• Journal of Korean Neurosurgical Society
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• v.30 no.7
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• pp.925-927
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• 2001

Multiple intracranial tumors of different cell types are rare. We report a case of double primary intracranial tumors of different histologic types : oligodendroglioma, and pituitary adenoma. Von Recklinghausen's disease or other etiologic factors supposedly associated with multiple brain tumors were not recognized in this 36-year-old male patient.

• Journal of Korean Neurosurgical Society
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• v.30 no.sup1
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• pp.140-143
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• 2001

We report a case of huge trigeminal schwannoma in a 10-year-old boy with neurofibromatosis type II, extending into the three spaces of the left middle, posterior, and infratemporal fossa. Initially we thought the child had a solitary trigeminal schwannoma, and most of the mass was resected successfully through one-stage operation, cranio-orbito-zygomatic intradural approach. However during the follow-up of the patient we found radiographically other multiple intracranial tumors of bilateral acoustic schwannomas, right trigeminal schwannoma, and foramen magnum tumor. Eventually the patient was diagnosed as neurofibromatosis type II presenting multiple intracranial tumors. We think childhood trigeminal schwannoma, even though in the case of solitary tumor, should be considered as possible initial manifestation of neurofibromatosis type II and that careful follow-up for the possibility of occurrence of other brain tumors such as schwannomas or meningiomas is necessary.

• Investigative Magnetic Resonance Imaging
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• v.19 no.4
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• pp.252-255
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• 2015

Intracranial involvement in multiple myeloma patients takes up around 1%, and is usually known to be present in the parietal bone or skull base in cases of skull vault involvement, while it presents in the dura and parenchyma in cases of intracranial involvement. Primary pachymeningeal invasion is even rarer with extremely rapid progression and very poor prognosis. It is our intent to report a case in which we had to differentiate multiple myeloma with other metastatic tumors, lymphoma, and leukemia with intracranial involvement. Our patient showed an osteolytic lesion of the skull with dural involvement and subdural mass formations.

• Journal of Korean Neurosurgical Society
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• v.30 no.sup1
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• pp.25-29
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• 2001

Objective : Intracranial metastasis is responsible for nearly 50% of mortalities of systemic cancers. Although its frequency is increasing and there is little doubt that improving the quality and expectancy of life is the final goal, the mode of treatment is still disputed. The authors report the postoperative motor function after surgery in patients with metastatic tumors around the motor cortex. Materials and Methods : We studied 24 patients with metastatic tumors around the central sulcus during the last 22 months. Motor function was assessed pre- and post-operatively as well as its response to corticosteroids. MRI, neuronavigation system and intraoperative ultrasonography were used for tumor localization and functional MRI and cortical stimulator were used to define the motor cortex. Results : Single metastasis was found in 13 cases(54%) and 11 cases(44%) had multiple foci. Thirteen cases were located in precentral, 7 in postcentral, and 4 in superior or middle-frontal lobe. The most common primary focus was the lung(16 cases). There was no difference in postoperative motor function improvement between the steroid responsive group and non-responsive group(92% versus 90%). Ninty-two percent of the patients showed significant improvement of motor function and lived independently but there was worsening in the upper extremity in one and in another no improvement. Whole brain radiation of 3000cGy was given in all cases and 4 patients died of recurrence in primary or intracranial focus during mean follow-up periods of 14 monthes. Conclusion : Surgery may provide substantial improvement of the motor function and quality of life of the patients with metastatic tumors around the motor cortex.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.28 no.5
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• pp.348-352
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• 2002

Ameloblastoma of the maxilla is an unusual epithelial tumor of odontogenic origin. According to many authors and reports, ameloblastoma account for approximately 1% of all tumors of the jaws, but when pseudotumors and cysts are excluded, the ratio rises to 11%. Of these tumors,80% originate in the mandible, while 20% originate in the maxilla. Although it is considered benign histopathologically, it can behave in a slowly growing infiltrative fashion, with multiple recurrences and eventual intracranial, or even distant, spread. We clinically analyzed common site in maxilla, radiographic findings, recurrence rate, duration between treatment and recurrence, the presence and site of distant metastasis in 15 patients who were diagnosed as ameloblastoma of the maxilla and took treatments from 1985 to 1999 in Dept. of Oral and Maxillofacial Surgery, Dental Hospital, Seoul National University. In this paper, treatment outcomes and our clinical experiences of maxillary ameloblastoma are reported with review of literatures.

• Journal of Korean Neurosurgical Society
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• v.65 no.4
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• pp.499-506
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• 2022

Objective : We conducted this study with the aim of predicting the biological behavior of meningiomas, and determining the benefits of associating histological subtype and grade with the expression of proliferative markers and tumor suppressor proteins. Methods : The study included 29 patients with primary intracranial and intraspinal meningioma diagnosed in the pathology laboratory of Konya City Hospital between January 2014 and December 2020. Clinicopathological characteristics of the patients including parameters such as age and gender were obtained from the hospital records. Histopathological findings were obtained by re-evaluating the preparations stained with Hematoxylin-Eosin, which were extracted from the archive, and by evaluating new sections obtained from paraffin blocks of patients stained with Ki67, p53, and p57 immunohistochemical stains. Results : A moderate correlation was found between tumor size and Ki67 proliferation index (PI) (p=0.003, r=0.530). There was no significant difference between grade I and grade II tumors in terms of p53 (p=0.184) and p57 (p=0.487) expressions. There were higher levels of Ki67 PI in grade II tumors. The histological subtypes of the tumor had no significant difference with Ki67 PI (p=0.018), p53 (p=0.662), and p57 (p=0.368) expressions. Conclusion : In order to obtain more definitive results, there is a need for studies, which are conducted with a greater number of patients and in multiple centers, and in which a long prospective follow-up is planned. The combination of histological, surgical, and imaging markers could make a more sensitive tool for predicting recurrence, and this could also be tested in future studies.

• Journal of the Korean Society of Radiology
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• v.83 no.4
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• pp.951-957
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• 2022

Meningiomas are the most common intracranial tumors. However, microcystic and angiomatous meningiomas are very rare subtypes that present unusual imaging findings. Hence, radiological diagnosis of these tumors can be challenging. We herein describe a case of mixed angiomatous and microcystic meningioma in an 81-year-old male. MRI revealed an extra-axial mass with high T2 signal intensity, measuring 1.5 cm in diameter, with multiple tiny intralesional cysts and entrapped peritumoral cyst formation. After tumor resection, a histopathological diagnosis of mixed angiomatous and microcystic meningioma was made.

• Radiation Oncology Journal
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• v.18 no.2
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• pp.92-100
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• 2000

Purpose :This study was performed to determine the optimal treatment velum of Patients treating with radiation therapy for intracranial germ cell tumor. Materials and Methods : From 1993 to 1998, 19 patients with intracranial germ cell tumors treated by gamma knife radiosurgery were analyzed. The location of tumor was as follows; 9 cases on pineal region, 1 case on suprasellar region, and 9 cases of multiple lesion. 7 patients were pathologically verified; 5 cases of germ cell tumor and 2 cases of non germinomatous germ cell tumor. Tumor volume was ranged from 2.4 cm$^{3}$ to 74 cm$^{3}$. Irradiation dose was 10 Gy to 20 Gy with 50% isodose curve. Follow up period was 10 months to 54 months. Results : Recurrences were observed in 14 cases among 19 (74%) patients. Complete remission and partial remission were achieved in 2 (11%) and 10 (53%) respectively. No response was observed in 7 (36%). 2 cases were recurred within original tumor bed. 6 cases were recurred beyond but contiguous with tumor bed. Ventricular relapses separated from pretreatment tumor bed were 3. Spinal recurrences were 4. Among 8 recurred cases of which tumor volume is smaller than 20 cm$^{3}$, 2 were recurred within original tumor bed, 4 were recurred beyond but contiguous with tumor bed, and 1 spinal recurrence. Meanwhile, 6 cases of which tumor volume larger than 20 cm3, 1 case was recurred beyond but contiguous with tumorbed, 2 ventricular recurrences separated with original tumor bed, and 3 spinal recurrences. 5 cases which did not show any recurrence sign showed characteristics of single lesion, tumor volume smaller than 20 cm$^{3}$ and normal tumor marker. All of 4 cases of spinal recurrences happened in the case having ventricular invasion or lesion. Among 9 cases having multiple lesion, only 3 cases recurred within original tumor bed or around tumor bed, the other 6 cases recurred separated from pretreatment tumor bed. Conclusion : Gamma knife radiosurgery is not recommended for the treatment of intracranial germ cell tumor. It is because of small treatment volume and inadequate radiation dose that are characteristics of gamma knife radiosurgery. Tumor volume, ventricular invasion or ventricular lesion in multiple lesion are important factors to be considered for the wide field radiation therapy Tumor volume smaller than 20 cm$^{3}$, single lesion, no ventricular lesion or invasion, and normal tumor marker are ideal indications for small involved field radiation therapy. Prophylactic spinal irradiation seems to be necessary when there is ventricular lesion, ventricular invasion, and multiple lesions. When the tumor volume is larger than 20 cm$^{3}$, multiple lesions, abnormal tumor marker, and whole ventricular irradiation or partial brain irradiation would be possible and neoadjuvant chemotherapy would be most beneficial in these group.

• Journal of Korean Neurosurgical Society
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• v.30 no.5
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• pp.652-656
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• 2001

Uveal melanoma is uncommon but life-threatening intraocular malignancy and has been treated by irradiation, local excision and enucleation. Gamma-Knife radiosurgery allows a high dose of radiation to be delivered to an intracranial target with a very high spatial accuracy and has been used for the treatment of ocular melanomas. We have treated two cases of uveal melanoma between October 1994 and December 1999. They include one man and one woman(34, 62 years, respectively). They were followed up for 12 momths. Mean maximal dose was 65Gy. In one case, the tumor disappeared 7 months after gamma-knife radiosurgery. In another case, multiple tumors (uveal, suprasellar and cerebellar tumor) had decreased in size. These results show that single and high dose gamma-knife radiosurgery is may be an option in the local control of uveal melanoma which can spare the eyeball and vision.

• Journal of Korean Neurosurgical Society
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• v.30 no.7
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• pp.934-938
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• 2001

Oligodendrogiomas account for about 4 per cent of intracranial gliomas and surgery is known to be an essential first step to establish an accurate diagnosis and when oligodendrogliomas recur with or without anaplastic features after initial resection, radiation and chemotherapy consisting of the administration of procarbazine, lomustine, and vincristine are usually indicated. We report our experience of an excellent result with intraventricular methotrexate chemotherapy for a patient with disseminated anaplastic oligodendroglioma. A 29-year-old male patient presented with diplopia and headache for two months. MRI showed a irregular, faintly enhanced mass in the posterior fossa. The hisotological diagnosis was an anaplaplastic oligodendroglioma and he was treated with chemotherapy of PCV regimen and radiotherapy followed by surgery. CSF dissemination was revealed by a follow-up MRI during the period. Intraventricular methotrexate(0.175mg/kg) was given twice a week for 4 weeks through ommaya reservoir and the size of the multiple tumors was decreased significantly on follow-up MRI. This case report suggests that an aggressive treatment involving intravent-ricular chemotherapy may be helpful even when anaplastic oligodendrogliomas disseminates to leptomeninges.