World Neurosurg
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Case Reports
CSF Leak In Juvenile Nasopharyngeal Angiofibroma - Rare Sequelae Of Flutamide Induced Tumour Shrinkage.
Nonsteroidal androgen receptor blockers like flutamide have been described as an adjuvant treatment for preoperative shrinkage of extensive juvenile nasopharyngeal angiofibroma. We present a case of cerebrospinal fluid (CSF) leak due to flutamide-induced tumor shrinkage. ⋯ CSF leak is a rare complication following flutamide therapy, especially if large areas of the anterior skull base are involved.
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Case Reports
Thoracic Paraspinal Castleman Disease in a Young Mexican American Male with Postcoital Hematuria.
Castleman disease (CD) is an uncommon disorder of deregulated lymphoproliferation with unicentric (UCD) and multicentric forms based on extent of nodal involvement. Gross resection with histopathologic analysis remains the gold standard for diagnosis of UCD and is curative in most cases. Symptomatic paraspinal UCD is a rare presentation with potentially dangerous complications, and its tendency to mimic more common spinal tumors presents a significant diagnostic challenge. ⋯ Compared with previous reports, our case of postcoital hematuria and radiculopathy accompanying a paraspinal thoracic mass in a young Mexican-American man is a unique presentation. Awareness and early consideration of UCD in the work-up of a paraspinal mass may spare affected patients adverse and dangerous sequelae, such as spinal cord compression and excessive intraoperative hemorrhage.
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A reliable, noninvasive method to differentiate high-grade glioma (HGG) and intracranial metastasis (IM) has remained elusive. The aim of this study was to differentiate between HGG and IM using tumoral and peritumoral diffusion tensor imaging characteristics. ⋯ Tract count and tract density were significantly different in tumoral and peritumoral regions between HGG and IM. Differences in microenvironmental interactions between the tumor types may cause these tract differences.
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Solitary extramedullary plasmacytoma (SEP) is a plasma cell neoplasm located outside the bone. It is rarely observed in the intracranial area. It is very difficult to diagnose this condition radiologically before surgery. In addition, dural SEP is usually misdiagnosed. ⋯ Some pathological entities should be considered in the differential diagnosis of acute subdural hematomas. Furthermore, to the best of our knowledge, we report the first case of dural SEP mimicking acute subdural hematoma.