion recurrence. Fewer than 10 cases of lipomatous ganglioneuromas have been reported in the literature, being this the first paravertebral case wih intraspinal extension and with neurological deficit, hence the interest of this work.
Assuntos
Ganglioneuroma , Lipoma , Adulto , Ganglioneuroma/diagnóstico por imagem , Ganglioneuroma/cirurgia , Humanos , Lipoma/complicações , Lipoma/diagnóstico por imagem , Lipoma/cirurgia , Recidiva Local de Neoplasia/fisiopatologiaRESUMO
Choroid plexus papilloma is an uncommon tumour of the central nervous system, accounting for less than 1% of all intracranial neoplasm. The usual locations are the lateral ventricle in infants and children and the fourth ventricle in adults. The third ventricle is a rare location, with few cases reported in the literature. We describe the case of a 3-month-old boy who was admitted to our centre with signs of raised intracranial pressure. Neuroimaging studies showed a third ventricular mass with associated hydrocephalus. The patient underwent complete tumour removal through a transfrontal approach and ventriculo-peritoneal shunt surgery. Postoperative course of the child was uneventful and follow-up magnetic resonance imaging revealed no residual tumour. Histopathology of the resected lesion confirmed the diagnosis of choroid plexus papilloma. We discuss the clinical, radiological and histological features of this infrequent type of tumours.
Assuntos
Hidrocefalia , Papiloma do Plexo Corióideo , Terceiro Ventrículo , Adulto , Criança , Quarto Ventrículo/diagnóstico por imagem , Quarto Ventrículo/cirurgia , Humanos , Hidrocefalia/etiologia , Hidrocefalia/cirurgia , Lactente , Imageamento por Ressonância Magnética , Masculino , Papiloma do Plexo Corióideo/diagnóstico por imagem , Papiloma do Plexo Corióideo/cirurgia , Terceiro Ventrículo/diagnóstico por imagem , Terceiro Ventrículo/cirurgiaRESUMO
El tumor glioneuronal papilar (TGNP) es una neoplasia del sistema nervioso central de reciente descripción. En el año 2007, la Organización Mundial de la Salud clasificó este tumor como una neoplasia neuronal-glial de grado i. Los pacientes suelen ser niños o adultos jóvenes que presentan clínica de cefalea o crisis comiciales. Describimos el caso de un paciente varón de 13 años de edad que fue remitido a nuestro centro tras presentar un traumatismo craneal leve a consecuencia de un accidente de circulación. La tomografía computarizada realizada en urgencias mostraba una lesión temporo-occipital derecha hipointensa. La imagen de resonancia magnética confirmó la presencia de una lesión indicativa de un tumor cerebral primario. Se realizó una exéresis quirúrgica completa de la lesión, con adecuada recuperación postoperatoria. El estudio de anatomía patológica de la lesión demostró una estructura seudopapilar con astrocitos y neuronas, compatible con TGNP. Discutimos los hallazgos clínicos, radiológicos e histológicos de este tipo de tumores poco frecuentes
Papillary glioneuronal tumor (PGNT) is a recently described central nervous system neoplasm. In 2007, the World Health Organization classified this tumor as a grade I neuronal-glial neoplasm. Patients are usually juvenile and young adults who commonly present with headache or seizures. We report a case of a 13-year-old boy that was related to our hospital after suffering a mild head injury result of an automobile accident. Emergent CT scan showed a right hypointense temporo-occipital lesion. MRI confirmed the presence of a lesion suggestive of a primary brain tumor. The patient underwent total resection of the tumor, followed by an uneventful recovery. Pathological analysis of the lesion revealed characteristic pseudopapillary structure with astrocytes and neurons, compatible with PGNT. We discuss the clinical, Radiological and histological features of this infrequent type of tumors
Assuntos
Humanos , Masculino , Adolescente , Neoplasias Encefálicas/diagnóstico por imagem , Neoplasias Encefálicas/cirurgia , Neuroglia/patologia , Neurônios/patologia , Neoplasias Neuroepiteliomatosas/patologia , Sistema Nervoso Central/patologia , Traumatismos Cranianos Penetrantes/diagnóstico por imagem , Tomografia Computadorizada de Emissão , Diagnóstico DiferencialRESUMO
Papillary glioneuronal tumor (PGNT) is a recently described central nervous system neoplasm. In 2007, the World Health Organization classified this tumor as a grade I neuronal-glial neoplasm. Patients are usually juvenile and young adults who commonly present with headache or seizures. We report a case of a 13-year-old boy that was related to our hospital after suffering a mild head injury result of an automobile accident. Emergent CT scan showed a right hypointense temporo-occipital lesion. MRI confirmed the presence of a lesion suggestive of a primary brain tumor. The patient underwent total resection of the tumor, followed by an uneventful recovery. Pathological analysis of the lesion revealed characteristic pseudopapillary structure with astrocytes and neurons, compatible with PGNT. We discuss the clinical, Radiological and histological features of this infrequent type of tumors.
Assuntos
Neoplasias Encefálicas/diagnóstico por imagem , Ganglioglioma/diagnóstico por imagem , Adolescente , Neoplasias Encefálicas/patologia , Neoplasias Encefálicas/cirurgia , Ganglioglioma/patologia , Ganglioglioma/cirurgia , Humanos , Imageamento por Ressonância Magnética , Masculino , Tomografia Computadorizada por Raios XRESUMO
Hasta agosto 2013 se han descrito alrededor de 105 casos de neurocitomas extraventriculares intracraneales, de los cuales el 6% se localizan en el cerebelo y el 22% son neurocitomas extraventriculares atípicos. El neurocitoma extraventricular atípico es una variante infrecuente, con solo 24 casos descritos y con un pronóstico más sombrío que el neurocitoma central típico. Se presenta un neurocitoma extraventricular atípico de cerebelo, nunca publicado hasta la fecha; de ahí el interés de este trabajo. Destaca la singularidad de ser un tumor quístico con nódulo mural, una presentación poco frecuente. Los neurocitomas extraventriculares son tumores con baja incidencia que deben considerarse en el diagnóstico diferencial inicial de lesiones cerebelosas quísticas con nódulo mural. Dado que el pronóstico depende del grado de atipia y de la resección quirúrgica, en casos de neurocitomas extraventriculares atípicos el seguimiento debe ser más estrecho, por el mayor riesgo de recidivas que presentan
Through August 2013, 105 cases of intracranial extraventricular neurocytoma (EVN) had been described; 6% were located in cerebellum and 22% were atypical EVN.A rare morphologic form of neurocytoma, atypical EVN has had only 24 cases reported to date. Its prognosis is poorer than the typical central neurocytoma. This case report describes an atypical cerebellar EVN, a form that has not been reported yet, hence the interest of this article. We emphasise its cystic nature and mural nodule, in an infrequent presentation.EVN are low-incidence tumours that we need to take into consideration when making the differential diagnosis of cystic cerebellar lesions with mural nodule. Given that the prognosis of atypical EVNs depends on the atypical nature and on the grade of resection, medical follow up has to be more constant, due to the greater degree of recurrence
Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , Neurocitoma/diagnóstico , Neoplasias Cerebelares/diagnóstico , Diagnóstico Diferencial , Hemangioblastoma/diagnóstico , Neoplasias Císticas, Mucinosas e Serosas/diagnósticoRESUMO
Through August 2013, 105 cases of intracranial extraventricular neurocytoma (EVN) had been described; 6% were located in cerebellum and 22% were atypical EVN. A rare morphologic form of neurocytoma, atypical EVN has had only 24 cases reported to date. Its prognosis is poorer than the typical central neurocytoma. This case report describes an atypical cerebellar EVN, a form that has not been reported yet, hence the interest of this article. We emphasise its cystic nature and mural nodule, in an infrequent presentation. EVN are low-incidence tumours that we need to take into consideration when making the differential diagnosis of cystic cerebellar lesions with mural nodule. Given that the prognosis of atypical EVNs depends on the atypical nature and on the grade of resection, medical follow up has to be more constant, due to the greater degree of recurrence.
Assuntos
Neoplasias Cerebelares/diagnóstico , Hemangioblastoma/diagnóstico , Neurocitoma/diagnóstico , Diagnóstico Diferencial , Feminino , Humanos , Pessoa de Meia-IdadeRESUMO
El meningioma de células claras es una variedad infrecuente de meningioma. Se describe el caso de un meningioma espinal multifocal de células claras presente en una paciente de 20 años de edad. Clínicamente refiere lumbalgia de aproximadamente 2 años de evolución. En el estudio de resonancia magnética nuclear (RMN) se evidencia gran tumoración lumbosacra, que ocupa el canal raquídeo de L4 a S2, asociada a 2 lesiones satélites en la región lumbar. Una tumoración intra-extradural fue resecada quirúrgicamente, confirmándose el diagnóstico anatomopatológico de meningioma de células claras. Se resecan así mismo ambas lesiones satélites con idéntico diagnóstico histológico. Por tanto, en pacientes jóvenes con lesión espinal sugestiva de meningioma debe considerarse la posibilidad de que se trate de un meningioma de células claras, así como su probable origen multifocal y la probabilidad de recidivas (AU)
Assuntos
Humanos , Feminino , Adulto Jovem , Meningioma/cirurgia , Plexo Lombossacral/patologia , Adenocarcinoma de Células Claras/cirurgia , Espectroscopia de Ressonância MagnéticaRESUMO
Clear cell meningioma is a rare morphological form of meningioma. This case report describes a very rare case of multifocal clear cell meningioma in the sacral and lumbar spine. The patient was a 20-year-old female who presented back pain. Magnetic resonance imaging (MRI) revealed a large tumour at L4 to S2 level associated with two, smaller, satellite tumours at the lumbar level. An intra-extradural tumour was surgically removed and the pathological diagnosis of clear cell meningioma was confirmed. Both satellite lesions were also resected and their histopathological diagnosis was the same. Therefore, clear cell meningioma should be considered in young patients with suggested meningioma in the lumbar spine, as well as the possibility of multifocal origin and postoperative recurrence.