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Neoplastic meningitis

Raquel Olmos-Jiménez, Alberto Espuny-Miró, Carlos Cárceles Rodríguez, María Sacramento Díaz-Carrasco
INTRODUCTION: Intrathecal chemotherapy is frequently used in clinical practice for treatment and prevention of neoplastic meningitis. Despite its widespread use, there is little information about practical aspects such as the volume of drug to be administered or its preparation and administration. OBJECTIVE: To conduct a literature review about practical aspects of the use of intrathecal chemotherapy. MATERIALS: Search in PubMed/ Medline using the terms "chemotherapy AND intrathecal", analysis of secondary and tertiary information sources...
January 1, 2017: Farmacia Hospitalaria
Kathryn Y Bray, Karen R Muñana, Kristina Meichner, Laura A White, Gabriela Seiler
A 12-year-old cat was presented for evaluation of progressive tetraparesis. Magnetic resonance imaging of the cervical spine demonstrated T2-hyperintensity, and contrast enhancement within the C4-C7 spinal cord, with marked meningeal contrast enhancement and segmental nerve root thickening. Lumbar cerebrospinal fluid contained 407 total nucleated cells/μL, with 99% eosinophils. The cat transiently improved with prednisolone, clindamycin, and ivermectin therapy, but subsequently worsened and was euthanized...
December 2016: Veterinary Clinical Pathology
Hardeep Singh Mudhar, Murtuza Nuruddin, Soma Roy
PURPOSE: To describe the clinical, radiological and histopathological features of a highly unusual primary orbital glioma. PROCEDURES: A 6-year-old female presented with right-sided proptosis that revealed a well-defined intraconal mass on CT imaging with intact orbital bony walls. During the removal of the lesion, it dissected away freely from the muscles and was separated from the optic nerve and globe. There was no communication with the brain. RESULTS: Histology showed histological features highly favouring a pilocytic astrocytoma enveloped by meninges...
October 2016: Ocular Oncology and Pathology
Jarish N Cohen, David A Solomon, Andrew E Horvai, Sanjay Kakar
Mesenchymal chondrosarcoma (MC) is an aggressive small round blue cell tumor with chondrogenic differentiation that typically arises in bony sites. Approximately a third of these tumors develop in extra-skeletal sites such as the meninges, and somatic soft tissue. MCs are well-circumscribed, lobulated masses, with focal calcification. Histologically, two distinct populations of neoplastic cells characterize MC: sheets of primitive small, round, blue cells surrounding islands of well-developed hyaline cartilage with mature chondrocytes in lacunae...
August 17, 2016: Human Pathology
Daniele Marchioni, Davide Soloperto, Alessia Rubini, João Flávio Nogueira, Mohamed Badr-El-Dine, Livio Presutti
Tympanic facial nerve segment surgery has been traditionally performed using microscopic approaches, but currently, exclusive endoscopic approaches have been performed for traumatic, neoplastic, or inflammatory diseases, specially located at the geniculate ganglion, greater petrosal nerve, and second tract of the facial nerve, until the second genu. The tympanic segment of the facial nerve can be reached and visualized using an exclusive transcanal endoscopic approach, even in poorly accessible regions such as the second genu and geniculate ganglion, avoiding mastoidectomy, bony demolition, and meningeal or cerebral lobe tractions, with low complication rates using a minimally invasive surgical route...
October 2016: Otolaryngologic Clinics of North America
A Tzankov
The mediastinum is a complex body region of limited space but containing numerous organs of different embryonic origins. A variety of lesions that are difficult to distinguish from each other can occur here. Non-neoplastic lesions of the mediastinum represent important differential diagnostic pitfalls to mediastinal tumors, clinically, radiologically and histopathologically. It is important to bear these lesions in mind and to adequately verify or exclude them before starting further differential diagnostic considerations on mediastinal neoplasms...
September 2016: Der Pathologe
Giulia Angelino, Maria Debora De Pasquale, Luigi De Sio, Annalisa Serra, Luca Massimi, Rita De Vito, Antonio Marrazzo, Laura Lancella, Andrea Carai, Manila Antonelli, Felice Giangaspero, Marco Gessi, Laura Menchini, Laura Scarciolla, Daniela Longo, Angela Mastronuzzi
BACKGROUND: Primary melanocytic neoplasms are rare in the pediatric age. Among them, the pattern of neoplastic meningitis represents a peculiar diagnostic challenge since neuroradiological features may be subtle and cerebrospinal fluid analysis may not be informative. Clinical misdiagnosis of neoplastic meningitis with tuberculous meningitis has been described in few pediatric cases, leading to a significant delay in appropriate management of patients. We describe the case of a child with primary leptomeningeal melanoma (LMM) that was initially misdiagnosed with tuberculous meningitis...
2016: BMC Cancer
Gaurav Saigal, Natalya Nagornaya, M Judith D Post
Imaging is useful in the diagnosis and management of infections of the central nervous system. Typically, imaging findings at the outset of the disease are subtle and nonspecific, but they often evolve to more definite imaging patterns in a few days, with less rapidity than for stroke but faster than for neoplastic lesions. This timing is similar to that of noninfectious inflammatory brain disease, such as multiple sclerosis. Fortunately, imaging patterns help to distinguish the two kinds of processes. Other than for sarcoidosis, the meninges are seldom involved in noninfectious inflammation; in contrast, many infectious processes involve the meninges, which then enhance with contrast on computed tomography (CT) or magnetic resonance imaging (MRI)...
2016: Handbook of Clinical Neurology
Mamdouh M M El-Bahnasawy, Mohammad Reda El Feky, Ayman T A Morsy, Mousa A M Ismail, Tosson A Morsy
Meningoencephalitis is an acute inflammation of the brain and spinal cord & their covering protective membranes. Meningitis can be life-threatening because of the inflammation's proximity to the brain and spinal cord; therefore, the condition is classified as a medical emergency. The commonest symptoms of meningitis are headache and neck stiffness associated with fever, confusion or altered consciousness, vomiting, and an inability to tolerate light (photophobia) or loud noises (phonophobia). Children often exhibit only nonspecific symptoms, such as irritability and drowsiness...
April 2016: Journal of the Egyptian Society of Parasitology
Lucas Alessandro, Julieta Piar Camporro, Naomi Arakaki, Nora Orellana, Claudia Andrea Mora
Bone involvement of syphilis can be observed in tertiary and congenital syphilis. It is infrequent during the secondary stage. The skull is the most affected bone in secondary syphilis, and its most frequent form of presentation is proliferative osteitis. If the skull is affected, headache is usual and can be as intense as in meningitis. Osteolyitic lesions may be seen in complimentary imaging studies, with a moth eaten aspect. These lesions raise concern over a number of differential diagnoses, among which are infectious, inflammatory and neoplastic diseases...
April 2016: Revista Chilena de Infectología: órgano Oficial de la Sociedad Chilena de Infectología
Xi Wu, Junling Li, Jianping Xiao, Boyan Yang, Lei Yu, Xiaoming Wu, Jinghai Wan, Haiyan Xu, Jianxin Kong
BACKGROUND: Leptomeningeal carcinomatosis is a rare type of metastatic tumors of the central nervous system. In recent years, with the improvement of neoplasms therapies and longer survival of patients by better systemic control, incidence of leptomeningeal metastases has increased every year. However, there is still lack of effective therapies. The aim of this study is to investigate the efficacy, security and prognosis of intrathecal chemotherapy with methotrexate (MTX) in the treatment of neoplastic meningitis...
May 20, 2016: Zhongguo Fei Ai za Zhi, Chinese Journal of Lung Cancer
Qiang Shi, Chenglin Tian, Xusheng Huang, Chuanqiang Pu
BACKGROUND: Carcinoembryonic antigen (CEA) in cerebrospinal fluid (CSF) is important for the diagnosis of meningeal carcinomatosis. Its relationship with CSF and serum in non-neoplastic diseases may be beneficial for earlier diagnosis and treatment. METHODS: CSF samples were obtained from 346 non-neoplastic inpatients. Among them, 238 pairs of CSF and serum were obtained and compared. The 97.5(th) percentile and maximum value of CSF CEA were obtained. RESULTS: The 97...
2016: Annals of Clinical and Laboratory Science
Liang Dong, Jiayu Huang, Luke Huang, Oumin Shi, Qiang Liu, Haige Chen, Wei Xue, Yiran Huang
Thyroid-like follicular carcinoma of the kidney (TLFCK) is an extremely rare subtype of renal cell carcinoma with close resemblance to the well-differentiated thyroid follicular neoplasms. TLFCK has not been included in the 2004 World Health Organization (WHO) classification due to the limited data available. Only 27 cases have been reported in the literature to date. Herein, we report a unique case of TLFCK that presented as a striking skull and meningeal metastasis 5 years after the initial diagnosis; this is the first case of TLFCK with such a novel metastasis pattern...
April 2016: Medicine (Baltimore)
Victoria T Trinh, Rafael Medina-Flores, Muhammad O Chohan
Leptomeningeal carcinomatosis (LMC) is a rare complication of cancer that often presents at an advanced stage after obvious metastasis of a primary cancer or locally advanced disease. We present an uncommon case of LMC secondary to pancreatic carcinoma presenting with headache, unilateral VII nerve palsy, and lower extremity weakness. Initial cerebrospinal fluid (CSF) studies were concerning for chronic aseptic meningitis but negative for malignant cells; the diagnosis of tuberculous meningitis was erroneously evoked...
August 2016: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
Kelly Baldwin, Chris Whiting
Chronic meningitis can be a diagnostic dilemma for even the most experienced clinician. Many times, the differential diagnosis is broad and encompasses autoimmune, neoplastic, and infectious etiologies. This review will focus on a general approach to chronic meningitis to simplify the diagnostic challenges many clinicians face. The article will also review the most common etiologies of chronic meningitis in some detail including clinical presentation, diagnostic testing, treatment, and outcomes. By using a case-based approach, we will focus on the key elements of clinical presentation and laboratory analysis that will yield the most rapid and accurate diagnosis in these complicated cases...
March 2016: Current Neurology and Neuroscience Reports
Caroline Cluzel, Abdelkerim Ahamat Aboulmali, Stéphanie Dugas, Pascaline Pey, Julien Olive, Carolyn Gara-Boivin
Two adult male castrated dogs were evaluated for progressive paraparesis and ataxia. Neurologic examination showed severe ataxia, delayed proprioceptive placement in the pelvic limbs, pain upon palpation of the lumbar spine as well as facial paresis in one dog, and decreased withdrawal reflex of the pelvic limbs in the other dog. Magnetic resonance imaging (MRI) in both dogs showed diffuse meningeal and intramedullary lesions. However, no evidence of a mass was found. Biopsies could not be performed safely due to the location of the lesions...
March 2016: Veterinary Clinical Pathology
Ladislav Hadravsky, Dmitry V Kazakov, Jan Stehlik, Michal Michal, Romuald Curik, Petr Krupa, Alena Skalova, Denisa Kacerovska
This article reports an unusual case of aggressive extraocular sebaceous carcinoma located on the scalp with subsequent usurpation of the bone and penetrating through the bone and meninges to the brain in a 56-year-old man affected by Muir-Torre syndrome. Microscopically, the sebaceous neoplasm was located in the middle to deep dermis without any connection to the epidermis and showed a multinodular growth with neoplastic nodules with a central comedo-type necrosis separated from each other by fibrovascular stroma...
August 2016: American Journal of Dermatopathology
Qiang Shi, Chenglin Tian, Xusheng Huang, Chuanqiang Pu
BACKGROUND: Carbohydrate antigen series biomarkers in cerebrospinal fluid (CSF) are important for the diagnosis of brain metastasis and meningeal carcinomatosis. Its relationship with CSF and serum in non-neoplastic diseases may be beneficial for earlier diagnosis and treatment. MATERIALS AND METHODS: 161 pairs of CSF and serum samples were obtained and compared. The 97.5th percentile and maximum value of carbohydrate antigen series biomarkers were obtained. RESULTS: The 97...
2015: Annals of Clinical and Laboratory Science
S Abad, C Terrada, S Trad, D Sène, P Bielefeld, D Saadoun, P Sève
Uveomeningitis relates to an inflammatory state extending from iris and ciliary bodies to the choroid behind the eye. Because of a close contact between eye and brain, and barrier disruption, the inflammation can spread into the central nervous system (CNS). We review the clinical manifestations of uveitis, which are known to provide helpful clues to the diagnosis and describe the infectious, inflammatory, and neoplastic conditions classically associated with the uveomeningitis. Inflammatory or auto-immune diseases are probably the most common clinically recognized causes of uveomeningitis associated with a significant pleiocytosis...
January 2016: La Revue de Médecine Interne
Emilio Rodríguez-Castro, Aida Fernández-Lebrero, Iria A López-Dequidt, Xiana Rodríguez-Osorio, Francisco J López-González, José M Suárez-Peñaranda, Manuel Arias
INTRODUCTION: Hypertrophic pachymeningitis is an infrequent disorder that produces focal or diffuse thickening of the dura mater. It can be idiopathic or secondary to infectious, autoimmune or neoplastic processes. The recently described 'IgG4-related disease' could be the cause of many cases considered cryptogenic. CASE REPORT: A 54-year-old woman, with a history of bronchial asthma, presented with headache, dizziness and hearing loss on her left ear. The brain MRI study with gadolinium showed enhancement and thickening of the dura mater, extending from lateral wall of left cavernous sinus and medial temporal lobe to cerebellopontine angle and ipsilateral tentorium...
October 1, 2015: Revista de Neurologia
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