Background: Glioblastoma is one of the most malignant types of primary central nervous system tumors with a high recurrence rate and dismal prognosis. Multifocal glioblastoma has been shown to have a poorer prognosis than solitary glioblastoma. Cancer patients are at risk of contracting COVID-19. It is hypothesized that COVID-19 may induce glioma tumorigenesis via angiotensin enzyme 2 receptor. We reported a rare pediatric multifocal glioblastoma in a twelve-year-old boy complicated with COVID-19. Case Presentation: The patient was a twelve-year-old boy with a new-onset unprovoked seizure and headache. Magnetic resonance imaging (MRI) showed a heterogeneous solid cystic mass in the left temporal region (2.1x2.1x2.8 cm) with an increased choline/creatinine ratio and choline/n-acetyl acetate aspartate (NAA) ratio suggestive for high-grade glioma. The patient was contracting COVID-19 shortly after the diagnosis of glioblastoma. Two weeks later, patients came with significant neurological deterioration, hemiparesis, headache, and vomiting. MRI showed an infiltrative mass in the temporal and parietal region (5.05x8.03x8.3 cm) with intratumoral hemorrhage, also causing midline shift deviation (11.9 mm). The patient underwent trepanation and total safe resection of the tumor. Histopathological findings showed neoplastic cells with abundant mitotic figures, necrotic foci and pseudopalisading necrosis. These findings confirmed the diagnosis of multifocal glioblastoma. Conclusion: Glioblastoma is a rare disease in the pediatric population with a poor prognosis due to its infiltrative nature and high recurrence rate. The patient had an acute deterioration of the neurological condition and rapid growth of the tumor after he contracted COVID-19, which may or may not be incidental. Further observation of similar cases will be required to determine the association between glioblastoma and COVID-19.
Background: Posterior reversible encephalopathy syndrome (PRES) is characterized by a combination of clinical and radiological features. PRES presents with the rapid onset of neurological symptoms, such as headache, convulsion, altered consciousness and visual disturbance. If PRES is recognized and treated early, it has a good prognosis. We present a patient with PRES due to systemic lupus erythematosus (SLE) and hypertension. This report aims to provide information for the early diagnosis and prompt management of SLE-related PRES to maximize patient outcomes. Case presentation: A 24-year-old woman came to the emergency department with an acute severe headache and visual disturbance. Two years earlier, she was diagnosed with SLE and hypertension. She was fully awake with normal orientation. Her initial blood pressure was 170/100 mmHg. Her visual acuity was 1/∞ (light perception only). Brain T2-weighted magnetic resonance imaging showed multiple hyperintensity patches at the occipital lobe and cerebellum; these findings suggested a diagnosis of PRES. Due to SLE-related PRES, she was treated with intravenous methylprednisolone, and her blood pressure was monitored. Her blood pressure was maintained using a combination of oral antihypertensive drugs. She was also treated with intravenous phenytoin for seizure prophylaxis. Her symptoms resolved completely, and her visual acuity returned to normal after 2 days. She was discharged without any neurological sequelae. Conclusion: PRES is a clinical syndrome with specific imaging findings. The diagnosis of PRES requires thorough clinical and neuroimaging examinations. Identifying the underlying cause and delivering prompt treatment is important for achieving a better outcome and minimizing neurological sequelae or mortality in patients with PRES.
Introduction: Tuberculosis (TB) is a chronic disease caused by Mycobacterium tuberculosis. History of tuberculosis contact has consequences for TB infection. Density of occupancy may also accelerate TB transmission. Tuberculin test is a screening method that can detect TB infection. However, BCG immunization can reduce the specificity of tuberculin test results because it causes false positive results. Aim: The aim of this study is to see the relationship between history of TB contact and tuberculin test results. Other variables related to tuberculin test results were also examined i.e. occupancy density and incidence of BCG immunization. Methods: This research was conducted with cross-sectional analytic design using contingency coefficient test with a value of ɑ = 0.1. TB contacts subjects were taken from Surabaya Pulmonary Hospital and non-TB contacts subjects were volunteers from Medical Faculty of Widya Mandala Catholic University volunteers and Medical Faculty of Wijaya Kusuma. Each group consisted of 25 people taken using consecutive sampling technique. There is a significant correlation between history of tuberculosis contact and tuberculin test (p = 0,000); There is no significant correlation between BCG immunization history and tuberculin test results (p = 0.221) Result: There is a significant correlation between occupancy density and tuberculin test results (p = 0.066). Conclusion: It can be concluded that history of tuberculosis contact and occupancy density are associated with positive tuberculin test results.
BACKGROUND AND OBJECTIVE Cavernomas are well-circumscribed and multilobulated vascular malformations that can occur nearly anywhere in the body. Cavernomas are found 80% supratentorially, 15% in posterior fossa and only 5% in the spinal cord. Spinal cavernomas are most commonly intramedullar. Purely epidural spinal cavernoma constitute of less than 4% of all spinal epidural lesions. We report a case of histopathologically confirmed epidural cavernoma of the thoracic spine. CASE PRESENTATION A 24-year-old woman presented with a 6-month history of progressive chronic upper back pain. Physical examination revealed no neurological deficit. Her VAS pain scale was 6/10. Conservative treatments did not relieve her symptoms. Thoracal MRI without contrast shown a lesion that hyperintense on T2-weighted images and isointense on T1-weighted images. The lesion sized 14x13x7 mm at T5 vertebral level located at posterolateral spinal canal. Thoracal MRI with contrast showed extradural mass with homogenous contrast enhancement. The mass was located at left posterolateral spinal canal suspected extradural meningioma. The surgery was done via posterior approach. Left hemilaminectomy was done at T4-T5 vertebral level. Reddish soft tissue mass was observed at the epidural space. The mass was well defined and there were no signs of bony invasion. Gross tumor removal was done under the microscope. Histopathological examination of the mass showed large dilated vessel filled with erythrocyte and lined by endothelium which support the diagnosis of cavernoma. After the surgery, her pain symptom was improved. CONCLUSION Spinal epidural cavernomas are rare, but it should be considered as one of the differential diagnosis for spinal epidural lesions. Exact preoperative diagnosis is hard because there are no pathognomonic MRI findings of spinal epidural cavernoma. Total surgical resection of the lesions was the treatment of choice in symptomatic patients to prevent progressive neurological deficit and prospective hemorrhage.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.