Traditionally corpus callosotomy is done through a craniotomy centered at the coronal suture, with the aid of a microscope. This involves dissecting through the interhemispheric fissure below the falx to reach the corpus callosum. The authors describe a posterior interhemispheric approach to complete corpus callosotomy with an endoscope, which bypasses the need to perform interhemispheric dissection because the falx is generally close to the corpus callosum in this region.
Abstract Fetoplacental neuroblastoma metastasis has been postulated as a mechanism accounting for concordant cases where one twin develops a primary tumour and the second twin manifests the disease without an identifiable primary site. These tumours may originate and spread concomitantly due to the same genetic background shared by monozygotic twins. This study investigated the molecular profile of stage MS neuroblastoma presenting concomitantly in monozygotic twins. Comparative genomic hybridisation (aCGH) was done for each of the twin liver tumour and peripheral blood samples at diagnosis. Comparison of copy-number variation (CNV) regions revealed a set of CNVs that were common to both tumour specimens and not apparent in the blood. The CNV signature in both twins’ tumours was highly similar, suggesting a common clonal origin. Additional findings included large deletion of chromosome 10 and amplification of chromosome 17. Notably, both liver samples had amplification of a short region involving DEIN (chromosome 4q34.1). Similar CNVs strongly support a common clonal origin and metastatic spread from one twin to the other. DEIN is a long-coding RNA (IncRNA) that has been found highly expressed in stage MS neuroblastoma and is likely involved in biological processes such as cell migration and metastasis.
To evaluate the potential role of ultrasonography probes and coupling gel for cross-infection in patients undergoing ultrasonography; to describe a cost-effective method of probe handling; and to emphasize the importance of position of the probes in the boxes.Cultures were taken from 43 probes used in different scanning regions. Cultures were also taken from probe boxes and coupling gel.After abdominal scanning, cleaning with paper seems to be effective, but even wiping with alcohol is insufficient for inguinal and axillar regions. Before scanning of these areas is started, cleaning the inguinal and axillar regions with alcohol reduces the contamination risk. Placing the probes downward in boxes also increases the risk of contamination.Wiping the probes with dry paper seems to be effective only for abdominal scanning; for inguinal and axillar scanning, cleaning the region with alcohol before scanning seems more appropriate. Placing the probes downward in boxes may also be a source of contamination.
Buerger's disease is a recurrent inflammatory, nonatherosclerotic vasoocclusive disease, which typically affects small and medium-sized arteries, veins, and nerves of the upper and lower extremities. Systemic manifestations involving cerebral, mesenteric, and coronary arteries are exceptional. Moreover, multisystem involvement of 2 or more organs is extremely rare. The authors present a case of Buerger's disease in a patient who subsequently developed cerebral and bowel infarcts as well as cavernomatous transformation of the portal vein. Therefore, Buerger's disease, although rare, does have a chronic aggressive nature in some patients.
Diffuse Intrinsic Pontine Glioma (DIPG) is an extensively invasive tumor of brainstem. Tumor biopsy was rarely performed until recently, because of the possible complications associated with the procedure, therefore, the data on the DIPG histology is relatively limited. We identified 29 consecutive cases of DIPG diagnosed from 2002 to 2017 at Children’s Hospital of Michigan, and tumor biopsy was performed in 22 cases. The histology was consistent with low grade glioma (LGG) in 4 of the 22 cases (18%). We retrospectively reviewed these 4 cases, including the histology, MRI findings, H3 mutation and BRAF alteration status, treatment and survival. There was one Grade I astrocytoma, one Grade I ganglioglioma, and two grade II astrocytomas. Radiologically, 3 were consistent with typical DIPG, one with atypical DIPG. The testing for H3 mutation and BRAF alteration was performed in two recent cases. One case had H3F3A K27 mutation, but no BRAF alteration was identified in either case. All patients received involved-field external beam radiation as part of their initial treatment. Three patients succumbed to their disease with overall survival of 9–17 months, and one patient is alive with no clinical or radiological sign of disease at 6 months following diagnosis. In summary, histology was consistent with LGG in 4 out of 22(18%) of our biopsied DIPG series. One patient with ganglioglioma was found to have histone H3 mutation, a rare finding in LGG but common in midline high grade glioma, who progressed at 11 months, and died at 17 months following initial diagnosis.
Penile metastatic tumors are relatively infrequent and very rare compared to extraurogenital tumor metastasis. We present an interesting rare occurrence of a late penile metastasis on an adenocarcinoma of the rectum.
This case report of sternal dehiscence, complicated by pronounced migration of fractured sternotomy wires, demonstrates the utility of computerized tomography (CT) in the precise localization of the wire fragments. Although CT is not typically used to evaluate sternal wire abnormalities, selected cases of sternal dehiscence can benefit from this detailed survey. A review of the literature regarding complications was also performed.
