Spotaneous or non-traumatic cerebrospinal fluid rhinorrhea is an uncommon condition and may present a diagnostic challenge to clinicians. This condition is often being misdiagnosed for allergic rhintis or chronic sinusitis since the precipitating cause is not readily apperent in most patients. The mechanism of rhinorrhea is stil not completely clarified. We describe a case of this condition occuring in association with allergic rhinitis and sinusitis. A 52 year-old, obese female patient presented with two weeks history of bilateral clear nasal discharge and postural headache. Sample of nasal discharge tested for glucose and protein. The result was that the collection fluid was cerebrospinal fluid. The origin of cerebrospinal fluid fistula could not be identified despite the diagnostic tests.
Choroid plexus tumors are rare intraventricular papillary neoplasms derived from choroid plexus epithelium, which account for approximately 2% to 4% of intracranial tumors in children and 0.5% in adults. Almost all choroid plexus carcinomas are seen in children and are extremely rare in adults. Headache, diplopia, and ataxia are the most common symptoms usually caused by mechanical obstruction of cerebrospinal fluid flow followed by hydrocephalus, regardless of tumor location. We present an illustrative case with 73 years old male patient who was consulted with headache to our neurosurgery department. In cranial computed tomography, there was a mass in 4th ventricle and we confirmed the mass with magnetic resonance imaging. After surgery had been performed, pathology specimen was diagnosed as choroid plexus carcinoma which was rarely seen in this age group.
ÖZETMeme kanserinin kranial metastazları; kemik, dura veya beyin parankimine olmaktadır. Semptomlar metastazın lokalizasyonuna göre değişir. Kitleler; solid, kistik veya parsiyel kistik şekilde olabilirler. Meme kanserinin kistik intrakranial metastazları oldukça nadirdir. Cerrahi sonrası radyoterapi ve/veya kemoterapi uygulanır. Kırksekiz yaşında bayan olgu, baş ağrısı ve generalize tonik-klonik nöbet şikayetleri ile başvurdu. Sekiz yıl önce sol meme kanseri nedeniyle sol total mastektomi ve sol koltukaltı lenfadenektomi ameliyatı yapılmış. Patolojisi adenoid kistik karsinom olarak gelmiş. Lenf nodlarında metastaz tespit edilen olguya adjuvan kemoterapi uygulanmış. Meme ameliyatından sekiz yıl sonra yapılan kranial MRG'sinde (Manyetik Rezonans Görüntüleme) sol frontalde ve serebellar orta hatta büyük kistik kitle lezyonları tespit edildi. Yapılan PET-CT (Pozitron Emisyon Tomografi) incelemesinde, başka herhangi bir organında metastaz tespit edilmedi. Meme açısından yapılan genel cerrahi konsültasyonunda herhangi bir patoloji bulunmadı. Her iki kranial lezyon nedeniyle bir hafta arayla iki kez ameliyat edilen olgunun yapılan patolojik incelemesinde, kistik meme kanseri metastazı tespit edildi. Ameliyat sonrasında olguya tüm beyin radyoterapi uygulandı. Kemoterapi uygulanmadı. Bu olgu dolayısıyla kranial kistik metastazlarda, ender de rastlansa meme kanseri metastazlarını ayırıcı tanıda düşünmemiz gerektiğini vurgulamak istedik. Anahtar Kelimeler: Kistik intrakranial metastaz, meme kanseri, kistik metastaz, beyin metastazı ABSTRACT Breast cancer is most frequently metastasize dura, bone and parenchyma in cranial tissue. Symptoms vary according to the location of the metastasis. Masses may be solid, cystic and partial cystic form. Cystic intracranial metastases of breast cancer is very rare. Radiotherapy and/or chemotherapy could be performed after surgery. Forty-eight-year-old female patient was admitted with complaints of headache and generalized tonicclonic seizure. Patient underwent surgery for cancer of the left breast for eight years ago. Left total mastectomy and left axillary lymphadenectomy was performed. Pathology was determined as adenoid cystic carcinoma. Adjuvant chemotherapy was applied to patients with lymph nodes metastasis detected. Cranial MRI (Magnetic Resonance Imagination) was performed after eight years after breast surgery. In the left frontal and cerebellar midline, large cystic mass lesions were detected in cranial MRI. PET-CT (Positron Emission Tomography) examination was not detected in any other organ metastases. There was no pathology in terms of breast surgery consultation. Both cranial lesions were underwent surgery twice in one week. In the pathological examination of the patient, cystic breast cancer metastasis was detected. Whole brain radiotherapy was performed to the patient after surgery. We want to emphasize that in cranial cystic metastasis, rarely come across if breast cancer metastasis should be considered in differential diagnosis.
This work describes a simple technique for the safe removal of the midline parietal bone with the synostotic sagittal suture in infants with sagittal synostosis to avoid dural tearing and bleeding from the superior sagittal sinus. The technique consists of stepwise removal of the midline parietal bone in three pieces instead of one piece, starting with the anterior one-third midline bone being safely freed from the underlying dural sinus and then transversely cut using a craniotome. The step is repeated twice for the middle and distal one-third of the bone respectively. Once the midline bone is bilaterally cut along its entire length, the stepwise elevation of the superior sagittal sinus dura using an elevator and removal of the midline bone in three pieces allows a safer, controlled procedure minimizing the risk of tearing the underlying dural sinus and preventing sinus bleeding in infants with sagittal synostosis.
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.