RESUMO
Papillary meningiomas are rare meningeal tumors which are associated with a grim prognosis. These tumors usually recur locally and in some cases they metastasize. The clinical, radiological and histopathological features of a case of a papillary meningioma with a pleural metastasis in a 13-year-old boy are presented. The literature on metastasizing papillary meningiomas is reviewed. Up to now, 131 cases of papillary meningioma have been reported in the literature. Only 8 cases gave rise to metastases outside the central nervous system. The preferential site of metastasis appeared to be the lung. This is the first report of a papillary meningioma giving rise to a metastasis in the pleura.
Assuntos
Neoplasias Meníngeas/diagnóstico , Meningioma/diagnóstico , Neoplasias Pleurais/secundário , Adolescente , Evolução Fatal , Humanos , Imageamento por Ressonância Magnética , Masculino , Neoplasias Meníngeas/patologia , Meningioma/secundário , Neoplasias Pleurais/diagnósticoRESUMO
OBJECTIVE: "Cerebellar mutis" and subsequent dysarthria (MSD) is a documented complication of posterior fossa surgery in children. In this prospective study the following risk factors for MSD were assessed: type, size and site of the tumour; hydrocephalus at presentation and after surgery, cerebellar incision site, postoperative infection, and cerebellar swelling. METHODS: In a consecutive series of 42 children with a cerebellar tumour, speech and neuroradiological studies (CT and MRI) were systematically analysed preoperatively and postoperatively. Speech was assessed using the Mayo Clinic lists and the severity of dysarthria using the Michigan rating scale. RESULTS: Twelve children (29%) developed MSD postoperatively. The type of tumour, midline localisation, and vermal incision were significant single independent risk factors. In addition, an interdependency of possible risk factors (tumour>5 cm, medulloblastoma) was found. CONCLUSION: MSD often occurs after paediatric cerebellar tumour removal and is most likely after removal of a medulloblastoma with a maximum lesion diameter>5 cm.
Assuntos
Astrocitoma/cirurgia , Neoplasias Cerebelares/cirurgia , Fossa Craniana Posterior/cirurgia , Disartria/diagnóstico , Disartria/etiologia , Ependimoma/cirurgia , Hemangioblastoma/cirurgia , Meduloblastoma/cirurgia , Mutismo/etiologia , Adolescente , Astrocitoma/diagnóstico por imagem , Astrocitoma/patologia , Neoplasias Cerebelares/diagnóstico por imagem , Neoplasias Cerebelares/patologia , Criança , Pré-Escolar , Ependimoma/diagnóstico por imagem , Ependimoma/patologia , Feminino , Hemangioblastoma/diagnóstico por imagem , Hemangioblastoma/patologia , Humanos , Imageamento por Ressonância Magnética , Masculino , Meduloblastoma/diagnóstico por imagem , Meduloblastoma/patologia , Mutismo/diagnóstico , Invasividade Neoplásica , Estadiamento de Neoplasias , Complicações Pós-Operatórias/etiologia , Estudos Prospectivos , Fatores de Risco , Índice de Gravidade de Doença , Síndrome , Tomografia Computadorizada por Raios XRESUMO
Vacuum extraction in nonprogressive labor is relatively safe. Only a few major complications have been mentioned. This article describes the rapid development of a growing skull fracture associated with a porencephalic cyst and parenchymal brain damage after a difficult vacuum extraction in a patient with congenital hydrocephalus and a thoracic meningomyelocele. The diagnostic and therapeutic management is discussed.
