Extracranial metastasis of primary brain tumors is rarely observed. Of all brain malignancies, glioblastomas, medulloblastomas and astrocytomas metastasize most frequently. Metastasis of oligondendroglioma is rare. We present a case of breast metastasis in a 58-year-old man with an anaplastic oligodendroglioma.
To investigate the relationship between tumor volume and serum microsomal prostaglandin E2 (mPGE2) levels in patients with astrocytic tumors. The study included patients with astrocytic tumors who were treated at our clinic between August 2015 and December 2016. Preoperative and postoperative contrast-enhanced cranial magnetic resonance imaging (MRI) scans were performed (within the first 24 h), and preoperative and postoperative residual tumor volumes were calculated. Microsomal prostaglandin E2 (mPGE2) levels were measured and compared in the serum samples of the patients before surgery, on the first day after surgery, and at 1 week after the surgery. The study included 20 patients, 13 of whom were males and 7 were females, with a mean age of 57.20 ± 14.66 yr. The mean postoperative tumor volume was 9,180.69 mm3 (range, 0.00-41,961.60), which was significantly lower than the preoperative mean tumor volume of 37,323.84 mm3 (range, 4,457.40-108,247.20; z = -3.920, p < 0.001). On the first postoperative day, the mean mPGE2 level was 1,776.50 pg/ml (range, 771-5,010), which was similar to the preoperative mean mPGE2 level of 1,769.20 pg/ml (range, 681-3,480). On the seventh postoperative day, the mean mPGE2 level was 955.50 pg/ml (range, 31-2,130), which was significantly lower than the preoperative and postoperative first-day mean mPGE2 levels (p < 0.001). No correlation was found between preoperative and postoperative tumor volumes and mPGE2 levels. Compared with preoperative mPGE2 levels, mPGE2 levels decreased significantly on the seventh postoperative day. However, no correlation was observed between the tumor volume removed and decrease in mPGE2 levels.
Ependymomas are rare neuroectodermal tumors arising from ependymal cells of the ventricular system, choroid plexus, filum terminale, or central canal of the spinal cord. Ependymomas are relatively uncommon nervous system tumors, constituting 1.2% to 7.8% of all intracranial neoplasms or 2% to 6% of all gliomas.1–8 Extraventricular ependymomas are especially rare, and whereas they have definite ependymal morphology, their histogenesis remains uncertain. Some tumors may extend to the gray matter reaching the pial surface, but pure cortical ependymomas are uncommon. We have encountered a few pediatric cases of supratentorial cortical ependymoma in the English literature.1–10
We present a case of an 11-year-old boy with a large supratentorial cortical ependymoma with massive calcification and central cyst formation manifested as generalized convulsion.
AIM:To compare the effectiveness of laminoplasty and laminectomy with fusion in the treatment of patients with cervical spondylotic myelopathy (CSM). MATERIAL and METHODS:This study retrospectively reviewed 52 patients diagnosed with CSM who underwent either laminoplasty (LP group) or laminectomy with fusion (LF group).The preoperative and postoperative clinical outcomes were evaluated using Cobb's angle of cervical lordosis, visual analogue scale (VAS) and modified Japanese Orthopaedic Association (mJOA) scores, and radiographs showing the antero-posterior diameter and area of the spinal canal. RESULTS:The mean age of the LP group was 60.12 years, while that of the LF group was 63.84 years.The pre-and postoperative mean mJOA scores were 11.46 ± 1.27 and 15.27 ± 0.87, respectively, in the LP group and 10.15 ± 1.89 and 14.92 ± 1.23, respectively, in the LF group.The pre-and postoperative Cobb angles were 16.22 ± 6.36° and 14.45 ± 4.50°, respectively, in the LP group and 14.39 ± 5.34° and 15.10 ± 6.21°, respectively, in the LF group.Recovery rates were 58.26% and 60.76% in the LP and LF groups, respectively.The mJOA scores, antero-posterior diameter and area improved significantly after surgery in both groups, while the Cobb angle increased in the LF group and decreased in the LP group.CONCLUSION: Laminoplasty and laminectomy with fusion improved neurological functions in patients diagnosed with CSM.Laminectomy with fusion should be the preferred choice when treating patients with preoperative axial pain as, despite expanding the spinal canal successfully, laminoplasty can also worsen the pain.However, laminectomy with fusion (except for OPLL) should not be the treatment of choice in a mobile spine as it severely restricts neck movements and impairs the Health-Related Quality of Life (HRQoL) of the patient.In the absence of kyphotic deformity, laminoplasty should be the preffered method for treatment.
