Suprasellar germ cell tumor with extracranial metastases.

A case of metastasizing suprasellar germ cell tumor is described. Serum tumor markers were measured and the immunochemistry of the tumor was studied. The rarity of extracranial metastasis from suprasellar germinomas is noted, and the relevance to mixed tumors is discussed. The difficulties associated with small biopsies and the importance of tumor marker studies in all cases of an intracranial germ cell tumor are emphasized by the case study.

Primary glioblastoma multiforme of the cerebellum. A case report.

A case of glioblastoma multiforme arising in the right cerebellar hemisphere is reported. The clinical, pathological, and radiographic similarity of this entity to the supratentorial glioblastomas is emphasized.

Isolated histiocytosis X of the hypothalamus. Case report.

Failure to consider histiocytosis X in the differential diagnosis of hypothalamic masses may lead to inappropriate empirical radiotherapy. This report concerns a case of histiocytosis X of the hypothalamus, unassociated with systemic histiocytic lesions, in which early biopsy allowed specific therapy with subsequent total regression of the lesion.

Chronic arachnoiditis after a pantopaque study of the posterior fossa.

Reported is a case in which chronic arachnoiditis resulted as a complication of using Pantopaque in studying the posterior fossa. The possibility that prophylactic intrathecal injections of methylprednisolone acetate while performing Pantopaque myelography help avoid serious complications is discussed.

Ultrastructural study of the pineal germinoma in vivo and in vitro.

The fine structure of a pineal germinoma was studied in tissue blocks and in tissue culture. The original tumor contained large primary tumor cells, lymphocytes, macrophages, plasma cells, and astrocytes. The large primary tumor cells were characterized by large nuclei, relatively scanty organelles, abundant glycogen, and junctional complexes. The neoplasm grew well in vitro and, with the exception of plasma cells, contained the same cell types found in vivo. The ultrastructural characteristics of the cells in vivo and in vitro were similar. In culture there were few large primary tumor cells. Macrophages, often involved in active phagocytosis, were prominent in the original tumor and were the most common cell type found in vitro. A tumor-associated immune response is postulated in this neoplasm.

Removal of an intracranial glioblastoma in a hemophiliac.

A case report of a Factor VIII deficient hemophiliac, who underwent surgery for a glioblastoma, is presented. Emphasis is placed on diagnosing the hemostatic deficiency by the use of four hematological tests: bleeding time, platelet count, partial thromboplastin time, and prothrombin time. With close cooperation of a hematologist during the intraoperative and postoperative period, there should be a low mortality associated with intracranial surgery in a hemophiliac patient.

Biological behavior of the primitive neuroectodermal tumors: significant supratentorial childhood gliomas.

Supratentorial gliomas in the pediatric age group at the University of Kentucky Medical Center accounted for 20% of all childhood brain tumors. Seventeen of the 20 children with these tumors, regardless of histologic type, mode of therapy, or other parameters died within five years after tissue diagnosis, and most were dead within two years. Unlike the astrocytic gliomas, the poorly differentiated primitive neuroectodermal tumors tended to spread diffusely throughout the central nervous system and accounted for 35% of the supratentorial gliomas in children at our institution. Results of this study suggest that therapy for the primitive neuroectodermal tumor, unlike other childhood supratentorial gliomas, should be considered for the entire neuraxis.

Preparation of nitroso-13N-labeled nitrosoureas.

A method is described for the preparation of 13N-labeled N-nitrosoureas, specifically 1-(2-chloroethyl)-3-cyclohexyl-1-nitrosourea. The 13N is generated as ammonia by the 12C(d,n)13N reaction on methane gas. The product is selectively trapped and subsequently oxidized to nitrous acid which reacts with the parent urea in solution to form the 13N-labeled nitrosourea.