Herein, we report on an unusual case of craniopharyngioma arising in the temporal lobe with no prior history of surgery and with no connection to the craniopharyngeal duct. MR images showed a cystic tumor with a small solid portion. To the best of our knowledge, this is the first case of a craniopharyngioma occurring in the temporal lobe.
Adult ; Brain Neoplasms/diagnosis/*pathology/surgery ; Craniopharyngioma/diagnosis/*pathology/surgery ; Human ; Magnetic Resonance Imaging ; Male ; Temporal Lobe/*pathology/surgery

Adult ; Brain ; pathology ; Brain Neoplasms ; metabolism ; pathology ; surgery ; Diagnosis, Differential ; Female ; Ganglioglioma ; metabolism ; pathology ; surgery ; Humans ; Neoplasms, Neuroepithelial ; pathology ; S100 Proteins ; metabolism ; Synaptophysin ; metabolism

OBJECTIVETo study the clinicalpathologic features of intracranial multiple lesions.

METHODSThe clinical, radiologic and pathologic features of intracranial multiple lesions in 62 cases during the period from 2005 to 2009 in Xuanwu Hospital were retrospectively reviewed.

RESULTSThere were 32 males and 30 females in 62 cases. The mean age of seize onset and duration of disease were 37.4-year-old and 11.6 months, respectively. The lesions could affect cerebral hemisphere, basal ganglia, brain stem, cerebellum and other parts, most lesions were located above the tentorium. Pathological diagnosis as follows: 13 patients with glioma; metastatic tumors in 13 cases; 12 cases of central nervous system infection; immune-mediated inflammatory demyelinating disease in 8 cases; 5 cases of primary lymphoma of central nervous system; primary angiitis of the central nervous system 3 cases; mitochondrial encephalopathy 2 cases; vein thrombosis in 2 cases; Rosai-Dorfman disease in 2 cases; 2 case of radiation encephalopathy. Among them, mitochondrial encephalopathy and vein thrombosis lesions located in the cortex; metastatic tumor and blood-borne infection mainly involving junction of grey and white matter; glioma, radiation encephalopathy and demyelinating disease include white matter lesions; vascular inflammation showed cortical and subcortical white matter lesions.

CONCLUSIONSA variety of tumor and non-neoplastic diseases can be expressed in intracranial multiple lesions, which gliomas, metastatic tumor and central nervous system infections are more common. In order to improve the diagnosis of intracranial multiple lesions, active work in the brian biopsy, study the clinical, imaging and pathological findings must be closely.

Adolescent ; Adult ; Aged ; Brain Neoplasms ; diagnosis ; pathology ; surgery ; Child ; Demyelinating Diseases ; diagnosis ; pathology ; surgery ; Female ; Glioma ; diagnosis ; pathology ; surgery ; Histiocytosis, Sinus ; diagnosis ; pathology ; surgery ; Humans ; Lymphoma, Large B-Cell, Diffuse ; diagnosis ; pathology ; surgery ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Neoplasms, Neuroepithelial ; diagnosis ; pathology ; surgery ; Retrospective Studies ; Toxoplasmosis, Cerebral ; diagnosis ; pathology ; surgery ; Tuberculosis, Central Nervous System ; diagnosis ; pathology ; surgery ; Young Adult

Metastasis of nasopharyngeal carcinoma (NPC) to the dura, an extremely rare condition, can be symptomatically silent and mistaken for a benign entity radiographically. Missed diagnosis can lead to serious consequences or prove immediately fatal. We report a woman with dural metastasis of NPC that mimicked a meningioma on radiography. Craniectomy with tumour resection was performed due to rapid progression from the onset of symptoms to disability. The patient was still alive two years after surgery. This case emphasises the need to keep in mind the possibility of dural metastasis of NPC in patients with abnormal imaging features. This would not only avoid wrong and optimistic diagnosis, but also allow for appropriate treatment in a timely manner. To our knowledge, this is the first report of metastasis of NPC to the dura. We provide detailed information on the neoplastic lesion, which masqueraded as a benign entity and caused potentially fatal consequences.
Adult ; Brain Neoplasms ; diagnosis ; secondary ; surgery ; Carcinoma ; Diagnosis, Differential ; Disease Progression ; Dura Mater ; pathology ; Female ; Humans ; Magnetic Resonance Imaging ; Meningioma ; diagnosis ; pathology ; Nasopharyngeal Neoplasms ; diagnosis ; pathology ; Neoplasm Metastasis

Actins ; metabolism ; Adult ; Brain Neoplasms ; metabolism ; pathology ; surgery ; Desmin ; metabolism ; Diagnosis, Differential ; Dura Mater ; chemistry ; pathology ; Female ; Granuloma, Plasma Cell ; metabolism ; pathology ; surgery ; Humans ; Immunohistochemistry ; Meningeal Neoplasms ; pathology ; Meningioma ; pathology ; Neoplasms, Muscle Tissue ; metabolism ; pathology ; surgery ; Vimentin ; metabolism

OBJECTIVETo study the immunohistochemical expression and diagnostic significance of CD34 in brain tumors of patients with refractory epilepsy.

METHODSImmunohistochemical study for CD34 was performed on formalin-fixed paraffin-embedded tissue blocks of 54 cases of brain tumors occurring in patients with refractory epilepsy. The tumor types included ganglioglioma (GG, number = 21), dysembryoplastic neuroepithelial tumor (DNT, number = 8), tumors/lesions which had the transitional features that between glioneuronal hamartia and mixed neuronal-glial tumor (number = 21) and pleomorphic xanthoastrocytoma (PXA, number = 4). Cases of glioblastoma (number = 4) and oligoastrocytoma (number = 5) were used as controls.

RESULTSTwenty of the 21 cases of GG, 1 of the 8 cases of DNT, 16 of the 21 cases of tumors/lesions which had the transitional features and 3 of the 4 cases of PXA showed cytoplasmic and membranous positivity for CD34. The adjoining brain tissues in 9 of the 18 cases of GG, 6 of the 16 cases of tumors/lesions which had the transitional features and 1 of the 3 cases of PXA also expressed CD34. In contrast, only 1 case of glioblastoma showed membranous positivity for CD34.

CONCLUSIONSCD34 preferred to staining for GG and PXA. Which represent a valuable tool for distinguishing GG, PXA and DNT, oligoastrocytoma, glioblastoma.

Antigens, CD34 ; metabolism ; Astrocytoma ; complications ; metabolism ; pathology ; surgery ; Brain Neoplasms ; complications ; metabolism ; pathology ; surgery ; Diagnosis, Differential ; Epilepsy ; etiology ; Ganglioglioma ; complications ; metabolism ; pathology ; surgery ; Glioblastoma ; complications ; metabolism ; pathology ; Humans ; Neoplasms, Neuroepithelial ; complications ; metabolism ; pathology ; surgery

The clinical outcome and prognostic factors of patients with synchronous brain metastases from non-small cell lung cancer (NSCLC) who were treated with gamma knife radiosurgery (GKS) were analyzed. A total of 35 patients with NSCLC underwent GKS as an initial treatment for metastatic brain lesions of synchronous onset. The period of survival and various prognostic factors such as age, gender, performance status, multiplicity of the brain lesions, intracranial tumor volume, and extent of the primary tumor were analyzed. The overall median survival time for this series was 12 months (range 0.75 to 43 months) from the diagnosis. Of the 21 patients who were no longer alive at the conclusion of this study, only 7 (33.3%) died of neurological causes. Multivariate analysis of these data revealed that N stage, whole-brain radiotherapy (WBRT), and chemotherapy were significant predictors for survival (p<0.05). Survival of patients with NSCLC and synchronous brain metastases is mainly dependent upon the progression of the systemic disease, provided that the cerebral lesions are treated adequately with local treatment modalities including radiosurgery. Application of radiosurgery as an initial treatment option and aggressive local and systemic modalities to control extracranial disease may improve survival.
Treatment Outcome ; Time Factors ; Radiosurgery/*methods ; Prognosis ; Neoplasm Metastasis ; Middle Aged ; Male ; Lung Neoplasms/*diagnosis/pathology/*surgery ; Humans ; Female ; Carcinoma, Non-Small-Cell Lung/*diagnosis/pathology/*surgery ; Brain Neoplasms/*diagnosis/pathology/*surgery ; Aged, 80 and over ; Aged ; Adult

BACKGROUNDOlfactory neuroblastoma (ONB) is a rare tumor that often arise from the nasal cavity. The aim of this study was to investigate the clinical characteristics and treatments of intracranial invasive ONB.

METHODSBetween July 2001 and August 2005, 5 patients with intracranial invasive ONB were treated in our department. Their clinical features, radiological and pathological characteristics, and surgical treatments were analyzed. Among the 5 patients, 1 received transnasal biopsy, and 4 were operated through the transfrontal or extended bifrontal approaches to reconstruct the skull base. After the operation, all the patients received radiotherapy, and one received chemotherapy. They were followed up for 6 to 45 months.

RESULTSThe ONB was resected totally in the 4 patients. In all the patients, nasal obstruction was alleviated without cerebrospinal fluid leakage. The visual acuity was improved in 3 patients, who had a decreased visual acuity before the operation. Two patients had metastasis into the lumbosacral spinal canal 6 and 8 months after the operation, one of them received a second operation and the other died.

CONCLUSIONONB has no specific symptoms. Intracranial ONB should be resected as far as possible, and treated by radiotherapy after the operation.

Adolescent ; Adult ; Brain Neoplasms ; diagnosis ; pathology ; surgery ; Esthesioneuroblastoma, Olfactory ; diagnosis ; pathology ; surgery ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Tomography, X-Ray Computed

OBJECTIVETo study the clinical characteristics, diagnosis and surgical treatment of malignant intracranial teratomas.

METHODSThirty-four patients with intracranial teratoma proved by histopathology were treated by operation. The growth pattern of this tumor, assessed by its clinical manifestations and neuroimaging together with surgical treatment and results were analyzed retrospectively.

RESULTSOnly 6 lesions had been correctly suspected as teratoma before surgery. Total removal was achieved in 14 patients with a operative mortality of 32.4%. The survival of 23 patients with lesions showing aggressive growth was significantly different from those without (P < 0.05). Nineteen of these patients did not survive beyond the sixth month after surgery.

CONCLUSIONAccurate preoperative diagnosis is difficult in malignant intracranial teratoma, especially for patients with the tumor in the sella region. The invasive biological behavior of the tumor is proved to be the main cause of surgery being dwarfed. Protection of the hypothalamus and brainstem, relief of hydrocephalus are the crucial points in surgical treatment. Comprehensive histopathologic examination combined with serum and CSF tumor marker detection is necessary for correct diagnosis and treatment.

Adolescent ; Adult ; Biomarkers, Tumor ; blood ; cerebrospinal fluid ; Brain Neoplasms ; diagnosis ; mortality ; pathology ; surgery ; Child ; Female ; Humans ; Male ; Neoplasm Invasiveness ; Prognosis ; Teratoma ; diagnosis ; mortality ; pathology ; surgery

Adolescent ; Brain Neoplasms ; metabolism ; pathology ; surgery ; Diagnosis, Differential ; Ependymoma ; metabolism ; pathology ; Ganglioglioma ; metabolism ; pathology ; surgery ; Glial Fibrillary Acidic Protein ; metabolism ; Humans ; Immunohistochemistry ; Male ; Tubulin ; metabolism ; Vimentin ; metabolism