✓ A case is described of spontaneous intracranial extradural hematoma in which the clinical presentation and the underlying mechanism differed from those previously described.
We recommend early surgical intervention for such delayed symptomatic radionecrotic masses that do not resolve following non-operative management. We also recommend caution in interpretation of SPECT scan results when attempting to differentiate radionecrosis from neoplasia.
A 53-year-old man presented with a 9-month history of symptoms of right-sided weakness, tingling and hypersentivity to clothes on both sides of the body. MRI revealed a large intraspinal intradural tumour at the level of C3-C4 in the cervical cord. The final histology was a solitary fibrous tumour (SFT) of the cervical spinal cord. The radiological diagnosis, surgical management and histology are reviewed.
Cytogenetic studies over many years have established absence or deletion of chromosome 22 as a common finding in meningiomas. Enormous karyotypic variation is recognised: an abnormal hyperdiploid clone can occur in a histologically benign meningioma. The cytogenetic, histopathological and macroscopic findings in 13 meningiomas of a prospective study are presented. Where the neuropathologist reported the presence of malignant change, a cytogenetically abnormal clone was more common in short-term culture of the tumour tissue. Histologically benign meningiomas showed great cytogenetic variation, from normal chromosomes to hyperdiploid clones with extensive karyotypic abnormality indicating malignant change. We suggest the addition of cytogenetic findings to histopathological features in assessing 'malignancy' in meningiomas and the risk of recurrence or regrowth.
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