RESUMO
Anaplastic oligodendrogliomas (AOs) correspond to 23% of all oligodendrogliomas. They correspond to a tumor with malignant histological characteristics, focal or diffuse, associated with a worse prognosis. In the present case report, we describe the case of a 30-year-old female submitted to resection of a right parietal lesion whose histology showed to be an AO. She underwent complementary treatment with chemotherapy and radiotherapy according to the Roger Stupp protocol. Four years after the initial diagnosis, there was tumor recurrence within the superior sagittal sinus, with no evidence of recurrence elsewhere. In the literature, we have found no similar published case reinforcing the rarity of this condition.
Assuntos
Humanos , Feminino , Adulto , Oligodendroglioma/cirurgia , Oligodendroglioma/complicações , Oligodendroglioma/radioterapia , Oligodendroglioma/diagnóstico por imagem , Seio Sagital Superior/anormalidadesRESUMO
INTRODUCTION: An unusual case of positive immunological testing for cysticercosis in the cystic fluid obtained from an anaplastic oligoastrocytoma is presented. CASE REPORT: A 15-year-old boy was admitted with multiple brain lesions. The biggest was a cyst with a mural node and neurocysticercosis was suspected. In order to relieve intracranial pressure, the cyst was punctured and the immunological testing for cysticercosis was positive, reinforcing the clinical suspicion and leading to a clinical trial with albendazole and steroids. As the patient deteriorated the cystic lesion was removed and the diagnosis of anaplastic oligoastrocytoma was established. A second lesion was eventually approached and the histopathological diagnosis of both specimens concurred. DISCUSSION: Although some authors believe that chronic inflammatory changes following neurocysticercosis could induce the formation of brain tumors, this association may be a mere coincidence. In our case no clinical evidence of a prior infestation by Cysticercus was found. In fact, an exhaustive examination of the specimens did not reveal any areas of inflammatory reaction. We believe that the similarity of the glioma and cysticercosis antigens may be the cause of the positive reactions in the cystic fluid.
Assuntos
Neoplasias Encefálicas/complicações , Cisticercose/complicações , Oligodendroglioma/complicações , Adolescente , Neoplasias Encefálicas/diagnóstico , Neoplasias Encefálicas/metabolismo , Cisticercose/diagnóstico , Cisticercose/metabolismo , Proteína Glial Fibrilar Ácida/metabolismo , Humanos , Imuno-Histoquímica/métodos , Imageamento por Ressonância Magnética/métodos , Masculino , Oligodendroglioma/diagnóstico , Oligodendroglioma/metabolismo , Tomografia Computadorizada por Raios X/métodosRESUMO
In the last years, new techniques of neuroimages and histopathological methods have been added to the management of cerebral mass lesions in patients with AIDS. Stereotactic biopsy is necessary when after 14 days of empirical treatment for Toxoplasma gondii encephalitis there is no clinical or neuroradiologic improvement. We report a woman with AIDS who developed a single focal brain lesion on the right frontal lobe. She presented a long history of headache and seizures. After two weeks of empirical treatment for toxoplasma encephalitis without response, a magnetic resonance image with spectroscopy was performed and showed a tumoral pattern with a choline peak, diminished of N-acetyl-aspartate and presence of lactate. A stereotactic biopsy was performed. Histopathological diagnosis was a diffuse oligodendroglioma type A. A microsurgical resection of the tumor was carried out and antiretroviral treatment was started. To date she is in good clinical condition, with undetectable plasma viral load and CD4 T cell count > 200 cell/uL.
Assuntos
Síndrome da Imunodeficiência Adquirida/complicações , Neoplasias Encefálicas/patologia , Oligodendroglioma/patologia , Adulto , Neoplasias Encefálicas/complicações , Feminino , Humanos , Imageamento por Ressonância Magnética , Oligodendroglioma/complicações , Técnicas EstereotáxicasRESUMO
Focal somatosensory epileptic seizures ipsilateral to a brain tumor is reported and the literature reviewed. It is an exceptional occurrence, having been described only six cases, with several mechanisms being proposed. The proximity of the lesions with the low cerebral convexity (perisylvian) suggests the compromising of the secondary somatosensorial area, seeming to prove the experimental observation of somatosensorial crises originating in this area.
Assuntos
Neoplasias Encefálicas/complicações , Epilepsias Parciais/etiologia , Oligodendroglioma/complicações , Córtex Somatossensorial , Neoplasias Encefálicas/diagnóstico , Neoplasias Encefálicas/cirurgia , Epilepsias Parciais/tratamento farmacológico , Epilepsias Parciais/cirurgia , Feminino , Humanos , Imageamento por Ressonância Magnética , Pessoa de Meia-Idade , Oligodendroglioma/diagnóstico , Oligodendroglioma/cirurgiaRESUMO
A patient with a right thalamic oligodendroglioma developed seizures characterized by circling behavior, speech arrest, and secondarily generalized seizures. Gyratory epilepsy is relatively uncommon and may either represent a benign form of primary generalized epilepsy or occur secondary to a focal cortical lesion. Thalamic stimulation has been shown experimentally to induce circling movements, but no other clinical cases with a thalamic lesion have been described.
Assuntos
Neoplasias Encefálicas/complicações , Epilepsia/etiologia , Oligodendroglioma/complicações , Tálamo , Idoso , Neoplasias Encefálicas/diagnóstico por imagem , Eletroencefalografia , Epilepsias Parciais/etiologia , Feminino , Humanos , Oligodendroglioma/diagnóstico por imagem , Tálamo/diagnóstico por imagem , Tomografia Computadorizada por Raios XRESUMO
A case of a 32-year old male patient with complaints of frontal headache progressive decrease in visual acuity, altered behaviour, and positive results of immunological tests for cysticercosis performed on the cystic and cerebrospinal fluids is presented. After several clinical and surgical proceedings, the frontal craniotomy was indicated and a multi-lobulated cystic tumor was excised. Biopsy material revealed an oligodendroglioma invading the degenerated membrane of cystic wall. Some aspects related to the possible mechanisms involved in the association of oligodendroglioma with neurocysticercosis in the presented case are discussed. Three different types of conclusions may be reached: (1) neurocysticercosis may have acted as an oncogenetic factor for the oligodendroglioma; (2) the glycoprotein nature of the antigens of gliomas and cysticercosis and the similarity in the molecular weight range of their polypeptides may be responsible for the positivity of the reactions for cysticercosis in the cystic fluid; or (3) the association of oligodendroglioma with cysticercosis may be a simple coincidence. The present study strengthens the opinion that other pathologies should be looked for when clinical treatment of cysticercosis does not follow the expected course.