Neuro-oncology - DocNeuro

Case: PRES or mets?

Naoum P. Issa MD PhD — Sun, 06 Jul 2014 18:46:53 +0000

Case history: 55 year old female with history of lung adenocarcinoma presents with difficulty seeing. She was treated with carboplatin and paclitaxil two months prior to admission. CT head showed hypodensities in bilateral posterior white matter, as shown below. What is your diagnosis? Initial interpretation based on posterior hypodensity was like PRES (Posterior Reversible […]

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Clinical Findings of Neurofibromatosis-1

Jeffrey Waggoner MD — Fri, 15 Mar 2013 20:33:10 +0000

Neurofibromatosis is a condition that can involve almost any organ system. It can be divided into two major subtypes, neurofibromatosis 1 (NF-1, traditionally known as Von Recklinghausen Disease) and neurofibromatosis 2 (NF-2). A third variant is known as segmental NF, disease limited to a single body region; this condition is an autosomal dominant condition. This article […]

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Radiation Necrosis

Christopher Buckle MD — Thu, 21 Feb 2013 18:57:06 +0000

Radiotherapy is commonly used as an adjuvant therapy to surgery and chemotherapy in the management of primary brain neoplasms. Radiation destroys cells and damages the tumor blood supply. Addition of radiation therapy to surgery has been shown to improve GBM survival from 3-7 to 7-12 months. Diagnosis: Radiation necrosis Figure 1: axial (a) and sagittal […]

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Residual/Recurrent Tumor

Christopher Buckle MD — Thu, 21 Feb 2013 18:46:14 +0000

Imaging plays an important role in the diagnosis and management of patients with primary brain neoplasms. In particular, imaging is typically performed within 48 hours of tumor resection. Diagnosis: Residual GBM after surgery Figure 1: (a, red arrrow) Pre and immediate post operative (b, blue arrow) MRI imaging of a GBM demonstrates decreased but persistent […]

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Tectal Plate Glioma

Christopher Buckle MD — Thu, 21 Feb 2013 18:40:31 +0000

Masses of the pineal region can be divided into pineal and non pineal. Non pineal masses can arise from any of the structures in the region and include glioma (from the tectum or corpus callosum), meningioma (from the dura), epidermoid and arachnoid cysts (from the CSF) and lipoma (from the interhemispheric fissure). Other processes, like […]

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Pineoblastoma

Christopher Buckle MD — Thu, 21 Feb 2013 18:34:26 +0000

Tumors of the pineal gland can be categorized into pineal cell and germ cell depending of their cell type of origin. Unlike germ cell tumors, pineal cell tumors tend to expand the pineal gland with calcifications seen along the periphery of the gland. Unlike non-pineal masses, these primary pineal tumors are much more likely to […]

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Parotid Lymphoma

Christopher Buckle MD — Thu, 21 Feb 2013 18:29:53 +0000

Parotid masses are often seen incidentally on CT scans of the brain and neck. The most common primary parotid mass is the benign mixed tumor (also known as a pleomorphic adenoma). These masses are hyperintense on T2 and well circumscribed. Diagnosis: Parotid lymphoma Figure 1: (a, red arrow) axial neck CT with contrast demonstrates small […]

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Paraganglioma

Christopher Buckle MD — Thu, 21 Feb 2013 18:26:49 +0000

Paragangliomas are rare neuroendocrine tumors that originate In the glomus cells of the sympathetic nervous system. The most common location is the carotid space, either involving the carotid body (glomus cells involved in homeostasis sensitive to the partial pressure of oxygen in the blood) or the vagus nerve. Diagnosis: Paraganglioma (glomus vagale) Figure 1: (a,red […]

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Orbital Lymphoma

Christopher Buckle MD — Thu, 21 Feb 2013 18:23:34 +0000

The differential diagnosis for an orbital mass is extensive and includes both benign (cavernous hemangioma, sarcoid, varix, meningioma and pseudotumor) and malignant (orbital lymphoma, metastasis, glioma) lesions. Diagnosis: Orbital lymphoma Figure 1: (a,red arrow) post contrast head CT demonstrates a smoothly marginated homogenously hyperdense extraconal mass, inseparable from the adjacent lateral rectus muscle. (b,blue arrow) […]

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Neurofibromatosis

Christopher Buckle MD — Sat, 16 Feb 2013 22:56:24 +0000

Also known as Von Recklinghausen’s disease, neurofibromatosis (NF) is an inherited neurocutaneous syndrome with systemic manifestations, the most notable of which is the occurrence of multiple neurofibromas. Diagnosis: Neurofibromatosis Figure 1: (a, red arrow) axial T1, (b, blue arrow) T1 post contrast and (c, green arrow) T2 with fat suppression demonstrate multiple T2 hyperintense, homogenously […]

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