Purpose of Study: To assess adequacy of relative cerebral blood volume (rCBV) and permeability index in differentiating radiation necrosis and tumour necrosis.
Materials and Methods: In this study we analyzed relative cerebral blood volume rCBV and permeability index from the enhancing areas to the contralateral white matter in 10 post treatment malignant brain lesions. The lesions were compatible with features of MR-morphological tumor progression. The diagnosis (real progression vs. radiation necrosis) was determined by histopathology or by clinical/MRI-follow-up.
Results: There were significant differences between tumor progression (N = 5) and radiation necrosis (N = 4) and mixed (N=1). An increased rCBV and permeability index are highly predictive of tumour progression.
Conclusion: Initial results of CBV and permeability map in differentiating tumor necrosis and tumor growth were highly promising.
A 24 year old female complained of recurrent headache, facial fullness and purulent discharge in her mouth. Intra oral examination showed an absence of the right upper third molar with no history of previous extraction. The diagnosis was made radiographically with plain sinus X-rays, which revealed, right maxillary third molar inside the maxillary sinus indicating ectopic eruption. Caldwell-luc operation was done and the wisdom tooth was removed with a diseased mucosa. In conclusion; in cases of persistent symptoms of chronic sinusitis with absence of upper third molar, ectopic eruption should not be overlooked.
Aim: Spiradenoma is a rare tumor. Spontaneous pain and tenderness on palpation is a frequent symptom of the disease. Although the cause of pain in spiradenoma is not clarified yet, thickened nerve fibers in the capsule of tumor have been suggested to be related to the pain symptoms.
Case: We here report a woman with painful nodules on her abdomen for two months. The histopathological examination confirmed the diagnosis of spiradenoma. Immunohistochemically the tumor nodule and capsule were both S-100 positive, whereas the neuron specific enolase stained only the capsule of the tumor.
Discussion: Although further studies are required to explain the exact mechanism of pain in these tumors, by reporting this case, we provide additional evidence for the existence of thickened nerve fibers in the capsule of spiradenoma.
Aim: To enlighten and update the clinicians about the diagnosis and management of foreign body entrapment in root canal of a tooth.
Case Presentation: The current case is of a single, uncommon case of a stapler pin in the root canal of maxillary central incisor. Ellis class III fracture was noticed without any sinus tract opening or swelling. Endodontic retrieval and management with subsequent one year follow up.
Discussion: Habitual oral insertion of foreign objects by children and their accidental entrapment into the teeth are frequently reported. Sometimes these may get diagnosed accidentally. The particles retrieved, ranged from staples, pencil leads, needles, screws, beads and pins. Several complications have been reported like actinomycosis and sinusitis due to foreign bodies acting as foci of infection and that have not been removed in time.
Conclusion: Foreign objects are possible source of infections and must be removed immediately once noticed.
Primary central nervous system lymphoma (PCNSL) constitutes a rare group of extra nodal Non -Hodgkin’s lymphoma (NHL). Immunodeficiency is the main risk factor phenotype and involvement of the cranial vault is an unusual manifestation of aggressive PCNSL.
We report a case of Primary central nervous system anaplastic lymphoma in an immunocompetent patient.
A 25 year-old man with a history of left hemiplegia, headache, raised intracranial pressure and 8 cm sized cerebral tumor was admitted in Neurosurgery Department of Sahloul Hospital in Sousse, Tunisia in July 2003.
Magnetic resonance imaging (MRI) showed of 3 cm parasagital right heterogeneous cerebral tumor with perilesionnel edema. Biopsy concluded to the diagnosis of meningioma, a resection of the tumor mass was done. Ten months later an occipital cerebral tumor appeared, the biopsy concluded to the diagnosis of large cell anaplastic lymphoma ALK+, CD30+. The patient underwent 4 cycles of chemotherapy ACVBP regimen followed by 2 cycles of high dose Methotrexate and 4 cycles of Etoposide- Ifosfamide and consolidation therapy with whole brain radiotherapy with great tolerability, the patient remain in complete remission without late neurological toxicity within a follow-up of 8 years.
This case illustrate the difficulty of pathological diagnosis of PCNSL and the possibility of complete remission with combination of chemotherapy regimens with drugs passing the blood brain barrier and radiotherapy have given the best reported results up to now.
