World Neurosurg
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Although carcinoma metastasis to primary intracranial neoplasms has occasionally been reported, metastasis to a cerebral arteriovenous malformation (AVM) has been exceedingly rare, with only 5 cases reported to date. In the present study, we have reported a case of lung carcinoma that had metastasized to a cerebral AVM. To the best of our knowledge, the present report is the first case in which the pathological examination detected the bleeding mechanism of this rare condition, showing destruction of the feeders by the metastatic tumor. ⋯ Although rare, clinicians should recognize that undifferentiated carcinomas can metastasize to AVMs and cause bleeding. Because the preoperative diagnosis can be difficult, even using the latest imaging modalities, careful examination of the resected specimen is required to reveal such pathological conditions.
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Case Reports
Preoperative Intracranial Dissemination of Spinal Myxopapillary Ependymoma Attributed to Tumor Hemorrhage.
Spinal myxopapillary ependymoma (SME), generally considered a benign entity, can exhibit brain and whole-spine metastases as well as local recurrence after surgery. However, the presence of preoperative retrograde intracranial dissemination at the time of diagnosis is very rare. ⋯ Screening of the whole brain and spine at the time of diagnosis is imperative when tumor is detected at any level of the neuraxis. The present case of SME with a preoperative intracranial lesion is the fifth case documented in the medical literature.
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Posterior fossa localization of a hydatid cyst is uncommon; in these cases, the cysts usually grow in the cerebellum. Localization within the subarachnoid spaces or the cerebrospinal fluid ventricular system is exceptional. In the present report, which appears to be the sixth in the literature, we describe a case of a hydatid cyst in the cerebellopontine cistern. ⋯ The cyst was successfully removed using the puncture, aspiration, irrigation, and resection technique via a retrosigmoid approach. Histopathologic examination confirmed the cysts to be Echinococcus granulosus in nature. Hydatid cyst may be considered in the differential diagnosis of arachnoid cysts of the cerebellopontine cistern to determine which surgical procedure to perform and to avoid unexpected complications.
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Case Reports
Third Ventricle Cavernous Malformation and Obstructive Hydrocephalus Thought to Be a Colloid Cyst.
Third ventricle cavernous malformations (CMs) associated with ventriculomegaly and obstructive hydrocephalus are quite rare in patients. Preoperative surgical planning can be challenging due to the lesion's non-specific appearance on CT and magnetic resonance imaging that can mimic other intraventricular pathologies, such as a colloid cyst. Management of these lesions can be varied in the setting of obstructive hydrocephalus. ⋯ A third ventricle CM was discovered after a neuroendoscopic approach for resection of a presumed colloid cyst in a patient with obstructive hydrocephalus. A neuroendoscopic septostomy was performed to treat the obstructive hydrocephalus and no resection was attempted. The patient suffered no complications and is at her neurologic baseline with no deficits.
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In conjunction with neurofibromas, schwannomas are the second most commonly occurring intradural extramedullary tumor. They are a benign encapsulated nerve sheath tumor that are typically slow growing. They occur equally as frequently in the cervical and lumbar spine. ⋯ In this surgical technique video, we present a case of a 70-year-old woman who presented with worsening symptoms consistent with cauda equina syndrome secondary to intradural masses at the L1-2 level. A minimally invasive resection of the intradural lesions was performed without any complication. Final pathology of the resected masses revealed schwannoma.