Different outcomes for transplant-eligible newly diagnosed multiple myeloma patients in Latin America according to the public versus private management: a GELAMM study.

The aim of this study was to describe clinical and survival characteristics of transplant-eligible multiple myeloma (MM) patients in Latin America (LA), with a special focus on differences between public and private healthcare facilities. We included 1293 patients diagnosed between 2010 and 2018. A great disparity in outcomes and survival between both groups was observed. Late diagnosis and low access to adequate frontline therapy and ASCT in public institutions probably explain these differences. Patients treated with novel drug induction protocols, followed by autologous stem cell transplantation (ASCT) and maintenance, have similar overall survival compared to that published internationally.

[Invasive sinonasal papilloma with intracranial invasion: Case report and bibliographic review]. / Papiloma invertido sinunasal con invasión intracraneal: Reporte de caso y revisión bibliográfica.

INTRODUCTION: Inverted papilloma is a locally-aggressive benign neoplasm of the paranasal sinuses with a high potential for recurrence and malignancy. Intracranial extension is infrequent, and dural penetration even more so, typically associated with recurrence of the disease or its degeneration into squamous cell carcinoma. CLINICAL CASE: A 32-year-old female patient consulted us for an exophytic lesion in her right nostril and exophthalmos, associated with headache, anosmia and dysgeusia. Craniofacial and brain CT and brain MRI demonstrated a lesion in the right nostril, extending into the aerial sinuses, orbital lateral wall and anterior fossa, with osteolysis and intracranial invasion towards the right frontal region. A mass effect and brain compression were noted. A histological diagnosis of inverted papilloma was made initially. Upon later resection of the lesion by double access, with reconstruction of the anterior cranial fossa, a definitive diagnosis was made of inverted papilloma of the Schneiderian type, with areas of atypical transformation in situ. Post-operatively, the patient has had a favorable course, with full upper airway patency and neither complications nor signs of recurrence after four years of follow-up. CONCLUSIONS: Intracranial invasion of this pathology is extremely uncommon. When it exists, the tumor has a high potential for local recurrence. Consequently, complete excision of the lesion determines the patient's prognosis.

Schwannoma intraventricular del plexo coroideo. Descripción de un caso y revisión de la bibliografía / Intraventricular schwannoma of the choroid plexus. Case report and review of the literature

Introducción: Los tumores intraventriculares representan alrededor del 10% de los tumores del sistema nervioso central. Los schwannomas intraventriculares son infrecuentes y solo existen 15 casos descritos en la literatura. Caso clínico Paciente de 41 años de edad, con antecedentes de migrañas de 17 años de evolución, que consultó por cefaleas y náuseas. La tomografía y resonancia magnética de cerebro evidenciaron una lesión nodular sólida a nivel del asta occipital derecha con realce homogéneo con contraste. Se realizó una exéresis completa a través de una craneotomía parietal y un abordaje transcortical. La evolución postoperatoria fue favorable. La anatomía patológica informó: schwannoma. La resonancia de control a los 18 meses no mostró recidiva. Conclusión Los schwannomas intraventriculares son lesiones muy infrecuentes. El tratamiento quirúrgico de elección es la resección completa. Es un diagnóstico a tener en cuenta en tumores intraventriculares (AU)

Introduction: Intraventricular tumors account for approximately 10% of central nervous system tumors. The intraventricular schwannomas are rare because there are only 15 cases reported in the international literature. Case report: A forty-one years old female, with a history of migraines during 17 years, consulted for headaches and nausea. Brain computed tomography and magnetic resonance imaging evidenced solid nodular lesion at the right occipital horn with homogeneous contrast enhancement. Complete excision was performed through a right parietal craniotomy and a transcortical approach. The postoperative evolution was favorable. The pathologyreport: schwannoma. The magnetic resonance imaging 18 months after resection showed no recurrence of tumors. Conclusion: Intraventricular schwannomas are very rare tumors. Surgery is treatment of choice for total resection. This is a diagnosis to consider in intraventricular tumors (AU)

[Intraventricular schwannoma of the choroid plexus. Case report and review of the literature]. / Schwannoma intraventricular del plexo coroideo. Descripción de un caso y revisión de la bibliografía.

INTRODUCTION: Intraventricular tumors account for approximately 10% of central nervous system tumors. The intraventricular schwannomas are rare because there are only 15 cases reported in the international literature. CASE REPORT: A forty-one years old female, with a history of migraines during 17 years, consulted for headaches and nausea. Brain computed tomography and magnetic resonance imaging evidenced solid nodular lesion at the right occipital horn with homogeneous contrast enhancement. Complete excision was performed through a right parietal craneotomy and a transcortical approach. The postoperative evolution was favorable. The pathology report: schwannoma. The magnetic resonance imaging 18 months after resection showed no recurrence of tumors. CONCLUSION: Intraventricular schwannomas are very rare tumors. Surgery is treatment of choice for total resection. This is a diagnosis to consider in intraventricular tumors.

Embolización preoperatoria con esponja de gelatina absorbente en meningiomas intracraneales. Réplica / No disponible

No disponible

Gliosarcoma multicéntrico / Multicentric gliosarcoma

Objetivo. Presentar un caso de esta infrecuente patología; realizar una revisión bibliográfica y analizar su etiología, características clínicas y tratamiento. Descripción. Paciente femenina de 60 años de edad, que consultó por presentar hemiparesia braquiocrural derecha y afasia de expresión de 30 días de evolución. La TAC y RMN evidenciaron lesiones localizadas a nivel parieto-occipital izquierda, parainsular y occipital derecha. El screening oncológico fue negativo. Intervención. Se realizó craniotomía y exéresis subtotal de la lesión parieto-occipital izquierda. La anatomía patológica informó gliosarcoma. Completó tratamiento con radioterapia holocraneana y quimioterapia con temozolamida. La paciente falleció a los diez meses del diagnóstico.

Objetive. We report a rare case of Multicentric Gliosarcoma, we review the literature and analyze its causes, clinical features and treatment.Description. Sixty-year-old female patient who has presented right hemiparesis and motor aphasia for a month. CT and MRI showed lesions at the left parieto-occipital lobes, right occipital and parainsular lobes. Oncologic screening was negative.Intervention. A craniotomy and subtotal excision of parietooccipital lesion was performed. Histological examination revealed gliosarcoma. She received radiotherapy and chemotherapy,however she died ten months after the diagnosis. Conclusion. Multicentric gliosarcoma is very unfrequent. Thereare only two cases reported in the literature. Even so, it must besuspected in multiple cerebral lesions.

Gliosarcoma multicéntrico / Multicentric gliosarcoma

Objetivo. Presentar un caso de esta infrecuente patología; realizar una revisión bibliográfica y analizar su etiología, características clínicas y tratamiento. Descripción. Paciente femenina de 60 años de edad, que consultó por presentar hemiparesia braquiocrural derecha y afasia de expresión de 30 días de evolución. La TAC y RMN evidenciaron lesiones localizadas a nivel parieto-occipital izquierda, parainsular y occipital derecha. El screening oncológico fue negativo. Intervención. Se realizó craniotomía y exéresis subtotal de la lesión parieto-occipital izquierda. La anatomía patológica informó gliosarcoma. Completó tratamiento con radioterapia holocraneana y quimioterapia con temozolamida. La paciente falleció a los diez meses del diagnóstico.(AU)

Objetive. We report a rare case of Multicentric Gliosarcoma, we review the literature and analyze its causes, clinical features and treatment.Description. Sixty-year-old female patient who has presented right hemiparesis and motor aphasia for a month. CT and MRI showed lesions at the left parieto-occipital lobes, right occipital and parainsular lobes. Oncologic screening was negative.Intervention. A craniotomy and subtotal excision of parietooccipital lesion was performed. Histological examination revealed gliosarcoma. She received radiotherapy and chemotherapy,however she died ten months after the diagnosis. Conclusion. Multicentric gliosarcoma is very unfrequent. Thereare only two cases reported in the literature. Even so, it must besuspected in multiple cerebral lesions.(AU)

Hidrocefalia aguda como forma de presentación de carcinomatosis meníngea: Reporte de 2 casos y revisión de la bibliografía / Onset of meningeal carcinomatosis as acute hydrocefalus

Objective: To present two cases of leptomeningeal carcinomatosis, their management, and a bibliographical revision. Description: case 1: patient of 48 years, who enters by sensory abnormalities, with CT that demotrated tetraventricular hydrocephalus. The CSF was positive for neoplasic cells. Primary tumor was found in bladder. Case 2: patient of 55 years, who entered by progressive cuadriparesia. He presented sensory abnormalities by acute hydrocephalus. The autopsy informed meningeal affectation by gastric carcinoma. Discussion: Although patognomonic signs do not exist, the more frequent clinical manifestations are affectation of cranial nerves, headache and alterations of the mental functions. The RNM with gadolinium is the best method, with a sensitivity of 70. In the infrequent cases of acute hydrocephalus, the CT is the first study to perform. Conclusion: Before the unspecific signs, the diagnosis of certainty of meningeal carcinomatosis is based on the help of radiological investigations and the findings of the LCR, on an oncologic context.