摘要:

GERM-CELL TUMORS CAN be subdivided into germinoma, embryonal carcinoma, choriocarcinoma, endodermal sinus tumor (yolk-sac tumor), and teratoma. They are also distinguished by their production of secreted markers such as α-fetoprotein produced in endodermal sinus tumors and embryonal carcinoma or β-human chorionic gonadotropin, produced by choriocarcinoma and embryonal carcinoma. Germinoma and teratoma produce none of the markers. Because it has been proposed that teratomas may differentiate from multipotent stem cells contained in embryonal carcinoma and are thus lineage related, the presence of markers indicates the presence of a nongerminomatous germ-cell tumor. Nongerminomatous germ-cell tumors are an invariably fatal subgroup within the pediatric pineal region germ-cell tumors. There is no effective, established therapeutic regimen. We report the treatment regimen for three children diagnosed with this highly aggressive tumor entity. The children were first given a course of chemotherapy with bleomycin, etoposide, and cisplatin. This resulted in the normalization of markers and the shrinkage of tumors. These were then removed by the infratentorial supracerebellar approach. Removal was followed by a second course of chemotherapy with vinblastine, ifosfamide, and cisplatin; after which the children underwent radiotherapy. All three children are well and without evidence of residual or recurrent disease 20, 30, and 32 months after surgery, respectively. We propose this therapy regimen for children in whom the markers are positive.

ISSN:0148-396X    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

PITUITARY ADENOMAS ARISING far from the pituitary gland occur rarely as a result of defects in embryological migration. Likewise, there have been reports of isolated suprasellar adenomas (clinically nonfunctioning), presumably derived from cells of the pars tuberalis. In this report, we present four cases of functional pituitary adenomas (three adrenocorticotrophic hormone, one prolactin) confined to the supradiaphragmatic region. In each case, the tumors were initially treated unsuccessfully by operations via the transsphenoidal route because of expected intrasellar processes with suprasellar extension.

ISSN:0148-396X    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

A 20-YEAR-OLD CAUCASIAN woman with a 5-year history of right arm, neck, and back pain sought treatment when an automobile accident (4 months before admission) exacerbated her pain. Magnetic resonance imaging revealed an intra- and extradural mass compressing the spinal cord at the C5-C6 level. It also extended into and widened the neural foramen, mimicking a neurofibroma. A singlecafe-au-laitspot was discovered in the inguinal region. A two-staged surgical resection was performed on an apparent hemorrhagic C6 nerve root mass. The mass exhibited diagnostic features of a malignant melanoma histologically, immunocytochemically, and ultrastructurally. A search for a primary lesion outside the nervous system or other metastases during an 8-year period from the onset of symptoms has been negative. The patient's chronic history, evidence of neural foraminal enlargement, and the absence of other malignant melanoma lesions or subsequent metastases indicates that this lesion may be a primary melanoma of the nerve root with a benign course.

ISSN:0148-396X    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

A RARE CASE of C2 vertebral body metastasis from a parasagittal meningioma is reported. The metastatic lesion was found 13 years after resection of the primary lesion. The primary and the metastatic lesions had a similar and benign histological appearance. Remote metastasis of a meningioma can occur even with a benign histological finding after a variable disease-free period.

ISSN:0148-396X    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

A 12-YEAR-OLD CAUCASIAN boy presented with a thoracic myelopathy. Magnetic resonance T1-weighted images revealed an enhancing lesion infiltrating the lower thoracic spinal cord to the level of the conus. Evaluation of the lesion by open biopsy revealed granulomatous angiitis of the spinal cord. Granulomatous angiitis is a rare vasculitic process that typically involves the brain and, less frequently, the spinal cord. Diagnosis must be established early by histopathological examination so that treatment with corticosteroids and/or cytotoxic agents may be instituted. When left untreated, patients with granulomatous angiitis of the spinal cord have developed fatal intracranial manifestations.

ISSN:0148-396X    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

WE REPORT THE clinical, radiological, and histological features of an 8-year-old boy with an unusual presentation of fronto-orbital sphenoidal fibrous dysplasia. The various forms of fibrous dysplasia are outlined and the differential diagnosis discussed. An approach to surgical management is proposed.

ISSN:0148-396X    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

A CASE OF worsening visual deficit after endovascular electrothrombosis therapy for a giant aneurysm of the internal carotid artery ophthalmic seg-ment is presented. Possible pathophysiological mechanisms are suggested. The need for both collaboration between the neurovascular surgeon and the interventionalist and appropriate case selection is emphasized.

ISSN:0148-396X    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

OF A TOTAL of 80 operated intraorbital lesions, 2 were located in the posterior intraconal space, medial and inferior to the optic nerve. Because they were unfavorably located for standard surgical approaches, we operated via a contralateral pterional transsphenoidal-transethmoidal route. This technique provided excellent exposure and results in these two cases of intraorbital cavernous malformations. A brief description of the approach is presented.

ISSN:0148-396X    

出版商:OVID    

年代:1994

数据来源: OVID

ISSN:0148-396X    

出版商:OVID    

年代:1994

数据来源: OVID

ISSN:0148-396X    

出版商:OVID    

年代:1994

数据来源: OVID