Glioblastoma multiforme is the most common malignant brain tumor in adults. Metastasis of intracranial glioblastoma via the cerebrospinal fluid to the spine is a rare occurrence. We present two cases of glioblastoma multiforme with spinal leptomeningeal spread who presented with back pain and paraparesis.
A 30-year-old female patient presented with complaints of backache, weakness in both lower limbs and bladder/bowel dysfunction. Imaging showed an osteolytic lesion at tenth dorsal (D10) vertebra with anterior compression on the spinal cord. Complete intralesional tumor excision with reconstruction was carried out using the anterolateral extrapleural approach. Histopathological examination was suggestive of giant cell tumor (GCT). Because of complete intralesional tumor excision and fear of post-radiation osteonecrosis of bone used for delayed bony union, a conservative approach was used, and radiation therapy was not given. After one year of follow-up patient is doing well without any recurrence of the tumor and is ambulant with support. GCT of dorsal vertebral body is an uncommon entity and total en bloc excision is difficult. Therefore, the treatment strategy is not well-defined. We discuss in brief about incidence, presentation and various treatment modalities available for spinal GCT.
We report a 16-year-old girl who had stunted growth and primary amenorrhea presenting with headache and vomiting. MRI of brain showed posterior fossa dermoid cyst with hydrocephalus and empty sella. Growth hormone (GH), Leutinizing hormone (LH) and Follicular stimulating hormone (FSH) were grossly reduced on endocrinological work-up. She underwent suboccipital midline craniectomy and complete excision of dermoid cyst .She had no additional deficit after the surgery. She had menarche six months after the surgery and developed adequate secondary sexual characters, however her height remains subnormal at follow-up after 2 years as compared to age matched controls. We briefly review the radiological features, pathogenesis and outcome of this underestimated entity.
KeywoRds: Hydrocephalus, Empty sella, Amenorrhea, Dermoid cyst, Brain tumors
ÖZBaşağrısı ve kusmayla gelen ve büyüme geriliği ve primer amenore gösteren 16 yaşında bir kız hastayı bildiriyoruz. Beyin MRG hidrosefali ve boş sella ile birlikte bir posterior fossa dermoid kisti gösterdi. Endokrin incelemede büyüme hormonu (GH), luteinizan hormon (LH) ve foliküler stimüle edici hormon (FSH) önemli ölçüde azalmıştı. Suboksipital orta hat kraniyektomi ve dermoid kistin tam eksizyonu yapıldı. Cerrahiden sonra herhangi bir defisit saptanmadı. Cerrahiden altı ay sonra menarş gelişti ve yeterli sekonder cinsel özellikler ortaya çıktı. Ancak hastanın boyu 2 yıllık takipten sonra yaş açısından eşleşmiş kontrollere göre halen normalin altında kaldı. Bu gereğinden az düşünülen durumun radyolojik özellikleri, patogenezi ve sonucunu kısaca gözden geçiriyoruz.
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