We reviewed the records of 28 patients who underwent transcranial(20 cases) or transsphenoidal(8 cases) surgery sellar and parasellar tumors. Both pre-and postoperative visual status(visual acuity and field) of each eye were analyzed under the rating system of Cohen, et al. The average duration of follow-up 3 months. The lesions encountered consisted of pituitary adenoma in 14 cases, craniopharyngioma in 5 cases, meningioma in 4 cases, chordoma in 3 cases, a dermoid cyst in 1 case, and an unspecified tumor in another case. All patients had objective signs of visual acuity or field defects preoperatively. Overall postoperative visual acuity and visual fields were normalized or improved in 73% and 71% of the eyes, respectively. The visual outcome of postoperative visual acuity was better in cases of craniopharyngioma(80%) than the other tumors. Visual evoked potentials(VEP) showed all postoperative improvement and was as helpful as visual fields in determining visual status. The visual outcome was better in patients with a shorter duration of symptoms and those with smaller tumors. Patients with lesser compromise of preoperative visual acuity had better outcome of postoperative visual acuity. However, the severity of preoperative visual field defects did not seem to influence postoperative field outcome. There also was no relationship between the presence of endocrine activity of the tumor and visual outcome. Patients who underwent transsphenoidal approach had either better visual acuity or field improvement than patients with transcranial approach.
Chordoma ; Craniopharyngioma ; Dermoid Cyst ; Follow-Up Studies ; Humans ; Meningioma ; Pituitary Neoplasms ; Visual Acuity ; Visual Fields

Intrathird ventricular tumors that mainly occupy the ventricle cavity without extending to the neighbouring structures are rare. These tumors are developed from the choroids plexus, tela, ependyma, subjacent neuroglia and embryonic cell rest. The authors experienced 11 cases of rare intrathird ventricular tumors during the past 10 years. During the same period, number of surgically proven brain tumors were 990 and intrathird ventricular tumors comprised 1.1%. These are two cases of choroids plexus papillomas, three craniopharyngiomas, two germ cell tumors, one meningioma, one glioependymal cyst, one ependymoma, one astrocytoma. Suprasellar craniopharyngiomas, thalamic gliomas, optic and hypothalamic gliomas were excluded. The age distribution was from 6 years old to 59 years old. The clinical manifestation was characteristic in that they usually had the sudden intermittent headache without specific localizing signs. Surgical approach to this area is by transcallosal or transcortical approach. Surgical total removal was quite feasible by either approach and outcome was rather favorable.
Age Distribution ; Astrocytoma ; Brain Neoplasms ; Child ; Choroid ; Craniopharyngioma ; Ependyma ; Ependymoma ; Glioma ; Headache ; Humans ; Meningioma ; Middle Aged ; Neoplasms, Germ Cell and Embryonal ; Neuroglia ; Optic Nerve Glioma ; Papilloma ; Papilloma, Choroid Plexus

Intrathird ventricular tumors that mainly occupy the ventricle cavity without extending to the neighbouring structures are rare. These tumors are developed from the choroids plexus, tela, ependyma, subjacent neuroglia and embryonic cell rest. The authors experienced 11 cases of rare intrathird ventricular tumors during the past 10 years. During the same period, number of surgically proven brain tumors were 990 and intrathird ventricular tumors comprised 1.1%. These are two cases of choroids plexus papillomas, three craniopharyngiomas, two germ cell tumors, one meningioma, one glioependymal cyst, one ependymoma, one astrocytoma. Suprasellar craniopharyngiomas, thalamic gliomas, optic and hypothalamic gliomas were excluded. The age distribution was from 6 years old to 59 years old. The clinical manifestation was characteristic in that they usually had the sudden intermittent headache without specific localizing signs. Surgical approach to this area is by transcallosal or transcortical approach. Surgical total removal was quite feasible by either approach and outcome was rather favorable.
Age Distribution ; Astrocytoma ; Brain Neoplasms ; Child ; Choroid ; Craniopharyngioma ; Ependyma ; Ependymoma ; Glioma ; Headache ; Humans ; Meningioma ; Middle Aged ; Neoplasms, Germ Cell and Embryonal ; Neuroglia ; Optic Nerve Glioma ; Papilloma ; Papilloma, Choroid Plexus

Thallium(T1) has recently been used as a pharmaceutical for tumor imaging and staging. The aim of this study was to evaluate the clinical significance of the T1 analogue, 99m-Tc-MIBI(methoxyisobutylisonitrile), for imaging of intracranial lesions. The advantages of MIBI were though to be a lower radiation exposure and better image quality than with T1. 99m-Tc-MIBI SPECT studies were done in 30 patients with brain tumors(14 astrocytomas, 7 meningiomas, 2 hemangioblastomas, 2 craniopharyngiomas, 1 ependymoma, 4 metastatic tumors) and in twelve patients with non-tumorous lesions(2 abscesses, 2 granulomas, 2 cysticercosis, 3 old intracerebral hemorrages, 1 infarction. 1 postoperative gliosis, 1 unknown pathology), and semiquantitative assessment of tracer uptake was made using a ratio of radioactivity for lesion to contralateral normal brain(Lesion/Contralateral normal brains ; L/C). Twenty six of thirty tumors showed high L/C ratios(>1.5) and another four tumors low L/C ratios(<1.5). Of 12 non-tumorous intracranial lesions, 11 showed little or no uptake, but one moderate uptake. In conclusion, it appears that brain tumors show more intense focal uptake than non-tumorous brain lesions. However, further studies would be warranted to evaluate the clinical significance of MIBI SPECT in tumor staging(grading) and in differentiating necrosis from tumor regrowth more clearly.
Abscess ; Astrocytoma ; Brain ; Brain Neoplasms ; Craniopharyngioma ; Cysticercosis ; Ependymoma ; Gliosis ; Granuloma ; Hemangioblastoma ; Humans ; Infarction ; Meningioma ; Necrosis ; Radioactivity ; Thallium ; Tomography, Emission-Computed, Single-Photon*

Ovarian squamous cell carcinoma constitutes less than 2% of all gynecologic malignancy. Most of ovarian primary squamous cell carcinoma arise in mature dermoid cyst. Malignant transformation occurs in less than 2% of benign mature teratoma. Of all three germ layers, the ectoderm is thought to be commonest to undergo malignant change, hence sguamous cell carcinoma is by far the most frequent seen tumor that is over 80% of reported cases in large series followed by the much rare adenocarcinoma, melanoma, and carcinoid. Most patients of ovarian squamous cell carcinoma were postmenopausal. Several authors had reported the poor prognosis of this malignancy but there is no consensus on optimal therapy. Due to its rarity, there is also no consensus regarding the efficacy of postoperative therapy. A Rare presenting symptom associated ovarian squamous cell carcinoma is rectal mass secondary to invasion into the distal rectum. We also present a case of rectal invasion of ovarian squamous cell carcinoma.
Adenocarcinoma ; Carcinoid Tumor ; Carcinoma, Squamous Cell* ; Consensus ; Dermoid Cyst ; Ectoderm ; Germ Layers ; Humans ; Melanoma ; Prognosis ; Rectum ; Teratoma*

OBJECTIVE: to evaluate the clinicopathologic characteristics of patients with ovarian malignant germ cell tumor. METHODS: We reviewed records of women who had malignant germ cell tumors of the ovary from 1991-2000. RESULTS: Thirty-seven women had surgical resections of malignant ovarian germ cell tumors and most received adjuvant therapy. Twenty-five women (68%) presented with stage I disease, and 12 (32%) had more advanced disease. Histology subtypes were: immature teratoma (n=16), dysgerminoma (n=9), yolk sac tumor (n=8), choriocarcinoma (n=2), embryonal carcinoma (n=1), and mixed germ cell tumor (n=1). The frequency of positive tumor markers were aFP, CA-125, beta-hCG, CA 19-9 and LDH in decreasing order. The mean age of the patients at presentation was 23.9 years (4-58). Surgical management of the 32 patients consisted of unilateral oophorectomy, or salpingo-oophorectomy, 1 woman with stage III disease underwent bilateral salpingo-oophorectomy and 4 women underwent total abdominal hysterctomy, bilateral or unilateral adnexectomy. Thirty-two women were treated with adjuvant combination chemotherapy (BEP, VAC, VBP) according to indications. The 5-year survival rate was 100%, and 5-year disease-free rate was 91.8%. Among twelve patients who attempted pregnancy, 8 succeeded in it and delivered normal full term babies. CONCLUSION: Current therapeutic strategies can allow most women with ovarian malignant germ cell tumors to have conservative surgery without compromising survival and to preserve their reproductive potential.
Carcinoma, Embryonal ; Choriocarcinoma ; Drug Therapy ; Drug Therapy, Combination ; Dysgerminoma ; Endodermal Sinus Tumor ; Female ; Germ Cells* ; Humans ; Neoplasms, Germ Cell and Embryonal* ; Ovariectomy ; Ovary* ; Pregnancy ; Survival Rate ; Teratoma ; Biomarkers, Tumor

Malignant germ cell tumors of the ovary are uncommon neoplasms. Although 20-25% of all ovarian tumors are derived from germ cells, only about 3% of germ cell tumors are malignant. Mixed germ cell tumors contain at least two malignant germ cell elements. These lesions should be managed with combination chemotherapy, preferably BEP. Recently we experienced a case of mixed germ cell tumor with 6 components of germ cell and sarcomatous change in a 11 year old girl. Preoperative CA-125, B-hCG, aFP, LDH, a-1-antitrypsin were elevated and the final pathologic report was mixed germ cell tumor composed of endodermal sinus tumor, embryonal carcinoma, mature and immature teratoma, choriocarcinoma, dysgerminoma and sarcomatous change, Postoperative chemotherapy with 6 courses of BEP regimen was performed and all tumor markers became normal after 4 courses of chemotherapy. What we interested in this case was several components of germ cells and sarcomatous change and the sarcomatous change might be derived from the mature cystic teratoma component, so we present this case with a brief review of the literatures here.
Carcinoma, Embryonal ; Child ; Choriocarcinoma ; Drug Therapy ; Drug Therapy, Combination ; Dysgerminoma ; Endodermal Sinus Tumor ; Female ; Germ Cells* ; Humans ; Neoplasms, Germ Cell and Embryonal* ; Ovary ; Pregnancy ; Teratoma ; Biomarkers, Tumor

Studying 50 cases with spinal intramedullary tumor at Nerve Department of Bach Mai hospital to diagnose before surgering from 1998 to 2003. Among them, 6 cases with ependymomas and 3 with astrocytomas were taken magenetic resonance. Result showed that ependymomas and astrocytomas were two major typies in intramedullary tumors. Magenetic resonance imaging has some characterstics helping identify these typies according to considering different factors (ex age, site of tumor). Eoendymomas is more in adult. Astrocytomas is more in children.
Magnetic Resonance Imaging ; Diagnosis ; Spinal Cord Neoplasms ; Ependymoma ; Astrocytoma

Carcinoid tumors have been described in almost every organ and may affect virtually every body system. Cardiac involvement manifesting as right-sided valvular disease is characteristic of the carcinoid heart disease. Myocardial metastasis is an unusual manifestation of carcinoid heart disease and it was manifested as a mass lesion in the previous reports. We observed a myocardial metastasis of carcinoid tumor manifesting as diffusely infiltrative pattern.
Carcinoid Heart Disease* ; Carcinoid Tumor* ; Neoplasm Metastasis

Thirteen patients with malignant germ cell tumars of the ovary have been treated with a combination chemotherapy. The age of the patients ranged from ll to 50 years and there was no history of radiation therapy of chemotherapy except operation, Stage distributions are as follow ; 2 pstients are stage IV, 3 are stage II and remainied 8 are stage I. 4 patients with immature teratama and 2 patients with mixed germ cell tumor received VAC chemotherapy, as primary therapy, and among them 1 lost to follow up but remained 5 cases live without evidence of disease 39 to 83 gnontha. There were 3 patients with endodermal sinus tumor and 1 received VAC and remeined 2 received FVB as primary chemotherapy, Of them 1 died of disease after 9 months of oyeration and the other 2 live now with no evidence of disease. There were 2 patiente with dysgerminoma and 2 with primary ovarian choriocarcinoma. 1 patient with dysagerminoma and 1 wit choriocarcinoma were died because of chemotherapy toxicity, 1 patient with dysgerminoma, who refused further ehemotherapy after l course of chemot.herapy, died of progressive disease. l patient wit choriocarcinoma now live well without evidence of disease at 35 months. The combination chemotherapy using VAC or PVB regimen represents an effective treatment for malignant. germ cell turnars of the ovary and reveals moderate oxicity.
Choriocarcinoma ; Drug Therapy ; Drug Therapy, Combination* ; Dysgerminoma ; Endodermal Sinus Tumor ; Female ; Germ Cells* ; Humans ; Lost to Follow-Up ; Neoplasms, Germ Cell and Embryonal* ; Ovary ; Pregnancy