Atypical location, younger age and histopathological features are some of the interesting findings in this case, which need to be documented. To the best of our knowledge, this is the youngest patient of spinal cord neurocytoma.
Hydatid disease or hydatidosis caused by Echinococcus granulosus is the most widespread, serious human cestode infection in the world. Bone involvement is reported in 0.5-4% with spinal involvement reported in 50% of these cases. We report a case of this rare entity of an isolated primary hydatid cyst of the spine in a 15-year-old boy, who presented with progressive back pain for 8 months, lower extremity weakness and urinary incontinence for 3 months. Neurological examination was suggestive of upper motor neuron type of paraperesis grade 1/5 with complete sensory loss below T4 level. MRI of the spine showed multiple cystic extradural lesions at the T4-5 level with involvement of the paraspinal muscles. The patient underwent a T4-5 laminectomy, and a total excision of the multiple epidural and paraspinal cysts. The diagnosis of hydatid disease was confirmed on histopathology. Albendazole was started postoperatively. At 6 months follow-up the boy had no neurological deficit, was playful, active and walking. Postoperative MRI at 6 months showed no recurrence of the lesion. Analysis of the other reported cases is discussed with relevance to our case.
BackgroundPapillary meningiomas are rare meningeal tumors and are associated with aggressive clinical behavior as compared with other meningiomas. Because of their rare occurrence, they may pose a diagnostic dilemma to the unwary pathologist. We report a case of papillary meningioma in a 16-year-old boy.Case PresentationA 16-year-old boy presented with complaints of headache, progressively diminishing vision and more recently generalized seizures. MRI revealed a large bifrontal meningioma which showed presence of a predominantly papillary pattern with areas of focal necrosis, frequent mitoses and bone invasion. He underwent radical excision of the tumor and is free from recurrence or metastasis at 15 months follow-up.ConclusionPapillary meningiomas are rare but well recognized variants of meningioma. They need to be differentiated from other intracranial tumors with a papillary pattern. They are malignant, frequently show bone and parenchymatous invasion and have the potential for extracranial metastasis. Their timely recognition could prevent local and distant metastasis and the mortality or morbidity associated with it.
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