眶内恶性髓上皮瘤一例

患儿男,8个月。因右下眼睑肿物5个月于2005年5月入院。患儿3个月时,偶然发现其右下眼睑有一绿豆大肿物,逐渐长大,且生长迅速。体检:右眼眶下部可见约6 cm×6 cm巨大肿物,突出于眼外,睑外翻,眼球移位,睑裂不能睁开,皮肤表面血管扩张,左眼未见异常。实验室检查:白细胞12．3×109／L,血红蛋白109g/L,血小板325×109／L。CT检     

Nasal cerebral heterotopia: a case report

Nasal cerebral heterotopia (nasal glioma) are rare congenital benign masses of neurogenic origin with intranasal location, or both. An extranasal case is reported in a 2-year-old-boy without any bony defect or connection with brain. Histology and immunohistochemistry confirmed the diagnosis.     

Posterior antebrachial cutaneous neuropathy: case report

We are reporting the first case of posterior antebrachial cutaneous (PABC) neuropathy which was confirmed by the sensory nerve conduction test. PABC neuropathy and radial nerve palsy developed after an intramuscular injection in this case. Sensory nerve conduction study of the PABC nerve showed slow nerve conduction velocity but normal amplitude of compound nerve action potential (CNAP). Follow-up testing revealed an increase in the CNAP amplitude and normalization of nerve conduction velocity in the PABC nerve. Our study demonstrates that PABC neuropathy can be confirmed by the sensory nerve conduction test.     

Intracranial medulloepithelioma. A case report and review of the literature

Medulloepithelioma is a rare primitive neuroectodermal tumour of the central nervous system usually developing in childhood, displaying highly malignant behaviour, with early progression or recurrence. The Authors report a new case of intracranial medulloepithelioma removed from the right cerebellar hemisphere of a 13-year-old boy who showed unspecific signs of intracranial hypertension. Based on a review of the thirty seven cases reported in the literature, they analyse the clinical, histological, immunohistochemical, ultrastructural and therapeutic features of this rare nervous system tumour.     

Adult ocular medulloepithelioma diagnosed by transscleral fine needle aspiration: A case report

Ocular medulloepithelioma (ME) is a rare congenital tumor which occurs usually during childhood but is also reported in adults. They have seen an intraocular tumor in an 89 years‐old female with a history of small cell lung carcinoma. Transscleral fine needle aspiration was performed. Aspirates were rich and composed of two distinctive populations of cells. The first consisted of epithelioid large cohesive cells with rare rosettes. Nuclei were oval and chromatin was delicate with small nucleoli. The second population consisted of smaller and dispersed cells with regular nuclei and dusty chromatin. Immunohistochemistry performed on paraffin‐embedded cell block sections showed that the larger cells and rosettes were cytokeratin AE1/AE3, Synaptophysin, Chromogranin A, CD56, NSE, and EMA positive, whereas the smaller cells were always negative. Interestingly smaller cells expressed only weak nuclear positivity for TTF1, whereas larger cells were TTF1 negative. Melanocytic markers were negative in both populations. Morphological patterns and immunohistochemical staining confirmed ocular ME and allowed to exclude pulmonary metastasis or primary malignant melanoma. The patient was successfully treated by brachytherapy alone and is alive and well 10 months after treatment. Diagn. Cytopathol. 2017;45:561–564. © 2017 Wiley Periodicals, Inc.     

Posterior fossa epidermoid cysts

Epidermoid cysts in the central nervous system are rare tumours of controversial origin occurring mostly in the last adult age. We present here a series of four cases seen during the last five years. Their common clinical and histological features along with available literature have been discussed.     

成人腋窝囊状淋巴管瘤1例

患者男性,59岁,因发现右腋窝肿物3天就诊。查体:有腋窝触及一8cm×6cm×6cm肿块,质软,边界清楚,无压痛。彩超示:多房腋性暗区。初诊囊状淋巴管瘤。行手术摘除:术中见肿块为多房囊性,边界清楚,与     

Posterior choroidal leiomyoma: a rare case report and literature review

We report a literature review and detailed evaluation of a rare case of posterior choroidal leiomyoma to emphasize the importance of differentiating this from other choroidal tumors. A 30‐year‐old male presented with variable blurred vision in his right eye secondary to a choroidal tumor. Clinical examinations were performed including fundus photography, optical coherence tomography, B scans, fluorescein and indocyanine green angiography, computed tomography, and magnetic resonance imaging. Preoperative examination revealed a suspected choroidal melanoma and enucleation was performed. However, a definitive diagnosis of choroidal leiomyoma was made following postoperative pathological light microscopy and immunohistochemical studies. Published case reports were collected and the common characteristics and distinctive features were compared with the current case. Posterior choroidal leiomyoma was summarized from the literature, and beneficial information for diagnosis and treatment was obtained. In conclusion, posterior choroidal leiomyoma is rare and should be differentiated from amelanotic melanomas. Despite the benign nature, an explanation regarding the rare incidence and difficult diagnosis of posterior choroidal leiomyoma must be provided to patients, prior to enucleation or detrimental treatment.     

Desmoplastic cerebral astrocytoma of infancy: a case report.

We present a case of desmoplastic cerebral astrocytoma of infancy (DCAI) in a 9-month-old boy including immunohistochemical and proliferative activity studies. It was mainly composed of glial fibrillary acidic protein (GFAP)-positive astrocytes and desmoplastic stroma. Studies with Ki-67 and synthetic phase fraction disclosed a low proliferative activity. Flow cytometric study revealed diploidy pattern. These findings suggest a positive correlation with the favorable prognosis.     

Unique variation in the course of maxillary artery in infratemporal fossa: a case report

Maxillary artery is one of the key contents of the infratemporal fossa. Mandibular nerve and its branches form a clinically important relation of maxillary artery in this region. A comprehensive knowledge of variations of maxillary artery in the fossa is of special relevance in oral maxillofacial surgeries, management of epistaxis, intractable neuralgias or headaches. We found a unique variation of maxillary artery, presenting bilaterally, in relation to branches of mandibular nerve. During routine dissection in a 55-year-old male cadaver, maxillary artery was seen passing deep to lateral pterygoid muscle and crossed through the nerve loop formed between two roots of auriculotemporal nerve and posterior division of mandibular nerve. Further course of maxillary artery was medial to the posterior division of mandibular nerve. Maxillary artery gave its middle meningeal artery branch as it traversed through the nerve loop. A tortuous course taken by maxillary artery can lead to its entrapment causing headaches or nerve irritation presenting with neuralgia.     

双跖肌变异1例

在供学生局解实验操作的23具尸体中见,于1具尸体右侧见双跖肌变异,非常罕见,现报道如下.男性成人尸体,约50岁,身高175cm.在其右侧胭窝可见跖肌起于股骨外上髁,肌腹较短向内下走行,肌腱较长于跟腱的内侧单独止于跟骨.在该跖肌内侧稍上方有一块不明肌,该肌起自股骨粗线内侧唇上1/3段,肌腹呈梭形长6.32cm,宽1.26cm,厚0.52cm,肌纤维由内上斜向外下走形,在跖肌起点稍内侧移行为较长的肌腱.肌腱长13.52cm,宽0.38cm,厚0.10 cm,该腱越过跖肌腱的浅面,与跖肌腱交叉后沿着腓肠肌外侧头内侧缘深面向下走行,并与比目鱼肌浅面的深筋膜愈着,止于跟腱.该肌肌腹中部有血管连于胭静脉,动脉及神经已被破坏.     

Post-varicella cerebral thrombophlebitis with anti-protein S: report of a pediatric case

Purpura fulminans and venous thrombosis are rare complications of chickenpox. We report the case of a 6 year old with no history individuals who experienced cerebral thrombophlebitis, 3 weeks after varicella. MRI, performed at admission, has objectified longitudinal sinus thrombosis and a frontal parenchymal hematoma law. Meanwhile, a recent varicella seroconversion was demonstrated. The assessment of thrombophilia, meanwhile, has objectified a significant decrease in free protein S and activity, without associated DIC. Origin acquired this deficit was confirmed by the detection of antibodies (IgG and IgM) against the total protein S by ELISA. After evaluation of the benefit/risk only anticoagulation was initiated. The clinical and biological evolution was favorable, with rapid normalization of the S protein and decrease of anti-protein S. Many studies report the presence of anti-protein S in young children at the waning of chickenpox, without their exact frequency is determined. The decrease in protein S they cause leads to a transient hypercoagulable state may result in different clinical pictures. Cases of purpura fulminans seem more frequent when venous thrombosis isolated post chickenpox, sometimes atypical, appear rare.     

An anomalous muscle in the region of the popliteal fossa: case report

Variations in the hamstring muscles are not common. We describe here a rare anomalous muscle in the popliteal fossa and speculate on its functional significance.     

腰椎间盘髓核脱出游离至硬膜囊背侧1例报道并文献复习

目的 报道1例腰椎间盘髓核脱出游离至硬膜囊背侧并复习相关文献,总结该病的临床特点及治疗策略等。方法 结合文献回顾分析1例腰椎间盘髓核脱出游离患者的临床资料。患者男,65岁。主诉左下肢疼痛、发胀、麻木20 d,加重7 d。入院后腰椎MRI示L_4~5椎管占位。于2015年1月13日在全身麻醉下行“腰后路减压植骨融合内固定术”,术中游离组织送病理检查。结果 术后3个月,患者术前不适症状明显改善,左侧股四头肌肌力约Ⅳ级,左侧直腿抬高试验阴性,双侧跟、膝腱反射阳性。术后病理检查证实游离组织为变性髓核组织。结论 腰椎间盘髓核脱出游离至硬膜囊背侧临床少见,其MRI常与囊肿、脓肿、肿瘤、血肿相混淆,极易造成误诊;增强MRI表现为“牛眼征”,有助于该病的鉴别诊断;术后病理可明确诊断。该病可采用保守、微创、开放手术治疗,但要严格把握适应证,当出现急性马尾综合征时应积极行开放手术。     

Recurrent posterior fossa anaplastic ependymoma with prominent chondroid metaplasia: a case report and review of literature

We report an unusual case of a recurrent fourth ventricular anaplastic ependymoma with prominent chondroid metaplasia in a 16-year-old male. On initial presentation, the patient had a WHO Grade II tumor. However, at recurrence 1 year later, the tumor progressed to WHO Grade III tumor with more cellularity, necrosis and brisk mitotic activity. Chondroid metaplasia was present in both the initial and recurrent tumors.     

Posterior fossa tumours in childhood: evaluation of presenting clinical features

A retrospective review was performed of the age profile and clinical features at presentation of 79 children with posterior fossa tumours. The mean age at presentation in this series (6.6 years) is consistent with a decreasing trend over the past 70 years. Headaches, ataxia and torticollis emerge as significant symptoms worthy of further investigation whilst abdominal pain and constipation might herald the presence of a posterior fossa tumour on rare occasions.     

Posterior fossa neuroblastoma occurring in an elderly man

A case of a neuroblastoma occurring in the cerebellum of a 73-year-old man is reported. The patient presented with progressive truncal ataxia and was found to have an enhancing tumor mass in the cerebellar vermis. By light microscopy, the tumor was a small cell neoplasm and was similar to medulloblastoma, with areas showing structures suggestive of Homer-Wright pseudorosettes. By electron microscopy and immunoperoxidase techniques, however, the tumor showed convincing evidence of neuronal differentiation. The absence of previous reports of this tumor in the posterior fossa of adults suggests that immunoperoxidase techniques and/or electron microscopy of such small cell tumors may be required for accurate diagnosis.