• Journal of Veterinary Clinics
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• v.30 no.3
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• pp.206-209
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• 2013

A 12-year-old castrated male Miniature Schnauzer dog was presented with an acute seizure. On computed tomography, a mass was observed in the left nasal cavity and the lysis of the left cribriform plate was identified. Post-contrast magnetic resonance imaging showed a hyperintense mass in the left frontal lobe and hyperintense lesions in the left frontal sinus. The mass was tentatively diagnosed with a brain tumor secondary to a nasal tumor. Histopathology revealed that the mass was a nasal adenocarcinoma with invasion into the brain. This case report describes clinical, computed tomography, magnetic resonance imaging and histopathological findings of secondary intracranial tumor caused by extension of nasal adenocarcinoma in a dog. These findings may contribute to enhance the knowledge on secondary intracranial tumors in dogs.

• Journal of Korean Neurosurgical Society
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• v.52 no.3
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• pp.246-249
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• 2012

Intracranial extraskeletal myxoid chondrosarcoma is extremely rare, with only seven patients previously reported. We present a case report of a 21-year-old woman admitted for weakness in her right extremities and symptoms of increased intracranial pressure. Magnetic resonance imaging (MRI) revealed hydrocephalus and a well-enhanced large mass around her left thalamus. A left parietal craniotomy and a cortisectomy at the superior parietal lobule were performed. Total surgical resection was also performed, and pathology results confirmed an extraskeletal myxoid chondrosarcoma. Postoperative MRI showed no residual tumor, and the patient underwent radiotherapy. After six months of radiotherapy, the patient's headache and weakness had improved to grade IV. This malignant tumor showed high rates of recurrence in previous reports. We here report another occurrence of this highly malignant and rare tumor in a patient treated using total surgical excision and adjuvant radiotherapy.

• 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.

• Journal of Korean Neurosurgical Society
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• v.29 no.10
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• pp.1383-1388
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• 2000

We report a case of 54 years old male with malignant meningioma originating in the posterior fossa with multiple recurrences, intracranial and extracranial metastases. In spite of gross total removal of tumor and conventional external radiation therapy(CERT), 2 more recurrences, 5 more intracranial metastases and 1 extracranial metastasis to the rib were developed. We tried fractionated stereotactic radiation therapy(FSRT) and CERT to the intracranial metastasis with satisfactory result. Extracranial metastasis to the rib was resected and histological finding was similar to that of original tumor.

• Korean Journal of Head & Neck Oncology
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• v.15 no.1
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• pp.85-88
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• 1999

Neurinoma originates from any nerve covered with a Schwann cell sheath and can occur in any cranial, sympathetic, or peripheral nerve. Hypoglossal neurinomas are rare and most of them are intracranial, but they may extend extracranially. Most intracranial neurinoma arise from the sensory division of cranial nerve but a motor nerve such as hypoglossal nerve is rarely involved. Although the typical sign of hypoglossal neurinoma is ipsilateral hemiatrophy of the tongue, it is easily overlooked. For the diagnosis of hypoglossal nerve tumor, CT scanning with contrast enhancement and MRI should be included, and they are greatly aids in planning the radical removal of the tumor. We experienced a case of intracranial hypoglossal neurinoma with extracranial extension in a 43-year-old woman. The patient showed otherwise unremarkable except 4 months history of right infraauricular mass and right tongue hemiatrophy. Computed tomography and magnetic resonance imaging for local diagnosis was valuable and we could remove the mass by one stage operation via suboccipital transcervical approach.

• Journal of Korean Neurosurgical Society
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• v.60 no.1
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• pp.98-101
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• 2017

We report a case of primary intracranial malignant melanoma (PIMM) with extracranial metastases. The patient was an 82-year-old woman diagnosed with PIMM under the left cerebellar tentorium. We performed a tumor resection followed by gamma knife surgery. An magnetic resonance imaging at 11 months after surgery showed a local intracranial recurrence. At 12 months, vertebral metastasis was suspected, and 2-[fluorine-18]-fluoro-2-deoxy-D-glucose positron emission tomography/computed tomography (FDG-PET/CT) showed multiple extracranial metastases. She died at 13 months after surgery. Although extracranial metastases of PIMM are extremely rare, we should carefully follow up extracranial metastases together with intracranial ones, especially by FDG-PET/CT, even at an early asymptomatic stage.

• Journal of Korean Neurosurgical Society
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• v.57 no.5
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• pp.315-322
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• 2015

Intracranial germ cell tumors (ICGCT) occur in 2-11% of children with brain tumors between 0-19 years of age. For treatment of germinoma, relatively low radiation doses with or without chemotherapy show excellent 10 year survival rate of 80-100%. Past studies showed that neoadjuvant chemotherapy combined with focal radiotherapy resulted in unacceptably high rates of periventricular tumor recurrence. The use of generous radiation volume which covers the whole ventricular space with later boost treatment to primary site is considered as standard treatment of intracranial germinomas. For non-germinomatous germ cell tumors (NGGCT), 10-year overall survival rate is still much inferior than that of intracranial germinoma despite intensive chemotherapy and high-dose radiotherapy. Craniospinal radiotherapy combined with cisplatin-based chemotherapy provides the best treatment outcome for NGGCT; 60-70% of overall survival rate. There is a debate on the surgical role whether surgery can contribute to improved treatment outcome of NGGCT when added to combined chemoradiotherapy. Because higher dose of radiotherapy is required for treatment of NGGCT than for germinoma, it is tested whether whole ventricular irradiation can replace craniospinal irradiation in intermediate risk group of NGGCT to minimize radiation-related late toxicity in the recent studies. To minimize the treatment-related neural deficit and late sequelae while maintaining long-term survival rate of ICGCT patients, optimized administration of chemotherapy and radiotherapy should be selected. Use of technically upgraded radiotherapy modalities such as intensity-modulated radiotherapy or proton beam therapy is expected to bring an improved neurocognitive outcome with longitudinal assessment of the patients.

• Radiation Oncology Journal
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• v.35 no.2
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• pp.153-162
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• 2017

Purpose: To evaluate intracranial control after surgical resection according to the adjuvant treatment received in order to assess the optimal radiotherapy (RT) dose and volume. Materials and Methods: Between 2003 and 2015, a total of 53 patients with brain oligometastases from non-small cell lung cancer (NSCLC) underwent metastasectomy. The patients were divided into three groups according to the adjuvant treatment received: whole brain radiotherapy (WBRT) ${\pm}$ boost (WBRT ${\pm}$ boost group, n = 26), local RT/Gamma Knife surgery (local RT group, n = 14), and the observation group (n = 13). The most commonly used dose schedule was WBRT (25 Gy in 10 fractions, equivalent dose in 2 Gy fractions [EQD2] 26.04 Gy) with tumor bed boost (15 Gy in 5 fractions, EQD2 16.25 Gy). Results: The WBRT ${\pm}$ boost group showed the lowest 1-year intracranial recurrence rate of 30.4%, followed by the local RT and observation groups, at 66.7%, and 76.9%, respectively (p = 0.006). In the WBRT ${\pm}$ boost group, there was no significant increase in the 1-year new site recurrence rate of patients receiving a lower dose of WBRT (EQD2) <27 Gy compared to that in patients receiving a higher WBRT dose (p = 0.553). The 1-year initial tumor site recurrence rate was lower in patients receiving tumor bed dose (EQD2) of ${\geq}42.3Gy$ compared to those receiving <42.3 Gy, although the difference was not significant (p = 0.347). Conclusions: Adding WBRT after resection of brain oligometastases from NSCLC seems to enhance intracranial control. Furthermore, combining lower-dose WBRT with a tumor bed boost may be an attractive option.

• Journal of Korean Neurosurgical Society
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• v.30 no.sup2
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• pp.228-234
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• 2001

Objective : The goal of this study was to identify variables that were predictive of recurrence in primary intracranial ependymomas. Methods : We analyzed variables affecting recurrence in 30 patients with primary intracranial ependymomas. Age, location, CSF cytology, seeding on neuroimaging study, tumor grade, extent of surgery, use of chemotherapy, chemotherapy regimen, use of radiotherapy, and radiotherapy field were entered to test their impacts on recurrence. Results : Follow-up ranged from 2 to 110 months. Tumors were recurred at the primary tumor site only in 13 patients (43.3%). The overall average recurrence free period was 55 months, with overall recurrence free rates at 3 and 6 years of 61.0% and 20.9%, respectively. Extent of surgery was the strongest variable affecting recurrence. The median recurrence free period and 3-year recurrence free rate were 72 months and 78.4% for patients having complete excision and 33 months and 0% for those having incomplete excision(p=0.05). Other prognostic variables like age, location, tumor grade, use of chemotherapy, and use of radiotherapy did not affect recurrence(p=0.2848, 0.7899, 0.1714, 0.2157, 0.7076, respectively). Conclusions : Intracranial ependymomas have a propensity to recur after treatment, and recurrence at the primary site is still the main obstacle to cure. Among various variables, only extent of resection had the strongest impact on recurrence. Additional studies may still be needed to precisely define the prognostic variables on recurrence in intracranial ependymomas.

• Journal of Korean Neurosurgical Society
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• v.29 no.9
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• pp.1243-1247
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• 2000

Primary malignant leptomeningeal melanoma is very rare, accounting for less than 0.1 percent of tumors in the central nervous system. Patients with primary intracranial malignant melanoma tend to be younger than metastatic intracranial melanoma, most commonly in the fourth decade of life. This tumor is extremely rare and the biologic behavior is aggressive especially in children. The authors report a case of primary malignant leptomeningeal melanoma in a twelve-year-old boy which was initially diagnosed as meningitis. On autopsy, associated extensive leptomeningeal melanosis was confirmed and believed to be the origin of the tumor. This case emphasizes the pattern of clinical presentation and the significance of leptomeningeal melanosis in primary leptomeningeal melanoma.