Primary melanocytoma arising from the leptomeninges of the spinal cord is very rare. A surgical specimen of a thoracic meningeal tumor was resected from a 75-year-old woman complaining of gait disturbance was investigated. Magnetic resonance imaging and myelography showed a dumb-bell-type tumor in the subdural space at the 1st to 2nd thoracic vertebrae. The tumor was subtotally resected because of adhesion to the lamina and thoracic medulla. The localized, gelatinous black tumor showed a well-defined margin without dissemination or infiltration. The tumor had a thin capsule and was composed of solid proliferation of neoplastic melanocytes. Neither whorl formation nor foci of palisaded nuclei were observed. The neoplastic cells were of two major types: an epithelioid- or polygonal-shaped type and a spindle-shaped type, and had a large nucleus, a prominent nucleolus, coarse chromatin, and melanin-pigments in their cytoplasm. Only a few mitotic figures were observed. They were positive for HMB-45 and S-100 protein. This case was considered to be primary melanocytoma arising from the thoracic leptomeninges.

Aged↗

PubMedDate not supplied

Stereotactic radiosurgery for brain metastases using a linac system: evaluation of initial local response by imaging.

PURPOSE: We analyzed the efficacy of initial local response of MBT by imaging obtained within two months after treatment, to determine if there are factors that may be important for the initial local response of the disease. If an earlier local tumor response can be expected from SRS, patients with a poor prognosis should be treated with this modality. METHODS: Thirty-six patients with 59 lesions were treated by linac radiosurgery. The primary tumor, peripheral dose, tumor volume, and CT enhancement pattern of the tumor before treatment (homogeneous or ring-enhancing) were chosen as factors related to local tumor response and were used in the statistical analysis. RESULTS: 1) The initial local response of radiation-resistant tumors to conventional EBRT was worse than that of other tumors. The initial local responses of MBT from breast carcinoma, colon carcinoma, and pulmonary carcinoma were good. 2) Excluding radioresistant tumors, the cases irradiated at 25 Gy or more tended to show good local control. 3) No statistically significant differences were found between local response and factors such as the enhancement pattern and tumor volume in the analysis of MBT.

Brain Neoplasms↗

PubMedDate not supplied

Useful interventional thrombolytic and anticoagulant therapy for thrombosis due to embolization (TAE) in Budd-Chiari syndrome.

Transarterial embolization given for hepatoma in a patient with Budd-Chiari syndrome resulted in hepatic infarction and inferior vena cava thrombosis. Transarterial membranotomy and repeated infusion of thrombolytic agents and anticoagulants directly in the thrombus brought about improvement of the circulation surrounding the liver and IVC, and recovery from hepatic failure.

Budd-Chiari Syndrome↗

PubMedDate not supplied

Usefulness and problems of stereotactic radiosurgery using a linear accelerator.

Since the introduction of linac radiosurgery in October 1994, we have treated 27 patients with 36 lesions. We treated nine AVM, 12 metastatic brain tumors, two malignant lymphomas, one anaplastic astrocytoma, two meningiomas, and one brain tumor of unknown pathology. In the follow-up examinations at least five months after treatment, the local control rate was 83% for the metastatic tumors, and two malignant lymphomas disappeared completely. In addition, satisfactory results have been obtained with AVM and other brain tumors without any side effects. In comparison with gamma-knife radiosurgery, linac radiosurgery has some disadvantages such as longer treatment time and cumbersome accuracy control, but if accuracy control is performed periodically, accuracies of 1 mm or less can be obtained. There is some strengths of linac radiosurgery as follow. 1) The acquisition cost is relatively low. 2) Dose distribution are equivalent to gamma-knife. 3) There is no field size limitation. 4) There is great flexibility in beam delivery and linac systems. Radiosurgery using linear accelerators seems to become widely accepted in the future.

Brain↗