Cerebellar medulloblastoma in adults

From 1960 through 1981, 15 patients with cerebellar medulloblastoma, aged 16 years or over, were referred for irradiation following surgery. All patients received craniospinal irradiation; three patients received adjuvant chemotherapy. Five-year and 10-year survival rates of 63% and 38%, respectively, were obtained. The main cause of treatment failure was tumor recurrence in the posterior fossa. All local recurrences presented late, none developing within the first 3 years. One patient suffered systemic disease. The prognosis following relapse was poor. One patient achieved a prolonged remission following further surgery and radiotherapy, but died of treatment-related complications. The majority of the survivors are free of major deficit. One patient developed paraplegia 10 years after treatment. The possible risk of late damage to the hypothalamic-pituitary axis is discussed.     

Cerebellar mutism after removal of a vermian medulloblastoma in an adult

Cerebellar mutism is a rare postoperative phenomenon that generally occurs in children after resection of a cerebellar mass lesion. A 22-year-old man developed cerebellar mutism after posterior fossa surgery for a mass lesion in the vermis. Histological examination showed a medulloblastoma. The tumor was totally removed via a suboccipital approach. The patient developed mutism on the first postoperative day, which persisted for two weeks. Thereafter, this condition gradually improved. Although pathophysiology and the anatomical substrate of cerebellar mutism still remain unclear, it is important that neurosurgeons be aware of this syndrome after posterior fossa surgery in adults. This phenomenon usually has a self-limiting course and a favorable prognosis for resolution within the first three months.     

Buerger's disease in a 19-year-old woman

A 19-year-old female college student had numbness and the sensation of coldness of her left toes. She had a 3-year smoking history. Gangrene of the left foot developed rapidly. Angiography revealed peripheral arterial occlusion of both legs and arms. Detailed laboratory examination excluded collagen disease, a hypercoagulable state, and juvenile atherosclerosis. Below-knee amputation of the left leg was performed. Typical histologic findings of Buerger's disease were observed in the crural arteries and saphenous veins. The clinical course was uneventful after the patient stopped smoking. This is the second case report of Buerger's disease in a woman in the second decade of life. It is important that a correct diagnosis of Buerger's disease be established, because the disease process is benign, compared with collagen disease, if the patient stops smoking.     

Pulmonary hypoplasia in a 52-year-old woman

Pulmonary hypoplasia is a bronchopulmonary foregut anomaly characterized by a decreased number of alveoli and decreased alveolar air space. At autopsy, pulmonary hypoplasia is one of the important causes of death in newborns and infants. Pulmonary hypoplasia is rare in adults. In this paper, we present a case of pulmonary hypoplasia in a 52-year-old, asymptomatic woman. We discuss pulmonary hypoplasia and review the literature findings.