Primary intracranial malignant melanoma (PIMM) represents 0.07% of central nervous system tumours; clinical behaviour and prognosis are not well documented. Preoperative diagnosis of PIMM is complex and it could be easily misdiagnosed, especially with malignant meningioma.We are reporting a case of a man with a history of rapidly arising motor slowing associated with urinary incontinence, presenting with mild convergent strabismus caused by paralysis in abduction in the right eye. A brain CT showed a lesion compatible with malignant spheno-orbital meningioma, and the patient underwent gross total resection. Intraoperatively, the blackish lesion infiltrated and eroded the bone; it was placed externally on the dura mater with a mild reaction and without attachment. Histological examination confirmed PIMM.Intraosseous localisation of PIMM has been observed in the basic bone structure of the oral cavity. We report the first intraosseous spheno-orbital PIMM case and present an embryological theory about how this unusual tumour can develop.

Brain metastases (BrM) are treated with multimodality therapy, however the optimal combination and timing of modalities in the setting of recurrent tumours that have failed prior treatments remain poorly defined. We present a case of a patient with biopsy-confirmed renal cell carcinoma BrM with good performance status initially treated with laser interstitial thermal ablation therapy (LITT) followed by stereotactic radiosurgery and dual checkpoint inhibitor immunotherapy. He subsequently developed rapid in-field recurrence which was treated with salvage surgical resection and implantation of intracavitary cesium-131 brachytherapy. The patient\'s disease remained stable through 18 months postoperatively. This case illustrates the range of options available and provides a combination salvage therapy strategy in a select group of locally recurrent patients who have exhausted conventional treatment options.

BACKGROUND: Large-cell neuroendocrine carcinoma (LCNEC) of the prostate is a rare type of prostate cancer. Only eighteen case reports have been published in the literature to date. The present case report is the first case in the literature to describe brain metastasis of LCNEC of the prostate with neuroimaging, gross, and microscopic evaluation with immunohistochemistry CASE PRESENTATION: A 79-year old male with a history of high-grade prostatic adenocarcinoma treated with androgen deprivation therapy (ADT) who presented after remission with a severe headache and limbs weakness. Neuroimaging showed large right frontal lesion that caused a mass effect. Tumor resection was done, and the biopsy showed LCNEC of prostatic origin. The patient survived for 40 days after the diagnosis and tumor removal.
CONCLUSIONS: We discuss the spectrum of neuroendocrine differentiation in prostate carcinomas and the possible pathological pathways leading to the development of LCNEC of the prostate, and how it affects the presentation and the pattern of metastasis.
CONCLUSIONS: This case report describes a brain metastasis of a rare aggressive type of prostate cancer with poor prognosis. With metastatic lesions of prostatic adenocarcinoma, the probability of NE transdifferentiation increases. LCNEC has a poor prognosis attributed to its nature and late diagnosis. Thus, reporting and investigating such tumor will positively contribute to better management for future patients.

Glioma and cerebral ischemic stroke are two major events that lead to patient death worldwide. Although these conditions have different physiological incidences, ~10% of ischemic stroke patients develop cerebral cancer, especially glioma, in the postischemic stages. Additionally, the high proliferation, venous thrombosis and hypercoagulability of the glioma mass increase the significant risk of thromboembolism, including ischemic stroke. Surprisingly, these events share several common pathways, viz. hypoxia, cerebral inflammation, angiogenesis, etc., but the proper mechanism behind this co-occurrence has yet to be discovered. The hypercoagulability and presence of the D-dimer level in stroke are different in cancer patients than in the noncancerous population. Other factors such as atherosclerosis and coagulopathy involved in the pathogenesis of stroke are partially responsible for cancer, and the reverse is also partially true. Based on clinical and neurosurgical experience, the neuronal structures and functions in the brain and spine are observed to change after a progressive attack of ischemia that leads to hypoxia and atrophy. The major population of cancer cells cannot survive in an adverse ischemic environment that excludes cancer stem cells (CSCs). Cancer cells in stroke patients have already metastasized, but early-stage cancer patients also suffer stroke for multiple reasons. Therefore, stroke is an early manifestation of cancer. Stroke and cancer share many factors that result in an increased risk of stroke in cancer patients, and vice-versa. The intricate mechanisms for stroke with and without cancer are different. This review summarizes the current clinical reports, pathophysiology, probable causes of co-occurrence, prognoses, and treatment possibilities.

Frequent falls and dizziness are common complaints in children. These symptoms can be caused by wide range of underlying pathologies including peripheral vestibular deficits, cardiac disease, central lesions, motor skills delay and psychogenic disorders. We report three paediatric cases who presented with complaints of repeated falls and imbalance. MRI scan revealed underlying brain lesions (frontal lobe arteriovenous malformation, exophytic brain stem glioma and cerebellomedullary angle arachnoid cyst with cerebellar tonsillar ectopia). By reporting these cases, we would like to emphasise the importance of a thorough assessment of children with similar symptoms by detailed clinical history, physical examination and maintaining low threshold for investigations, including radiological imaging. Taking in consideration, the wide range of differential diagnosis, the challenge of obtaining detailed history and difficulty of performing reliable physical examination in this age group. Management of underlying disorders can be medical, surgical or just observational.

We report a case of a giant intra and extradural cervical schwannoma in a patient affected by a severe myelo-radiculopathy. Clinical features, diagnosis and the issues concerning the surgical management of this benign tumor are discussed. We also review similar cases previously reported in the literature. A 50-year old caucasian woman was complaining of a 1 year of neck pain and worsening motor impairment in all four limbs causing the inability to walk. Neuroradiological assessment revealed a suspected schwannoma involving the nerve roots from C3 to C5, compressing and deviating the spinal cord. The vertebral artery was also encased within the lesion, but still patent. A posterior cervical laminectomy with a microsurgical extradural resection of the lesion was performed. Moreover, an accurate dissection of the lesion from the vertebral artery and the resection of the intraspinal component was achieved. Vertebral fixation with screws on the lateral masses of C3, C5 and C6 and a hook on C1 was performed. The procedure was secured using electroneurophysiological monitoring. A progressive improvement of the motor functions was achieved. A cervical post-contrast MRI revealed optimal medullary decompression and a gross-total resection of the lesion. Schwannomas are benign, slowly growing lesions which may cause serious neurological deficit. Early diagnosis is necessary and it maybe aided by imaging studies such as MRI or CT. The accepted treatment for these tumors is surgical resection and, when indicated, vertebral fixation.