A 30-year-old female presented with a rare case of isolated recurrence of granulocytic sarcoma manifesting as extra-and intracranial masses 16 months after successful treatment of acute myeloblastic leukemia (M-2). She presented with a swelling located on her forehead that had appeared just after hitting her forehead, and never diminished in size. The mass was elastic hard and not freely mobile. Computed tomography and magnetic resonance imaging demonstrated enhanced masses in the right frontal extra-and intracranial region with no bone destruction. There was no evidence of relapse in the bone marrow. Needle aspiration biopsy of the subscalpal mass was performed. Fluorescence in situ hybridization revealed AML1/MTG8 fusion gene associated with t(8; 21). Two courses of systemic chemotherapy with high-dose cytarabine and total neural axis irradiation resulted in complete remission.
The collagen gel matrix assay is clinically useful to determine in vitro chemosensitivity that reflects in vivo chemosensitivity. Individual chemotherapy for malignant astrocytic tumors, based on chemosensitivity data, could contribute to longer survival, particularly in anaplastic astrocytoma-bearing patients.
A 22-year-old female developed intracranial and spinal subarachnoid metastases 9 years after radiation therapy for a pineal germinoma. Computed tomographic scans showed no evidence of local recurrence. Cerebrospinal axis irradiation achieved total remission. Delayed subarachnoid dissemination may be caused by germinoma cells remaining dormant in the subarachnoid space, outside the radiation field.
Portal vein aneurysm (PVA) includes focal dilatation of the portal vein, and was formerly thought to be a rare disease. We report a 46-year-old man with chronic aggressive hepatitis and intrahepatic portal vein aneurysm communicating with the hepatic vein. Hemangiomas in the liver and intracranial arteriovenous malformation (AVM) were also found. To our knowledge, this is the first report of a case of PVA in a patient with congenital intracranial AVM. As the PVA in this patient communicated with the hepatic vein, and as hemangiomas in the liver and intracranial AVM were also present, the pathogenesis in this patient seems to have been congenital anomaly of the vasculature.
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