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PubMed1993

Pituitary carcinoma of pars distalis as a common neoplasm in Fischer-344 rats.

The incidence of invasive spontaneous pituitary carcinomas in Fischer-344 rats were studied. The pituitaries were examined histopathologically together with surrounding tissues including sphenoid bone. The incidence of carcinoma was higher than that previously reported in Fischer-344 rats. All the carcinomas observed in this study showed evidence of local invasion either ventrally into bone and bone marrow or laterally into peripheral nerves and blood vessels. No dorsal infiltration into the brain was recognized. Pituitary carcinoma with local invasion is a relatively common neoplasm when examined histopathologically together with the surrounding tissues.

Adenocarcinoma↗
PubMed1996

Multiple peripheral nerve sheath tumors in the small intestine of a horse.

Multiple neurofibromas, schwannomas, and hyperplastic enteric plexuses were observed in the distal jejunum and ileum of a 6-year-old pinto gelding. The animal was presented because of an acute episode of colic. Three meters of distal small intestine, partially incarcerated in the epiploic foramen, were surgically removed. Numerous tumor nodules up to 10 mm in diameter were found adjacent to a Meckel's diverticulum, predominantly located in the subserosa of a hypertrophic segment. Histologically, tumors were well demarcated and composed of interlacing fascicles formed by spindloid cells. Adjacent enteric plexuses were hyperplastic. Immunohistochemically, all tumors were positive for vimentin and S-100. Desmin immunoreactivity was only observed in larger tumors (> 500 microns). Glial fibrillary acid protein was demonstrated nearly exclusively in smaller ones. Immunostaining for neurofilament was restricted to entrapped ganglion cells. Based on conventional light microscopic examination and immunohistochemical evaluation, the lesion was diagnosed as multiple benign peripheral nerve sheath tumors in the small intestine.

Animals↗
PubMed1984

Peripheral sensory neuropathy and cisplatin chemotherapy.

Patients with advanced cancer, previously untreated, were given 60 mg/m2 cisplatin plus 60 mg/m2 adriamycin by monthly intravenous injections. Signs and symptoms of a predominantly sensory peripheral neuropathy developed in 92% of the patients. Patients complained of dysesthesias and paresthesias in hands and feet. Clinically, there was progressive decrease or loss of tendon reflexes, decreased vibratory sense, and mild decrease in light touch and pin sensation. Distal sensory latencies became prolonged or dropped out completely, but there was little change in motor nerve conduction velocities or motor unit action potentials. Sural nerve biopsies showed loss of large-diameter nerve fibers, with axonal and myelin degeneration.

Carcinoma↗
PubMed2006

Concomitant conus medullaris ependymoma and filum terminale lipoma: case report.

OBJECTIVE: Ependymomas of the conus medullaris-cauda equina-filum terminale region are typically solitary lesions. In this report, we describe the clinical presentation, radiographic findings, operative details, and pathological features of a patient with a conus medullaris ependymoma and a filum terminale lipoma. CLINICAL PRESENTATION: A 40-year-old woman presented with increasing low back pain and bowel and bladder dysfunction. Magnetic resonance imaging revealed a partially cystic enhancing lesion at the conus medullaris and a T1-weighted hyperintense mass within the filum terminale. INTERVENTION: An L2-L3 laminotomy/laminoplasty was performed for gross total resection of the mass. Histopathological examination demonstrated a conus medullaris ependymoma and filum terminale lipoma. The patient experienced complete resolution of her preoperative symptoms. CONCLUSION: Spinal cord ependymomas are almost exclusively single lesions and their coexistence with other pathological entities is rare. In this report, we describe a patient with a concomitant conus medullaris ependymoma and filum terminale lipoma.

Adult↗
PubMed2003

Histopathologic type: an independent prognostic factor in primary soft tissue sarcoma of the extremity?

BACKGROUND: We attempted to define the effect of tumor histotype on local recurrence, distant metastasis, and disease-specific survival in patients with surgically treated primary extremity sarcoma. METHODS: A total of 951 patients with primary, localized soft tissue extremity sarcoma were followed up prospectively. Patient- and tumor-related variables, including histopathologic type, were used to identify independent prognostic factors for the study end points of local recurrence, distant recurrence, and disease-specific survival. RESULTS: There were 137 local recurrences, and significant adverse prognostic factors for local recurrence were patient age >50 years, microscopically positive margins, and malignant peripheral nerve tumor. Adverse prognostic factors for distant recurrence (200 patients) were tumor size >5 cm, tumors beneath the investing fascia, high tumor grade, and leiomyosarcoma. Of the 199 patients who died of disease-related causes, patient age >50 years, tumors beneath the investing fascia, high tumor grade, microscopically positive margin, tumor size >5 cm, leiomyosarcoma, and malignant peripheral nerve tumor were adverse prognostic factors. CONCLUSIONS: These data suggest that differences in biological behavior may exist between sarcoma histotypes and deserve further study.

Adult↗
PubMed2005

Two cases of schwannoma with marked cystic changes.

We report two cases of schwannoma displaying marked cystic changes; one in the temporalis muscle and one in the submandibular space. The first patient, a 44-year-old male, presented after complaining of a swelling rapidly increasing in size in the left temporal region. Computed tomography (CT) indicated a low-density area surrounded by soft tissue. Magnetic resonance imaging (MRI) revealed signal hypointensity on T1 weighted imaging and strong signal hyperintensity on T2 weighted imaging. The extirpated tumour specimen measured 58 mm x 58 mm x 30 mm. Histopathological examination identified schwannoma, comprising spindle cell proliferation in a palisading pattern with obvious cystic changes. The second case involved a 46-year-old female who presented with swelling of the right submandibular region. Panoramic radiography and lateral oblique mandible projection, which were used together with conventional sialography of the submandibular gland, revealed the so-called "ball in hand" appearance of the submandibular gland, and contrast-enhanced CT identified a lesion of 30 mm diameter with a well-defined annular margin and homogeneous low-density near the tumour centre. Benign pleomorphic adenoma was suspected, but histopathological examination identified schwannoma, predominantly comprising Antoni B type tissue.

Adult↗
PubMed1986

Prognostic implications of perineural spread in squamous carcinomas of the head and neck.

The occurrence and prognostic implications of perineural spread were examined in 239 patients with mucosal squamous carcinomas of the head and neck. Perineural spread was demonstrated in resections from 64 patients (27%), the majority having primary tumors at one of three sites: buccal cavity, larynx, and pharynx. Perineural spread near nodal metastases was uncommon. There was no evidence that perineural involvement was more commonly associated with large tumors or less differentiated ones. No association was established between perineural spread and coexistent lymph node deposits in the surgical resections. Perineural spread was, however, shown to be a statistically significant prognostic factor for an increased incidence of subsequent locoregional recurrence and for decreased survival.

Adult↗
PubMed2004

[Benign intercostal nerve schwannoma simulating pulmonary neoplasm: case report].

A 37 years-old white man, smoker, was interned for having dry cough and pain in the left hemithorax (HE). The exam has show diminished vesicle mumble in the medium third part of the HE. The thorax computer tomography showed expansive nodular lesion of the 7 degrees coster arch projecting within the HE, with density of the bulk part and discreet enhance by the contrast. Imuno-histochemistry was compatible to benign schwannoma. We consider the intercostal benign schwannoma diagnosis must be taken before all the posterior or lateral intrathoracic mass that follows with small syntomathology and absence of clinical manifestation of malignity.

Adult↗
PubMed2006

Adenoid cystic carcinoma of the cavernous region. Case report.

A 62-year-old Japanese male patient presented with right oculomotor, abducens, and trigeminal nerve disturbances. Neuroimaging revealed a right middle cranial fossa mass lesion with the characteristics of trigeminal schwannoma. The patient underwent a right temporal craniotomy for gross total resection. Histological examination confirmed a metastasis of adenoid cystic carcinoma (ACC). After the operation, no evidence of the primary lesion could be found. The patient was treated with radiation therapy. ACC can be difficult to identify before histological confirmation. The incidence of intracranial invasion of ACC is 4-22%, but in this case no evidence of the primary lesion was found.

Carcinoma, Adenoid Cystic↗
PubMed1975

Angiographic diagnosis of intra- and extraaxial tumors in the cerebellopontine angle.

Angiography is an effective diagnostic modality in the evaluation of patients with suspected cerebellopontine angle tumor, particularly when there is not a clear clinical differentiation between an intraaxial and an extraaxial mass, or when the patient presents with increased intracranial pressure. In a series of 17 extraaxial masses in the cerebellopontine angle and 2 cerebellar tumors which presented into the angle, the most common angiographic findings were: 1. elevation and/or medial displacement of the proximal portions of the superior cerebellar artery; this finding was seen only in the extraaxial tumors and has not been demonstrated with intraaxial masses; 2. downward, medial, and posterior displacement of the proximal portions of the posterior inferior cerebellar artery; 3. lateral displacement and stretching of the hemispheric branches of both the superior cerebellar and posterior inferior cerebellar arteries; and 4. displacement of the vein of the lateral recess and of the petrosal vein either downward and medially or upward and laterally.

Brain Neoplasms↗
PubMed2004

Primary brachial plexus tumors: imaging, surgical, and pathological findings in 25 patients.

OBJECT: The authors report on the treatment of primary brachial plexus tumors in 25 patients at the University of California, San Francisco. They compare their findings with those obtained in similar series. METHODS: The authors reviewed the electronic and medical records, radiological images, operative reports, and pathological findings in 25 consecutive cases of primary brachial plexus tumors. Cases of metastatic lesions or adjacent neoplasms extending into and involving the brachial plexus were excluded. At presentation patients ranged in age from 19 to 71 years (mean 47-15 years), and neurofibromatosis was present in eight patients (32%). Presenting signs and symptoms included palpable mass (60%), numbness/paresthesias (44%), radiating pain (44%), local pain (16%), and weakness (12%). Duration of symptoms ranged from 2 months to 10 years. Neuroimaging revealed lesions ranging widely in size (volume approximately 1 to 100 ml). Pathological diagnoses included schwannoma (15 [60%]), neurofibroma (five [20%]), malignant peripheral nerve sheath tumor (four [16%]), and desmoid tumor (one [4%]). CONCLUSIONS: Primary tumors arising in the brachial plexus are rare. Careful workup, surgical technique, and attention to pathological diagnosis optimize management.

Adult↗
PubMed2001

Surgical management and outcomes in patients with median nerve lesions.

OBJECT: One hundred sixty-seven of 250 patients with median nerve (MN) lesions, excluding carpal tunnel syndrome and nerve sheath tumors, at the levels of the arm, elbow, forearm, and wrist, underwent surgical treatment at Louisiana State University Health Sciences over a 30-year period. The most common causes of MN injuries were laceration, fracture-associated stretch and contusion, gunshot wound, compression, and injection injuries. In this study, surgically treated patients were followed and evaluated retrospectively for favorable functional outcomes. METHODS: Lesions not in continuity required primary or secondary end-to-end suture or graft repairs. With the aid of direct intraoperative recording of nerve action potentials (NAPs), MN injuries in which the lesion was in continuity underwent external or internal neurolysis, or resection of the lesion, followed by end-to-end suture or graft repair. A minimum of 12 months follow-up review (mean 18 months) was available in 85% of the surgically treated patients. For lesions in continuity, a functional recovery of Grade 3 or better was seen in 72 (95%) of 76 patients who underwent neurolysis, 18 (86%) of 21 who received suture repair, and 21 (75%) of 28 who received graft repair. In lesions not in continuity, favorable results (Grade > or = 3) were seen in 10 (91%) of 11 patients who received primary suture repair, seven (78%) of nine who received secondary suture repair, and 15 (68%) of 22 who received graft repair. CONCLUSIONS: Surgical intervention for MN injuries with complete or severe deficits achieved favorable outcomes.

Adolescent↗
PubMed2006

Desmoid-type fibromatoses involving the brachial plexus: treatment options and assessment of c-KIT mutational status.

OBJECT: Desmoid-type fibromatoses are a locally invasive soft-tissue lesion that is most commonly encountered in abdominal sites. The tumor also affects head and neck areas, particularly the supraclavicular region, where it may encase and distort the brachial plexus and compromise neurovascular structures. Neurosurgeons may be called on to treat desmoid-type fibromatoses in these sites. The authors describe their experience in treating four patients with desmoid-type fibromatoses involving the brachial plexus and report the results of immunohistochemical analysis of the tumors. METHODS: Gross-total excision with nerve sparing was the first-line therapy of choice, although the surgery was challenging. Intraoperative identification of the site of tumor origin from musculoaponeurotic tissues by the neurosurgeon was necessary in two of the four cases to achieve a correct frozen section or final pathological diagnosis. Immunostaining for c-KIT (CD117) was undertaken in all cases in light of a previous report of positive CD117 immunoreactivity in abdominal desmoid-type fibromatoses. All four tumors manifested weak focal immunostaining for c-KIT. One of the patients was given adjuvant imatinib mesylate therapy, with limited success. Subsequent polymerase chain reaction testing revealed that three of the four tumors manifested a single base pair change in exon 10 of the c-KIT gene (A to C in two cases and A to G in one case). There was local recurrence in three patients, despite gross-total excision. With the combination of surgery and radiation therapy, local disease control was achieved in three of the four patients. CONCLUSIONS: This represents the first report of c-KIT sequencing in desmoid-type fibromatoses and suggests a possible biological basis for continuing to explore the use of adjuvant imatinib mesylate therapy.

Adult↗
PubMed2002

Massive growth of a meningioma into the brachial plexus and thoracic cavity after intraspinal and supraclavicular resection. Case report and review of the literature.

Extracranial meningiomas comprise approximately 2% of all meningiomas. Involvement of peripheral nerves by meningioma, either by a primary tumor or through secondary extension of an intraaxial lesion, is a much rarer entity; there have been only two reported primary brachial plexus meningiomas and one description of secondary involvement of the brachial plexus by extension of an intraaxial lesion. Although thoracic cavity meningiomas have been described in the literature, their pathogenesis is poorly understood. The authors present the case report of a 36-year-old man who was initially treated for a thoracic spinal meningioma that infiltrated the brachial plexus. After resection, progressive and massive growth with infiltration of the brachial plexus and pleural cavity occurred over a 5-year period despite radio- and chemotherapy. The case report is followed by a review of the literature of this rare entity.

Adult↗