Radiation-induced bilateral cystic temporal lobe necrosis: reversal of memory deficit after fenestration and internal shunting. Case report

The authors report a case in which bilateral cystic temporal lobe necrosis developed after treatment of nasopharyngeal lymphoepithelioma with 7000 cGy of external beam radiation. The patient presented with an isolated memory deficit that was documented by neuropsychological testing. After fenestration and internal shunting of both cysts, there was striking resolution of the lesions and of the memory deficit.     

Familial frontal lobe oligodendroglioma. Case report

Two cases of frontal bilateral oligodendroglioma invading the corpus callosum occurred in a 56-year old man and his 32-year old son. CT images of both patients are presented.     

Solitary eosinophilic granuloma in the frontal lobe: case report.

A rare case of a solitary eosinophilic granuloma in the brain is reported. The mass, located in the right frontal lobe, mimicked a glioma not only grossly, but also by neuroimaging. The lesion was confirmed to be an eosinophilic granuloma by electron microscopy and immunohistochemical staining for S-100 protein and HLA-DR.     

Haemophilus paraphrophilus frontal lobe abscess: case report

We report a case of cerebral abscess due to Haemophilus paraphrophilus in a 51-year-old man who was otherwise healthy and had no cardiac abnormality. A source for the infection was not definitively identified; however, the patient had had dental manipulations 2 weeks before the onset of symptoms, and an oral source is probable. The patient was treated successfully with antibiotics after removal of the abscess. Bacteriological studies are discussed.     

Penetrating knife injury to the frontal lobe – a case report

Penetrating injuries of the craniofacial region are increasing and have the potential to cause severe vascular and neurological deficit. We present our management of a case with a knife stab injury to the infra-orbital region, traversing the orbit and penetrating into the anterior cranial fossa, the tip lying in close proximity to the anterior cerebral circulation.     

Lobar bronchial atresia demonstrating a cystic lesion without overinflation.

Congenital bronchial atresia (CBA) is an infrequent pulmonary anomaly characterized, in general, by a blindly terminating bronchus, mucoid impaction, and hyperinflation of the peripheral pulmonary parenchyma. We herein report an adult case of lobar bronchial atresia who showed no hyperinflation of the peripheral pulmonary parenchyma.     

Intraparenchymal epidermoid cyst of the right frontal lobe: a case report

Epidermoid cysts are most likely to occur at the cerebellopontine angle or in the suprasellar region. Intracerebral epidermoid cysts are rare and only 18 cases have been reported in the literature. This report presents a case of epidermoid cyst which developed in the right frontal lobe. A 24-year-old woman was admitted to our clinic on April 24, 1983 because of generalized convulsions. On admission no neurological abnormalities were found except for absence of the venous pulsation in an ophthalmoscopic study. A plain roentgenogram revealed a crescent shaped calcification in the right frontal lobe. An X-ray CT scan showed a round low density area (Hounsfield units + 12) surrounded by irregular ring-like high density spots in the right frontal lobe. Right carotid angiography showed round shift of the anterior cerebral artery to the left. The horizontal portion of the middle cerebral artery was stretched and lenticulostriate arteries were shifted laterally. Abnormal vascularization was not found. On May 11th 1983 a right fronto-temporal craniotomy was performed. Partial corticotomy was done along the cortical sulcus and the tumor was resected. The histological diagnosis was epidermoid cyst. In general an X-ray CT scan shows a low density area with irregular margin. Usually the low density area revealed -8 approximately +30 of Hounsfield units. Neither perifocal low density area nor enhancement by contrast medium is observed.     

鼻腔鼻窦畸胎癌肉瘤累及左侧额叶1例

正患者男,62岁,以"无明显诱因左侧鼻塞1月余,呈持续性、伴头痛、脓涕,受凉后加重;10天前出现左侧流眼泪,眼球突出"就诊。MRI:左侧鼻腔、蝶窦、双侧筛窦、额窦见团块状混杂长T1短/长T2信号,约32mm×54mm×63mm,脂肪抑制序列     

Two fluid-blood density levels in chronic subdural hematoma. Case report.

The case of a chronic subdural hematoma is presented in which the computerized tomography scan showed two parallel fluid-blood density levels. The authors emphasize the importance of this finding in the management of such cases.     

Ganglioglioma--neurogliogenic tumor involving the left frontal lobe: case report

A 5-year-old boy presented with a 7-month history of headache and projectile vomiting. Computerized axial tomography revealed a large, high density lesion involving the entire left frontal lobe. At operation a 330-g, apparently encapsulated, mildly cystic neoplasm was removed from the region of the left frontal operculum. Microscopic examination demonstrated moderately cellular astrocytic tissue interspersed with several large, bizarre, and occasionally binucleate ganglion cells. The pathological entity of ganglioglioma is briefly reviewed.     

Cystic cavernous hemangioma in the frontal lobe in an infant--case report

A 4-month-old infant was hospitalized following a generalized convulsion. Computed tomography showed a lesion of heterogeneous high density and a large low-density area in the right frontal lobe. At surgery, an angiomatous tumor was found within a large cyst containing bloody fluid. Histopathological diagnosis was a cavernous hemangioma. Only eight other cavernous hemangiomas in infants have been reported. The characteristic clinical features and computed tomographic findings of these cases are discussed.     

Radiation-induced cerebellar chondrosarcoma. Case report

The authors report a case of chondrosarcoma arising in the cerebellum 16 years after treatment of a cerebellar malignant astrocytoma by subtotal resection and irradiation. It is thought that the chondrosarcoma arising within the intracranial cavity was a probable consequence of previous ionizing radiation.     

Adenoid cystic carcinoma of lower lobe of right lung: report of a case

A 69-year-old male was admitted to the hospital for further examination of an abnormal shadow in the right lower lung fields. He was previously under medical treatment for right thoracic empyema. Chest computed tomography (CT) showed a solitary mass, 4.5 cm in diameter and broncofiberscopy evidenced a tumor in the right lower bronchus. The biopsy was performed and the tumor was diagnosed as a pleomorphic adenoma. Intraoperativefinding showed the tumor was 6 cm in gross, extended to the left atrium, and a daughter tumor was palpable in the middle lobe. The middle and lower lobe were resected. The tumor was located in S9, S10, 6 x 4 x 3.5 cm in size, 2 daughter tumor was found in the middle lobe, the pulmonary vein was thickened by tumor invasion. Pathohistologically, main tumor and daughter tumor showed malignant feature, were compatible with adenoid cystic cancer. Four years after operation, he is still now alive with home oxygen therapy.     

Magnetic resonance angiography demonstrating adult moyamoya disease progressing from unilateral to bilateral involvement--case report

A 21-year-old woman presented with moyamoya disease manifesting as speech disturbance and right quadrant hemianopsia on October 22, 1994. Magnetic resonance (MR) angiography showed occlusion of the left internal carotid artery (ICA) with the normal right ICA. The diagnosis was "unilateral" moyamoya disease by conventional angiography. Follow-up MR angiography revealed further occlusive changes of the right middle cerebral artery (MCA) trunk on July 30, 1995, which progressed to occlusion of the MCA on March 25, 1997. Conventional angiography confirmed occlusion of the right terminal ICA to MCA with basal moyamoya vessels. The diagnosis was "bilateral" moyamoya disease. She was successfully treated by bilateral superficial temporal artery-MCA anastomosis. Follow-up MR angiography should be performed in relatively young patients with "unilateral" moyamoya disease to detect any progression to bilateral moyamoya disease.     

Radiation-induced osteosarcoma of the calvaria--case report.

The authors report a case of radiation-induced calvarial osteosarcoma. A 58-year-old female received subtotal removal of the pituitary adenoma and 5000 rads postoperative irradiation. Seven years later, an osteoblastic osteosarcoma occurred in the frontotemporal region. She received total tumor removal and chemotherapy. However, computed tomography subsequently revealed multiple small lesions at the margin of the bone flap. A chest x-ray film demonstrated lung metastasis. Local recurrence and lung metastasis require careful attention in radiation-induced osteosarcoma patients.     

Radiation-induced bilateral coronary ostial stenosis in a 17-year-old patient

Mediastinal irradiation can induce coronary artery disease characterized by the localization of lesions at the proximal segment of the arteries. We report the case of a 17-year-old patient who underwent a mediastinal irradiation for pulmonary sarcoma and developed 15 years later an asymptomatic ischemic cardiopathy. Bilateral coronary ostial stenosis was discovered by a transthoracic echography and coronary angiography showed isolated bilateral ostial stenosis. Coronary bypass grafting was performed with internal thoracic arteries. We recommend testing exercise and echocardiography during follow-up of patients who have received more than 30 Gy of mediastinal radiation. Surgery is the treatment of choice in bilateral ostial stenosis using internal thoracic arteries in young patients if preoperative assessment shows patency.     

Angiocentric glioma and surrounding cortical dysplasia manifesting as intractable frontal lobe epilepsy--case report

A 26-year-old man presented with a case of angiocentric glioma manifesting as medically refractory epilepsy. Magnetic resonance imaging revealed a hyperintense lesion in the right superior frontal gyrus on T(2)-weighted imaging, with cortical hyperintense rim on T(1)-weighted images and minimum contrast enhancement. Video-electroencephalography (EEG) monitoring characterized his seizures as originating from the right frontal lobe. Long-term EEG recording from implanted subdural electrodes disclosed epileptic activities extending beyond the margin of the radiological lesion. Extended cortical resection of the superior frontal gyrus including the tumor and the surrounding epileptic cortices was performed. Postoperatively, he became seizure-free with antiepileptic medication during a 12-month follow-up period. Histological examination of the surgical specimen showed the characteristic findings of angiocentric glioma. Associated cortical dyslamination consistent with cortical dysplasia was found in the surrounding cortex. Angiocentric glioma is a slow-growing or stable tumor frequently presenting with intractable epilepsy. Surgical treatment would be aimed primarily at control of epilepsy. Complete lesionectomy usually results in postoperative seizure freedom, but the present case shows evidence for associated cortical dysplasia with this tumor entity. Careful pre-surgical evaluation for epilepsy is necessary to achieve better seizure outcome.     

Radiation-induced prostatic sarcoma: a case report

A 64-year-old man had a prostatic sarcoma 8 years after transurethral prostatectomy and radical bilateral pelvic lymph node dissection with insertion of 125iodine implants for stage B1N carcinoma of the prostate. Therapy for the sarcoma consisted of isolated pelvic perfusion and then pelvic exenteration with creation of an ileal conduit and colostomy. The pathology report showed well encapsulated grade 2 spindle cell sarcoma of the prostate. Multiple small metallic particles were embedded in the tumor specimen.