brain tumors

脑肿瘤
  • 文章类型: Case Reports
    室管膜下巨细胞星形细胞瘤(SEGA)是良性的,生长缓慢,经常与结节性硬化症(TSC)相关的非侵袭性肿瘤。诊断前应仔细考虑肿瘤的位置和患者的年龄。考虑SEGA作为鉴别诊断,即使在没有TSC的成年患者中,是必不可少的。在目前的情况下,一名22岁男性出现进行性头痛,头晕,和模糊的视野。放射学检查证实了肿瘤的部位,甲状腺转录因子1在神经节细胞成分中呈阳性表达,随着TSC1和TSC2中缺乏种系突变,导致SEGA的最终诊断没有TSC。
    Subependymal giant cell astrocytomas (SEGAs) are benign, slow-growing, noninvasive tumors frequently associated with the tuberous sclerosis complex (TSC). The tumor\'s location and the patient\'s age should be considered carefully before diagnosis. Considering SEGA as a differential diagnosis, even in adult patients without TSC, is essential. In the present case, a 22-year-old male presented with a progressive headache, dizziness, and blurring of vision. Radiological investigations confirmed the site of the tumor, and a positive expression of thyroid transcription factor 1 in the ganglion cell component, along with the absence of germline mutation in TSC1 and TSC2, led to the final diagnosis of SEGA without TSC.
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  • 文章类型: Case Reports
    脑膜瘤是常见的脑肿瘤,被归类为良性,非典型的,或恶性。该病例涉及一名75岁女性,有缺血性心脏病病史,高血压,和糖尿病。在接受与中风有关的症状评估时,她被诊断出患有非典型脑膜瘤。她在医院的演讲中,患者表现出身体右侧运动功能丧失等症状,弱点,吞咽困难,失语症,表示可能的行程。影像学检查证实了中风症状和非典型脑膜瘤的存在。她治疗的主要重点是解决中风症状。尽管脑膜瘤没有症状,患者选择保守治疗,拒绝侵入性治疗.她的决定得到了尊重,并制定了有关脑膜瘤的定期监测和咨询计划。此案例强调了在涉及偶然脑肿瘤的复杂临床情况下,量身定制的治疗决策的重要性。
    Meningiomas are common brain tumors that are classified as either benign, atypical, or malignant. This case involves a 75-year-old woman with a medical history of ischemic heart disease, hypertension, and diabetes. She was diagnosed with an atypical meningioma while being evaluated for symptoms related to a stroke. Upon her presentation at the hospital, the patient displayed symptoms such as loss of motor function on the right side of her body, weakness, dysphagia, and aphasia, indicating a possible stroke. Imaging tests confirmed both the stroke symptoms and the presence of an atypical meningioma. The primary focus of her treatment was addressing the stroke symptoms. Despite being asymptomatic for the meningioma, the patient opted for conservative treatment and declined invasive procedures. Her decision was respected, and a plan was put in place for regular monitoring and counseling regarding the meningioma. This case emphasizes the significance of tailored treatment decisions in complicated clinical situations involving incidental brain tumors.
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  • 文章类型: Case Reports
    一个斯派,8岁雌性贵宾犬,体重5.7公斤,主诉是视力障碍。视力评估,包括瞳孔光反射,威胁回应,炫目反射,在明视和暗视环境中进行迷宫导航,除了右眼的直接瞳孔光反射阳性和从右眼到左眼的合意瞳孔光反射阳性外,双眼均显示出阴性反应。系统评价,包括神经状态,血液剖面,和胸部X光片,没有发现任何异常。完成眼科检查,眼超声检查,视网膜电图没有确定失明的原因。在Funduscopy之后,左眼表现出增加的视盘直径,模糊的视盘边界,和生理坑的损失,以及血管弯曲的增加。在右眼,在非绒面眼底有多焦点褪色区域,在绒面眼底有一些色素斑点被暗淡的绒面反射区域包围。光学相干断层扫描显示左眼乳头周围区域的视神经头和布鲁赫膜严重的前变形。磁共振成像显示不规则,宽基鞍上肿块,具有颅内高压的特征,包括第三脑室的背侧位移,大脑镰向右移动,经天幕疝,周围水肿,后巩膜变平/突出,左侧视神经鞘直径大于右侧。这是第一份全面的报告,描述了患有脑肿瘤的狗的单侧乳头水肿,使用先进的眼科和神经成像模式。
    A spayed, 8-year-old female Poodle, weighing 5.7 kg, was presented with the chief complaint of vision impairment. Vision assessment, including pupillary light reflexes, menace response, dazzle reflex, and maze navigation in photopic and scotopic circumstances, revealed a negative response in both eyes except for positive direct pupillary light reflex in the right eye and positive consensual pupillary light reflex from the right eye to the left eye. Systemic evaluation, including neurologic status, blood profile, and thoracic radiographs, did not reveal any abnormalities. Complete ophthalmic examinations, ocular ultrasonography, and electroretinography did not identify a cause of blindness. Upon funduscopy, the left eye exhibited an increased optic disk diameter, blurred optic disk borders, and loss of the physiologic pit, as well as an increase in vascular tortuosity. In the right eye, there were multifocal depigmented areas in the non-tapetal fundus and several pigmented spots surrounded by a region of dull tapetal reflection in the tapetal fundus. The optical coherence tomography revealed severe anterior deformation of the optic nerve head and Bruch\'s membrane in the peripapillary region of the left eye. Magnetic resonance imaging revealed an irregular, broad-based suprasellar mass, with features suggestive of intracranial hypertension, including dorsal displacement of third ventricles, a rightward shift of the falx cerebri, trans-tentorial herniation, perilesional edema, flattening/protrusion of the posterior sclera, and lager optic nerve sheath diameter in left side than right side. This is the first comprehensive report that describes unilateral papilledema in a dog with a brain tumor, using advanced ophthalmic and neuro-imaging modalities.
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  • 文章类型: Case Reports
    颅内RDD是模仿不同诊断的罕见医学事件。虽然手术切除是最好的治疗选择,但是放射治疗也可以达到长期的次优结果.
    对一名有紧张型头痛病史的83岁男性进行了评估。他意识清醒,没有局灶性神经功能缺损。他的脑部MRI显示,起源于大脑镰状和上矢状窦硬脑膜的增强的双额叶肿瘤。由于患者对总切除的偏好和拒绝,她接受了立体定向活检.病理为Rosai-Dorfman病阳性。他接受了明确的靶向放射,总剂量为4500cGy,每日200cGy。他的4年随访显示区域肿瘤控制,神经系统预后良好。
    UNASSIGNED: Intracranial RDD is rare medical event mimicking different diagnoses. Although the surgical resection is the best treatment option, but radiation therapy can also achieves long-term suboptimal outcomes.
    UNASSIGNED: An 83-year-old male with a history of tension-type headaches was evaluated. He was conscious with no focal neurological deficits. His brain MRI revealed an enhancable bifrontal tumor originating from falx cerebri and superior sagittal sinus dura. Due to the patient\'s preference and decline for gross total resection, she underwent a stereotactic biopsy. The pathology was positive for Rosai-Dorfman diseases. He received definitive targeted radiation with a total dose of 4500 cGy administered in 200 cGy daily fractions. His 4-year follow-up showed regional tumor control with excellent neurological outcome.
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  • 文章类型: Case Reports
    背景:ETMR是一种独特且高度恶性的脑肿瘤,主要发生在婴儿身上。本报告全面概述了临床表现,组织学方面,放射学特征,和ETMR的治疗选择。作为NF1与ETMR共现的第一份报告,它突出了管理复杂医疗条件的病人的挑战。
    方法:我们介绍了一个3岁和1/2岁女孩患有1型神经纤维瘤病(NF1)的病例,后来诊断为幕上脑肿瘤,报告为具有多层玫瑰花结(ETMR)的胚胎性肿瘤,在免疫组织化学(IHC)上可能同时出现结构性错配修复缺陷(CMMRD);然而,未进行种系测试。尽管NF1可能与神经胶质瘤等肿瘤有关,文献中没有ETMR与NF1共存的病例报道.
    结论:探索NF1和ETMR与CMMRD之间的联系对于改善和建立更多的治疗方案至关重要。因此,报告每个病例的独特特征对于制定适当的治疗方案至关重要。
    BACKGROUND: ETMR is a unique and highly malignant brain tumor mostly occurring in infants. This report provides a comprehensive overview of the clinical presentation, histological aspects, radiological features, and therapeutic options of ETMR. Being the first report on the co-occurrence of NF1 with ETMR, it highlight the challenges of managing a patient with complex medical conditions.
    METHODS: We present a case of a 3 and 1/2-year-old girl with neurofibromatosis type 1 (NF1), later diagnosed with a supratentorial brain tumor reported as an embryonal tumor with multilayered rosettes (ETMR), along with possible co-occurrence of constitutional mismatch repair deficiency (CMMRD) on immunohistochemistry (IHC); however, germline testing was not performed. Even though NF1 can be associated with tumors such as gliomas, the literature has no previous case reports of ETMR coexisting with NF1.
    CONCLUSIONS: Exploring the link between NF1 and ETMR with CMMRD is crucial to improving and establishing more treatment protocols. Therefore, reporting each case\'s unique features would be essential in developing appropriate treatment protocols.
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  • 文章类型: Case Reports
    Pallister-Killian综合征(PKS;OMIM#601803)是一种罕见的遗传性疾病,通常以发育迟缓为特征,癫痫发作,稀疏的颞叶毛发,和面部畸形。PKS最常见的原因是马赛克超数同工染色体12p。这里,我们报告了一名27个月大的女孩,其产前诊断为PKS,组织病理学诊断为松果细胞瘤。
    Pallister-Killian syndrome (PKS; OMIM #601803) is a rare genetic disorder typically characterized by developmental delay, seizures, sparse temporal hair, and facial dysmorphisms. PKS is most frequently caused by mosaic supernumerary isochromosome 12p. Here, we report a 27-month-old girl with a prenatal diagnosis of PKS and a histopathological diagnosis of pineocytoma.
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  • 文章类型: Journal Article
    目的:机器人辅助活检在过去几年中越来越受欢迎。大多数机器人程序是用基于地板的机械臂执行的。最近,美敦力隐形汽车指南,与光学神经导航系统一起工作的小型化机械臂,已发射。其在儿科病例中的应用相对未被探索。在这项研究中,我们回顾性地报告了我们使用隐形导游的经验,用于儿科患者的无框立体定向活检。
    方法:本研究包括2020年7月至2023年5月使用StealthAutoguide颅骨机器人平台进行立体定向活检的儿科患者。临床,神经放射学,外科,收集和分析组织学数据。
    结果:19例患者接受了20次手术(平均年龄为9岁,范围1-17)。在四名患者中,活检是更复杂的外科手术(激光间质热疗法-LITT)的一部分.最常见的适应症是弥漫性内在脑干肿瘤,其次是弥漫性幕上肿瘤。在俯卧位进行了九次手术,八位仰卧位,和三个在横向位置。在六个程序中采用了面部表面注册,颅骨固定基准点14.仅接受活检的患者的活检诊断组织获取率为100%,而在活检/LITT组中,有一例未诊断。没有患者出现临床相关的术后并发症。
    结论:隐形自动引导系统已被证明是安全的,诊断,在小儿人群中对幕上和幕下病变进行立体定向活检时,具有很高的准确性。
    OBJECTIVE: Robot-assisted biopsies have gained popularity in the last years. Most robotic procedures are performed with a floor-based robotic arm. Recently, Medtronic Stealth Autoguide, a miniaturized robotic arm that work together with an optical neuronavigation system, was launched. Its application in pediatric cases is relatively unexplored. In this study, we retrospectively report our experience using the Stealth Autoguide, for frameless stereotactic biopsies in pediatric patients.
    METHODS: Pediatric patients who underwent stereotactic biopsy using the Stealth Autoguide cranial robotic platform from July 2020 to May 2023 were included in this study. Clinical, neuroradiological, surgical, and histological data were collected and analyzed.
    RESULTS: Nineteen patients underwent 20 procedures (mean age was 9-year-old, range 1-17). In four patients, biopsy was part of a more complex surgical procedure (laser interstitial thermal therapy - LITT). The most common indication was diffuse intrinsic brain stem tumor, followed by diffuse supratentorial tumor. Nine procedures were performed in prone position, eight in supine position, and three in lateral position. Facial surface registration was adopted in six procedures, skull-fixed fiducials in 14. The biopsy diagnostic tissue acquisition rate was 100% in the patients who underwent only biopsy, while in the biopsy/LITT group, one case was not diagnostic. No patients developed clinically relevant postoperative complications.
    CONCLUSIONS: The Stealth Autoguide system has proven to be safe, diagnostic, and highly accurate in performing stereotactic biopsies for both supratentorial and infratentorial lesions in the pediatric population.
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  • 文章类型: Case Reports
    多形性胶质母细胞瘤(GBM)是一种侵袭性原发性脑肿瘤,主要影响成人,儿童病例极为罕见。大体全切除,随后放疗和替莫唑胺,目前提供最大的整体生存率,是青少年GBM治疗的支柱。最大限度的手术切除可见的肿瘤块已被证明具有积极的预后效果,但是,对于儿童GBM中生长的大脑的辐射担忧和不同化疗方案的不一致结果使得年轻患者的治疗选择具有挑战性.这里,我们报道了一例11岁女性儿童的GBM病例,由于肿瘤的快速生长,患者出现了严重的神经功能缺损和临床恶化.
    Glioblastoma multiforme (GBM) is an aggressive primary brain tumor that primarily affects adults, with cases in children being extremely rare. Gross total resection with subsequent irradiation and temozolomide, currently delivering the greatest overall survival, is the mainstay of therapy for juvenile GBM. Maximal surgical excision of the visible tumor mass has been shown to have a positive prognostic effect, but radiation concerns for growing brains and inconsistent results from different chemotherapy regimens in pediatric GBM make treatment choices for young patients challenging. Here, we report a case of GBM in an 11-year-old female child who presented with a dramatic presentation of neurologic deficits and clinical worsening due to rapid tumor growth.
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  • 文章类型: Journal Article
    背景:这项研究旨在研究韩国和日本年轻人中脑肿瘤的风险与手机射频(RF)暴露之间的关系。
    方法:这项年轻人脑肿瘤的病例对照研究是在国际MOBI-Kids研究的框架下在韩国和日本进行的。我们纳入了2011年至2015年间诊断为脑肿瘤的118例患者和年龄在10-24岁之间的236例匹配的阑尾炎对照。通过面对面访谈收集了有关手机使用的信息。详细的射频曝光算法,基于MOBI-Kids算法,并根据日本和韩国手机和网络的特殊性进行了修改,使用条件逻辑回归计算总累积比能量的比值比(OR)。
    结果:在参考日期前1年的累积呼叫时间的最高三分位数中,调整后的OR为1.61(95%置信区间[CI],所有脑肿瘤为0.72-3.60),神经胶质瘤为0.70(95%CI,0.16-3.03),没有暴露趋势的迹象。特别是神经胶质瘤的OR,在最低暴露类别中低于1。
    结论:这项研究没有提供证据表明使用手机与整体脑肿瘤或神经胶质瘤的风险之间存在因果关系。需要进一步的研究来评估未来新的通信技术的影响。
    This study aimed to examine the association between risk of brain tumors and radiofrequency (RF) exposure from mobile phones among young people in Korea and Japan.
    This case-control study of brain tumors in young people was conducted in Korea and Japan under the framework of the international MOBI-Kids study. We included 118 patients diagnosed with brain tumors between 2011 and 2015 and 236 matched appendicitis controls aged 10-24 years. Information on mobile phone use was collected through face-to-face interviews. A detailed RF exposure algorithm, based on the MOBI-Kids algorithm and modified to account for the specificities of Japanese and Korean phones and networks, was used to calculate the odds ratios (ORs) for total cumulative specific energy using conditional logistic regression.
    The adjusted ORs in the highest tertile of cumulative call time at 1 year before the reference date were 1.61 (95% confidence interval [CI], 0.72-3.60) for all brain tumors and 0.70 (95% CI, 0.16-3.03) for gliomas, with no indication of a trend with exposure. The ORs for glioma specifically, were below 1 in the lowest exposure category.
    This study provided no evidence of a causal association between mobile phone use and risk of brain tumors as a whole or of glioma specifically. Further research will be required to evaluate the impact of newer technologies of communication in the future.
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  • 文章类型: Case Reports
    脑膜瘤作为原发性颅内肿瘤的发生频率很高。我们报告了一个16岁的女性病例,她有三周的持续性头痛病史,呕吐,和畏光。影像学研究显示,大脑右枕叶存在脑膜瘤。病人接受了手术切除,组织病理学分析证实了非典型WHO2级脑膜瘤的诊断。患者术后症状明显改善,随访影像学无复发迹象。该病例强调了在相对年轻的慢性头痛患者的鉴别诊断中考虑脑膜瘤的重要性。以及完全手术切除后与非典型WHO2级脑膜瘤相关的良好预后。
    Meningiomas have a high frequency of occurrence as primary intracranial tumors. We report the case of a 16-year-old female who presented with a three-week history of persistent headache, vomiting, and photophobia. Imaging studies revealed the presence of a meningioma in the right occipital lobe of the brain. The patient underwent surgical resection, and histopathological analysis confirmed the diagnosis of an atypical WHO grade 2 meningioma. The patient experienced a significant improvement in her symptoms postoperatively and had no evidence of recurrence on follow-up imaging. This case highlights the importance of considering meningioma in the differential diagnosis of relatively young patients presenting with chronic headaches, and the favorable prognosis associated with atypical WHO grade 2 meningiomas following complete surgical resection.
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