Cerebellar liponeurocytoma,a rare tumor: Case report and review of the literature

IntroductionCerebellar liponeurocytoma is a rare tumor of the central nervous system occurring mainly in the posterior fossa, which shows neuronal and variable astrocytic differentiation, along with foci of lipomatous differentiation.Case presentationHerein, we describe a 50-year-old female patient who presented to the hospital complaining of headache, tinnitus, and vertigo with positive cerebellar signs. MRI revealed a left cerebellar tumor. After tumor resection, histological examination and immunohistochemistry were done and the diagnosis of cerebellar liponeurocytoma was confirmed.DiscussionLiponeurocytoma may be mistaken as a medulloblastoma with lipidized cells or a lipomatous ependymoma. Histopathological examination, reinforced by immunohistochemistry and electron microscopy, are required to distinguish between these entities. The rarity of this tumor and paucity of pertinent information regarding its biological potential and natural history have resulted in the application of various treatment modalities.ConclusionLiponeurocytoma is a rare benign tumor with cerebellum is the typical site for it. Although surgery is the treatment of choice; however, postoperative radiotherapy may have a role in case of incomplete tumor resection or recurrence.     

Cerebellar liponeurocytoma. Case report with considerations on prognosis and management

Summary. Summary.  Background: Cerebellar liponeurocytoma has only recently been recognized as a distinct clinicopathological entity. Although the few cases described in literature support the relatively benign nature of this lesion, optimum treatment strategy and long term behaviour still have to be defined.   Clinical Presentation: This 61-year-old man came under our observation with unspecific signs of intracranial hypertension and a symptomathology revealing a probable posterior fossa lesion. Imaging studies showed a cerebellar mass lesion with prevalent adipose content.   Intervention: Gross total tumour removal was performed. The pathological examination revealed a lesion composed of medulloblastoma-like cells with prominent areas of lipidisation. A review of literature has been made in an attempt to investigate on recurrence patterns, importance of the extent of removal and the usefulness of radiotherapy.   Conclusion: The few cases reported in literature so far seem to confirm the relatively benign nature of cerebellar liponeurocytoma. No radiotherapy was given in our case and the reasons for this decision are reported.     

Neuroimaging of cerebellar liponeurocytoma. Case report.

Cerebellar liponeurocytoma is a newly recognized, rare clinicopathological entity. It manifests with posterior fossa symptoms in adults and is characterized histopathologically by advanced neuronal and focal lipomatous differentiation with a low level of mitotic activity. The authors analyzed the computerized tomography (CT) and magnetic resonance (MR) imaging findings in two patients with histopathologically proven cerebellar liponeurocytomas and review the literature. Cerebellar liponeurocytoma may be suspected on the basis of neuroimaging findings that demonstrate an intraaxial neoplasm with the propensity for exophytic growth into the adjacent subarachnoid spaces. On CT scans, the tumor commonly presents as a hypointense mass with intermingled areas exhibiting the attenuation values of fatty tissue. On T1-weighted MR images, the tumor is hypointense with scattered foci of hyperintense signal and displays moderate contrast enhancement. On T1-weighted MR images, the tumor is slightly hyperintense to cortex, and edema is usually absent. Areas of fat density as assessed on CT scans and of T1 hyperintensity seen on MR images help to distinguish this rare neoplasm from the more common adult medulloblastomas or ependymomas. The available follow-up data indicate a favorable clinical prognosis; therefore, knowledge and precise characterization of this tumor is important to avoid unnecessary adjuvant radio- or chemotherapy.     

Cerebellar aspergillosis: case report and literature review

OBJECTIVE AND IMPORTANCE: An unusual, but not unique, case of cerebellar aspergillosis associated with autologous peripheral blood stem cell transplantation for breast cancer is presented. CLINICAL PRESENTATION: A 45-year-old woman with breast cancer underwent chemotherapy and radiotherapy as well as autologous peripheral blood stem cell transplantation. She developed a cerebellar aspergillosis abscess that was treated successfully with two surgical resections. INTERVENTION: After removal of pus and the abscess wall, the patient received local application of amphotericin B (AmB). She received AmB 1 mg/kg/d for 3 months and itraconazole 100 mg/kg/d for 1 year. After 3 months of AmB treatment, magnetic resonance imaging revealed that disease had not recurred. CONCLUSION: In cases of central nervous system aspergillosis, to increase the therapeutic efficiency, AmB can also be applied to the abscess cavity. Computed tomographic and contrast-enhanced magnetic resonance imaging scans play an important role in establishing early diagnosis in high-risk, immunocompromised patients.     

SCIWORA-syndrome. Case report and review of the literature

The SCIWORA-syndrome was firstly described by Pang and Wilberger in 1982 [11]. It is characterized by a neurological injury without radiological appearance. Since the standardized use of MRI in spinal cord diagnosis, the number of the "real" SCIWORA-syndromes decreases.By the case report of a 14 years old boy falling down from a wall of 2 meters height with a complete paraplegia from Th12 without radiographic abnormality (even in MRI) we will give a short review of the literature.     

Cerebellar pleomorphic xanthoastrocytoma: case report and literature review

BACKGROUND: PXA generally has histologic features characteristic of benign biological behavior, although malignant forms have been reported. This neoplasm has also been observed in atypical locations. METHODS: The authors report a case of cerebellar PXA with rapid malignant transformation in a 58-year-old woman and review the rare presentations and atypical features of this tumor. RESULTS: Among the "unusual" locations, the most frequent is the cerebellum with 15 cases having been described, 9 in adults, with an average age of 33 years. In contrast, supratentorial forms had a younger age profile (26 years). The time from onset of symptoms to diagnosis was approximately 5.3 months. PXA in the posterior fossa had a higher rate of solid enhancing tumor (9/14). Regarding histologic appearance, two thirds were composite lesions. CONCLUSIONS: The clinicopathologic features of cerebellar PXA show some differences from PXA located in the cerebral hemispheres. Recognizing the potential for PXA to present with unusual manifestations, regardless of location, has an obvious impact on the accuracy of diagnosis.     

Cystic meningioma. Case report and literature review

BACKGROUND: Cystic meningioma is a rare variety of meningioma. It represents 1,6 to 10% of intracranial meningiomas, the authors report a case of intracranial cystic meningioma with a review of literature. CASE REPORT: A 46-year-old female presented with left parietooccipital headache followed by right side hemiparesis. CT scan brain showed a left parietal tumor with double solid and cystic components thought to be glioma or metastasis preoperatively. At surgery the extraaxial solid and cystic lesion had a well defined capsule that could be easily separated from the perilesional cortical surface. The tumor was totally removed. The histological study showed a cystic meningioma. CONCLUSION: Cystic meningioma is an uncommon tumor that should be considered in the differential diagnosis of brain tumors with a cystic component.     

Thoracic splenosis. Case report and literature review

Thoracic splenosis is the autotransplantation of splenic tissue into the thoracic cavity after thoracoabdominal trauma. We report a case of thoracic splenosis in a 35-year-old woman who had had a thoracoabdominal gunshot wound 12 years earlier. A review of the literature revealed 15 cases already reported. All patients had an asymptomatic thoracic lesion discovered on a plain chest film 9 to 32 years (mean 16) after the initial accident. In 13 cases an operation was necessary to establish the diagnosis. In two cases technetium 99m and indium 111 scans established the diagnosis.     

Dialysis-associated spondyloarthropathy. Case report and literature review

Hemodialysis has considerably prolonged the life of patients suffering from terminal renal failure. However, long-term hemodialysis leads to new bone complications and spinal disorders such as destructive spondyloarthropathy (DSA). At the present time DSA is reported in 8% to 18% of the dialysed patients. Diagnosis is based on severe narrowing of the intervertebral disk, erosions and geodes of the adjacent vertebral plates simulating infectious spondylitis. Lesions progressively involve posterior joints and may lead to severe destruction of the spine. The pathogenesis of this syndrome is still unknown. Several factors have been implicated, including microcrystal deposition, amyloidosis, inflammatory and foreign body reactions and suggest that the pathogenesis of erosive spondyloarthropathies of hemodialysed patients is multifactorial. Spinal instability inducing myelopathy and radiculopathy were observed in 8% of the cases. Treatment must be accorded to the natural disease course and to the quality of the bone. We report the case of a chronic dialysed patient with destructive spondyloarthropathy involving the cervical and thoracic spine. Pathogenesis, radiological datas and therapeutic approach are discussed.     

Cerebellar ganglioglioma. Case report

Gangliogliomas are rare neoplasms of the central nervous system. They are containing of mature ganglion cells and neoplastic glial cells. This report presents the clinicopathological findings in a patient with a cerebellar vermis ganglioglioma.     

Duodenal duplication. Case report and review of the literature

A case of duodenal duplication (cyst) in a 42-year-old male is reported. The late manifestation of this rare, little-known, but noteworthy congenital malformation was characterized by repeated attacks of acute pancreatitis and development of a high, duodenal obstruction. Radiographic examination and fiberoptic endoscopy was followed by exploratory laparotomy which demonstrated the accurate diagnosis. A review of the literature including 39 duodenal duplications in more than 300 duplications of the alimentary tract is presented.     

Subarachnoid-pleural fistula. Case report and review of the literature

A case is described of a subarachnoid-pleural fistula developing after resection of an intrathoracic benign nerve sheath tumor near the eleventh thoracic vertebra. The fistula was demonstrated by myelography and was corrected surgically. Of 12 previously reported cases, 11 occurred after trauma and one after an operation.     

Intrasacral meningocele. Case report and review of the literature

We have presented a case of a 28-year-old woman with an intrasacral meningocele. Diagnosis of this case was aided by the use of MRI. The literature regarding this problem has been reviewed.     

Multiple meningiomas. Case report and review of the literature

A case of multiple meningiomas without the stigmata of von Recklinghausen's disease is reported. The patient was followed up with serial computed tomography scanning over a 3-year period. The literature on multiple meningiomas is reviewed.