Trilateral retinoblastoma is a rare, but well recognized syndrome. These tumors usually occur in the pineal, parasellar, or suprasellar regions several years after successful management of ocular retinoblastomas without evidence of direct extension or distant metastasis. Here we report a case of trilateral retinoblastoma presenting initially with a sellar tumor and with concurrent unilateral retinoblastoma. The patient was a 5-month-old baby girl showing poor eye contact and nystagmus for several days. She had no family history of retinoblastoma. Brain MRI revealed a midline suprasellar tumor without evidence of cerebrospinal fluid seeding or extracranial metastasis. A pathologic diagnosis of retinoblastoma was made for her brain tumor, and a small, intraocular retinoblastoma was detected in the left eye by thorough examination of the fundus. If a retinoblastoma occurs in the midline of the brain, including the pineal and sellar regions, a careful screening to detect any additional retinal tumors should be performed. Moreover, since these tumors are often hereditary and harbor a worse prognosis, the diagnosis has implications for genetic counseling. This is the first report on a case of trilateral retinoblastoma in Korea presented with a sellar mass.
Brain/*pathology/radiography ; Brain Neoplasms/pathology/radiography/*secondary/surgery ; Female ; Humans ; Infant ; Retinal Neoplasms/*pathology/radiography/surgery ; Retinoblastoma/pathology/radiography/*secondary/surgery

A myeloid sarcoma (MS) is an extramedullary tumor consisting of primitive granulocytic precursor cells. Although most such tumors have been reported in patients with acute myelogenous leukemia, MS is rarely recognized as an isolated tumor without any evidence of leukemia. However, in such cases, the initial diagnosis of MS can be difficult, so initial misdiagnosis rates of up to 75% have been reported. This report describes an unusual case of MS in a 3-year 5-month-old girl presenting as bilateral renal enlargements, and brain masses, with multiple bone involvements, but no hematological abnormalities.
Bone Neoplasms/pathology/*radiography ; Brain Neoplasms/pathology/*radiography ; Child, Preschool ; Female ; Human ; Kidney Neoplasms/pathology/*radiography ; Sarcoma, Granulocytic/pathology/*radiography ; Tomography, X-Ray Computed

Meningioangiomatosis is a rare benign hamartomatous lesion. We describe a case of meningioangiomatosis in an 18-year-old boy with a 15 year history of seizures. Computed tomography reveals an irregular calcification density along the right temporal gyrus. Microscopically, irregularly branched blood vessels, surrounded by a concentric arrangement of proliferating spindle cells, are extending into the gray matter from the meningeal surface. Ultrastructural and immunohistochemical examination failed to demonstrate features of meningothelial cell origin in this case. This is the first case of meningioangiomatosis published in Korea along with immunohistochemical and electron microscopic studies. The pathogenesis and previous reports of this lesion will be discussed.
Adolescent ; Brain Neoplasms/*pathology/radiography/ultrastructure ; Hemangioma/*pathology/radiography/ultrastructure ; Humans ; Immunohistochemistry ; Male ; Microscopy, Electron

Perfusion is a fundamental biological function that refers to the delivery of oxygen and nutrients to tissue by means of blood flow. Perfusion MRI is sensitive to microvasculature and has been applied in a wide variety of clinical applications, including the classification of tumors, identification of stroke regions, and characterization of other diseases. Perfusion MRI techniques are classified with or without using an exogenous contrast agent. Bolus methods, with injections of a contrast agent, provide better sensitivity with higher spatial resolution, and are therefore more widely used in clinical applications. However, arterial spin-labeling methods provide a unique opportunity to measure cerebral blood flow without requiring an exogenous contrast agent and have better accuracy for quantification. Importantly, MRI-based perfusion measurements are minimally invasive overall, and do not use any radiation and radioisotopes. In this review, we describe the principles and techniques of perfusion MRI. This review summarizes comprehensive updated knowledge on the physical principles and techniques of perfusion MRI.
Arteries/chemistry ; Brain Neoplasms/radiography ; Contrast Media/diagnostic use ; Humans ; Magnetic Resonance Imaging/standards/*trends ; Spin Labels ; Stroke/radiography

Syphilis, along with the recent increase of human immunodeficiency virus (HIV) patients, has also been on the rise. It has a broad spectrum of clinical manifestations, among which cerebral gumma is, a kind of neurosyphilis, however, it is rare and can be cured by penicillin. Thus, cerebral gumma needs to be differentially diagnosed from other brain masses that may be present in syphilis patients. We have experienced a case where the patient was first suspected of brain tumor, but confirmed by surgery to be cerebral gumma due to neurosyphilis. This is the first such case encountered in Korea, therefore, we report it here in. A 40-year old woman complaining of headaches was found to have a brain mass on her CT scans and MRI. Suspecting a brain Tumor, a resection was performed on the patient, and histological results revealed that the central portion of the mass contained necrotic material and the peripheral region was infiltrated with plasma cells. Warthin-Starry staining of the region revealed spirochetes, and the patient was thus diagnosed as brain gumma. Venereal Disease Research Laboratory (VDRL) of cerebrospinal fluid (CSF) was reactive. After an operation, penicillin-G at a daily dose of 24x10(6) U was given for 10 days from post-operative day 10, and thereafter, the mass disappeared.
Adult ; Brain Neoplasms/*diagnosis/pathology/radiography ; Female ; HIV Infections/*diagnosis/radiography ; Humans ; Magnetic Resonance Imaging ; Neurosyphilis/*diagnosis/pathology/radiography ; Tomography, X-Ray Computed

With the evolution of immunochemical staining techniques and better imaging modalities with better image resolution and whole body coverage, gastrointestinal stromal tumor (GIST), the most common mesenchymal tumor of the gastrointestinal tract, is often encountered in clinical practice. Metastasis is common with malignant GIST and can be found in up to 50% of patients at presentation. Liver and peritoneum are the two most common sites of metastasis and accounted for 95% of cases. Lymphatics, bone and lung metastasis are rare. Malignant GIST with intracranial metastasis is even rarer, with only a few cases reported in the literature, and most of these had earlier metastasis elsewhere. Radiological features for GISTs are not specific but it does contribute to confirming early and accurate diagnosis of malignant GISTs by judging the tumor size, enhancement pattern and the invasion of adjacent structures. We report a case of a 26-year-old male with metastatic GIST to the liver and subsequently to the brain and skull vault. This is the first case reported in our locality and he is the youngest patient reported with this disease entity. The clinical progress, radiological features and the role of imaging will be discussed further in this paper. The radiological and clinical features of the primary tumor will specifically be addressed. The purpose of this paper is to enrich the current database of this rare disease entity and to alert both radiologists and clinicians about the imaging features of GIST with intracranial metastasis.
Adult ; Brain Neoplasms ; diagnostic imaging ; secondary ; Gastrointestinal Stromal Tumors ; complications ; diagnostic imaging ; Humans ; Male ; Radiography

In the study we assessed the distortion of 7.0 T magnetic resonance (MR) images in reference to 1.5 T MR images in the radiosurgery of metastatic brain tumors. Radiosurgery with Gamma Knife Perfexion(R) was performed for the treatment of a 54-yr-old female patient with multiple brain metastases by the co-registered images of the 7.0 T and 1.5 T magnetic resonance images (MRI). There was no significant discrepancy in the positions of anterior and posterior commissures as well as the locations of four metastatic brain tumors in the co-registered images between 7.0 T and 1.5 T MRI with better visualization of the anatomical details in 7.0 T MR images. This study demonstrates for the first time that 7.0 T MR images can be safely utilized in Perfexion(R) Gamma Knife radiosurgery for the treatment of metastatic brain tumors. Furthermore 7.0 T MR images provide better visualization of brain tumors without image distortion in comparison to 1.5 T MR images.
Adenocarcinoma/pathology/radiography ; Brain Neoplasms/pathology/secondary/*surgery ; Female ; Humans ; Lung Neoplasms/pathology/radiography ; *Magnetic Resonance Imaging ; Middle Aged ; *Radiosurgery ; Tomography, X-Ray Computed

A 41-year-old female complaining of easy fatigue, headache, thickened extremities and deepened facial folds was admitted to the hospital. As early as 6 years ago, she had been told by family members that her voice was changed and both hands was thickened. Cranial plain radiography indicated ballooning of sella turcica. Sella MRI disclosed 2.2cm sized pituitary tumor with suprasellar extension. The pituitary tumor with hypothalamic extension was removed via a transsphenoidal approach. The postoperative course was uneventful until hyponatremia with sudden headache and respiratory arrest was developed. The case was due to hyponatremic encephalopathy on the basis of the clinical course and symptoms, and 3% hypertonic saline was infused for 12 hours until the hyponatremia was corrected. We have experienced a mortality case of hyponatremic encephalopathy in which surgieal removal of a pituitary tumor from a female acromegalic patient in menstruant period was followed by the sudden occurrence of hyponatremia, which in turn was later associated with marked brain edema.
Adult ; Brain Edema ; Extremities ; Fatigue ; Female ; Hand ; Headache ; Humans ; Hyponatremia ; Magnetic Resonance Imaging ; Mortality ; Pituitary Neoplasms ; Radiography ; Sella Turcica ; Voice

A 45-yr-old female patient was admitted with one-month history of headache and progressive left hemiparesis. Brain magnetic resonance imaging (MRI) demonstrated a mass lesion in her right frontal lobe. Her brain tumor was confirmed as a small cell glioblastoma. Her follow-up brain MRI, taken at 8 months after her initial surgery demonstrated tumor recurrence in the right frontal lobe. Contrast-enhanced 7.0T brain magnetic resonance imaging (MRI) was safely performed before surgery and at the time of recurrence. Compared with 1.5T and 3.0T brain MRI, 7.0T MRI showed sharpened images of the brain tumor contexture with detailed anatomical information. The fused images of 7.0T and 1.5T brain MRI taken at the time of recurrence demonstrated no significant discrepancy in the positions of the anterior and the posterior commissures. It is suggested that 7.0T MRI can be safely utilized for better images of the maligant gliomas before and after surgery.
Brain Neoplasms/pathology/*radiography/surgery ; Female ; Frontal Lobe/radiography ; Glioblastoma/pathology/*radiography/surgery ; Humans ; In Situ Hybridization, Fluorescence ; *Magnetic Resonance Imaging ; Middle Aged ; Neoplasm Recurrence, Local ; Receptor, Epidermal Growth Factor/genetics

The purpose of this review is to summarize the results of studies on of the association between exposure to dental X-rays and health risk. To perform the systematic review, We searched the PUBMED, EMBASE, and MEDLINE databases for papers published before December 15, 2016. A total of 2 158 studies, excluding duplicate studies, were found. Two reviewers independently evaluated the eligibility of each study. The final 21 studies were selected after application of exclusion criteria. In terms of health outcomes, there were 10 studies about brain tumors, 5 about thyroid cancer, 3 about tumors of head and neck areas, and 3 related to systemic health. In brain tumor studies, the association between dental X-ray exposure and meningioma was statistically significant in 5 of the 7 studies. In 4 of the 5 thyroid-related studies, there was a significant correlation with dental diagnostic X-rays. In studies on head and neck areas, tumors included laryngeal, parotid gland, and salivary gland cancers. There was also a statistically significant correlation between full-mouth X-rays and salivary gland cancer, but not parotid gland cancer. Health outcomes such as leukemia, low birth weight, cataracts, and thumb carcinomas were also reported. In a few studies examining health effects related to dental X-ray exposure, possibly increased risks of meningioma and thyroid cancer were suggested. More studies with a large population and prospective design are needed to elaborate these associations further.
Brain Neoplasms ; Cataract ; Head ; Humans ; Infant, Low Birth Weight ; Infant, Newborn ; Leukemia ; Meningioma ; Neck ; Parotid Gland ; Prospective Studies ; Radiation Exposure ; Radiography ; Radiography, Dental ; Salivary Gland Neoplasms ; Thumb ; Thyroid Neoplasms