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Hu TH, Wang R, Wang HY, Song YF, Yu JH, Wang ZX, Duan YZ, Liu T, Han S. Coexistence of meningioma and other intracranial benign tumors in non-neurofibromatosis type 2 patients: A case report and review of literature. World J Clin Cases 2022; 10:4249-4263. [PMID: 35665119 PMCID: PMC9131210 DOI: 10.12998/wjcc.v10.i13.4249] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2021] [Revised: 10/29/2021] [Accepted: 03/16/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND The coexistence of meningioma and other intracranial primary benign tumors is rare, especially in non-neurofibromatosis type 2, and there is limited guidance for the management of such patients. Here, we report a series of 5 patients with concomitant meningioma and other intracranial benign tumors, including subependymoma and pituitary adenoma.
CASE SUMMARY Five non-neurofibromatosis type 2 patients with simultaneous occurrence of meningioma and other intracranial benign tumors were retrospectively reviewed. The patients had no history of previous irradiation. The clinical features, pre- and postoperative imaging, surgical procedure and pathological findings were extracted from electronic medical records. There were 4 female patients (80%) and 1 male patient (20%). The mean age was 42.8 years (range: 29-52 years). The coexisting tumors included subependymoma in 1 case (20%) and pituitary adenoma in 4 cases (80%). The most common clinical symptom was headache (3/5, 60%). Four patients (80%) underwent craniotomy. One patient (20%) underwent transsphenoidal surgery followed by transcranial operation. All tumor diagnoses were confirmed by histopathological examination. The mean follow-up was 38.8 mo (range: 23-96 mo), and all 5 patients were in a stable condition at the last follow-up.
CONCLUSION The simultaneous occurrence of meningioma and other intracranial benign tumors is a rare clinical event. Histological examination is necessary for the accurate diagnosis. Neurosurgeons should select the appropriate surgical strategy according to the clinical features of each patient, which may provide a more favorable prognosis for individual patients.
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Affiliation(s)
- Tian-Hao Hu
- Department of Neurosurgery, The First Hospital of China Medical University, Shenyang 110001, Liaoning Province, China
| | - Run Wang
- Department of Neurosurgery, The First Hospital of China Medical University, Shenyang 110001, Liaoning Province, China
| | - Hai-Yun Wang
- Department of Neurosurgery, The First Hospital of China Medical University, Shenyang 110001, Liaoning Province, China
| | - Yi-Fu Song
- Department of Neurosurgery, The First Hospital of China Medical University, Shenyang 110001, Liaoning Province, China
| | - Juan-Han Yu
- Department of Pathology, China Medical University, Shenyang 110001, Liaoning Province, China
| | - Zi-Xun Wang
- Department of Neurosurgery, The First Hospital of China Medical University, Shenyang 110001, Liaoning Province, China
| | - Yu-Zhou Duan
- Department of Neurosurgery, The First Hospital of China Medical University, Shenyang 110001, Liaoning Province, China
| | - Ting Liu
- Department of Radiology, The First Hospital of China Medical University, Shenyang 110001, Liaoning Province, China
| | - Sheng Han
- Department of Neurosurgery, The First Hospital of China Medical University, Shenyang 110001, Liaoning Province, China
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Endoscopic endonasal resection of coexisting pituitary adenoma and meningioma: Two cases' report and literature review. Neurochirurgie 2021; 67:611-617. [PMID: 33652068 DOI: 10.1016/j.neuchi.2021.02.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 12/24/2020] [Accepted: 02/06/2021] [Indexed: 11/22/2022]
Abstract
INTRODUCTION The coexistence of pituitary adenoma (PA) and para/suprasellar meningioma is an extremely rare event, which generally occurs in previous case reports. Literature on the endonasal endoscopic approach (EEA) to treat such synchronous tumours remains sparse. CASE DESCRIPTION Two cases of concomitant sellar and supra/parasellar tumours are reported. A 62-year-old woman with a PA and a tuberculum sellae meningioma and a 56-year-old woman with a PA and a cavernous sinus (CS) meningioma. Both coexisting tumours were resected through a single extended EEA and achieved a good prognosis. To the best of our knowledge, endoscopic endonasal resection of coexisting PA and CS meningioma has not been previously reported in the literature. CONCLUSION Our reports add to the literature two cases of coexisting PA and meningioma, with different consistence in sellar and para/suprasellar regions. Furthermore, the present case adds to the evidence that in the rare situation of coexisting sellar and suprasellar tumours located in the same sagittal plane, an extended EEA allows adequate exposure and safe removal of both tumours. However, for tumours coexisting in the sellar and parasellar region in the same coronal plane, we should draw attention to this rare situation for differential diagnosis of synchronous PA and CS meningioma to avoid unnecessary surgery and to decide the best strategy for treatment.
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de Vries F, Lobatto DJ, Zamanipoor Najafabadi AH, Kleijwegt MC, Verstegen MJT, Schutte PJ, Biermasz NR, van Furth WR. Unexpected concomitant pituitary adenoma and suprasellar meningioma: a case report and review of the literature. Br J Neurosurg 2019:1-5. [DOI: 10.1080/02688697.2018.1556782] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Affiliation(s)
- Friso de Vries
- Department of Internal Medicine, Division of Endocrinology, Leiden University Medical Center, Leiden, the Netherlands
| | - Daniel J. Lobatto
- Department of Neurosurgery, Leiden University Medical Center, Leiden, the Netherlands
| | | | - Maarten C. Kleijwegt
- Department of Otolaryngology, Leiden University Medical Center, Leiden, the Netherlands
| | - Marco J. T. Verstegen
- Department of Neurosurgery, Leiden University Medical Center, Leiden, the Netherlands
| | - Pieter J. Schutte
- Department of Neurosurgery, Leiden University Medical Center, Leiden, the Netherlands
| | - Nienke R. Biermasz
- Department of Internal Medicine, Division of Endocrinology, Leiden University Medical Center, Leiden, the Netherlands
| | - Wouter R. van Furth
- Department of Neurosurgery, Leiden University Medical Center, Leiden, the Netherlands
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4
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Amirjamshidi A, Mortazavi SA, Shirani M, Saeedinia S, Hanif H. 'Coexisting pituitary adenoma and suprasellar meningioma-a coincidence or causation effect: report of two cases and review of the literature'. J Surg Case Rep 2017; 2017:rjx039. [PMID: 28560021 PMCID: PMC5441250 DOI: 10.1093/jscr/rjx039] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2016] [Accepted: 05/09/2017] [Indexed: 01/13/2023] Open
Abstract
Coexistence of pituitary adenoma (PA) and another type of brain tumor is a very rare clinical scenario. Even though such a presentation can be an incidental event but a thorough review of the literature will be made to elucidate the possible mechanisms and treatment options in similar cases. Two cases of concomitant sellar and suprasellar/diaphragmatic tumors are reported. A 37-year-old lady with prolactinoma and a suprasellar diaphragmatic meningioma and a 42-year-old acromegalic man with suprasellar/diaphragmatic meningioma and a PA. Both meningiomas were removed transcranially. The prolactinoma could be managed medically and the growth hormone secreting adenoma was removed trans-sphenoidally. The visual problems and hormonal imbalances of both patients improved postoperatively. The literature is reviewed on this topic and the possible pathogenesis and management protocol of similar lesions are discussed.
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Affiliation(s)
- Abbas Amirjamshidi
- Department of Neurosurgery, Sina Hospital, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | | | - Mohamad Shirani
- Department of Neurosurgery, Sina Hospital, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Saeed Saeedinia
- Department of Neurosurgery, Sina Hospital, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Hamed Hanif
- Department of Neurosurgery, Sina Hospital, Tehran University of Medical Sciences (TUMS), Tehran, Iran
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Karekezi C, El Fatemi N, Egu K, Ibrahimi M, El Maaqili MR, El Abbadi N. Unusual coexistence of an epidermoid cyst with an atypical meningioma: Case report and review of the literature. Surg Neurol Int 2016; 7:24. [PMID: 27069741 PMCID: PMC4802990 DOI: 10.4103/2152-7806.178135] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2015] [Accepted: 01/06/2016] [Indexed: 01/19/2023] Open
Abstract
Background: Coexistence of multiple primary intracranial tumors of different cell types has rarely been documented; the association of a meningioma and a glioma has been reported as the most common combination. Hereby, we report an unusual case of a temporal epidermoid cyst coexisting with an atypical meningioma. Case Presentation: A 37-year-old male presented with progressive symptoms of raised intracranial progression with progressive loss of vision without any neurological deficit. On admission, magnetic resonance imaging (MRI) revealed a right frontal lesion appearing hypointense T1, hyperintense T2 slightly enhanced after gadolinium and a second right temporal, isointense T1, hyperintense T2 non-enhancing lesion. A right frontotemporal craniotomy was performed that revealed two distinct lesions: The whitish temporal lesion with the pearl appearance reminding of an epidermoid cyst, the second lesion was extraaxial fibrous lesion arising from the falx. Pathology confirmed an atypical meningioma WHO Grade II and an epidermoid cyst. Conclusion: The simultaneous occurrence of primary intracranial tumors of different cell types is rare. Epidermoid cysts are slow growing lesions believed to arise from inclusion of ectodermal elements during neural tube closure, while meningiomas arise from arachnoidal cells; their association has rarely been reported previously.
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Affiliation(s)
- Claire Karekezi
- Department of Neurosurgery, Mohamed Vth University, School of Medicine, Hospital Ibn Sina, CHU Ibn Sina, Rabat 10100, Morocco
| | - Nizare El Fatemi
- Department of Neurosurgery, Mohamed Vth University, School of Medicine, Hospital Ibn Sina, CHU Ibn Sina, Rabat 10100, Morocco
| | - Komi Egu
- Department of Neurosurgery, Mohamed Vth University, School of Medicine, Hospital Ibn Sina, CHU Ibn Sina, Rabat 10100, Morocco
| | - Mohamed Ibrahimi
- Department of Neurosurgery, Mohamed Vth University, School of Medicine, Hospital Ibn Sina, CHU Ibn Sina, Rabat 10100, Morocco
| | - Moulay Rachid El Maaqili
- Department of Neurosurgery, Mohamed Vth University, School of Medicine, Hospital Ibn Sina, CHU Ibn Sina, Rabat 10100, Morocco
| | - Najia El Abbadi
- Department of Neurosurgery, Mohamed Vth University, School of Medicine, Hospital Ibn Sina, CHU Ibn Sina, Rabat 10100, Morocco
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Prevedello DM, Thomas A, Gardner P, Snyderman CH, Carrau RL, Kassam AB. Endoscopic endonasal resection of a synchronous pituitary adenoma and a tuberculum sellae meningioma: technical case report. Neurosurgery 2007; 60:E401; discussion E401. [PMID: 17415151 DOI: 10.1227/01.neu.0000255359.94571.91] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVE The presence of a sellar macroadenoma with a concomitant tuberculum sellae meningioma typically requires a craniotomy for extirpation of the meningioma. We describe a single endoscopic approach for resection of both lesions. PRESENTATION A 52-year-old woman with complaints of continuous headache and right temporal visual field loss was found to have a 1.9 x 2.1 x 1.7-cm enhancing sellar mass on magnetic resonance imaging scans associated with a second enhancing extra-axial lesion at the planum sphenoidale measuring 1.0 x 0.6 cm and encroaching on the right optic nerve. INTERVENTION After the endoscopic transnasal resection of the pituitary tumor, the planum sphenoidale was drilled and the underlying dura was incised. The suprasellar tumor was identified and completely resected. Histological evaluation confirmed the concomitant presence of a meningioma and pituitary adenoma. CONCLUSION With advances in endoscopic and image-guidance technology and increasing understanding of the endoscopic anatomy of the sellar region, surgeons are capable of reaching both intrasellar and suprasellar/anterior cranial base region tumors through a single endoscopic approach. The use of endoscopes in transsphenoidal approaches may obviate the need for additional craniotomies in properly selected patients.
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Affiliation(s)
- Daniel M Prevedello
- Department of Neurological Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
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7
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Growth Hormone-Secreting Pituitary Macroadenoma and Meningioma in a Woman—A Case Report and Review of the Literature. ACTA ACUST UNITED AC 2001. [DOI: 10.1097/00019616-200107000-00014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
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8
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Dario A, Scamoni C, Cerati M, Marra A, Dorizzi A. Associated Olfactory Groove Meningioma and Acoustic Neurinoma. TUMORI JOURNAL 1996; 82:405-7. [PMID: 8890981 DOI: 10.1177/030089169608200423] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
The authors describe the case of a 71-year-old man without signs of phacomatosis with a history of progressive psychomotory lowering and two simultaneous tumors of the olfactory groove and of the cerebellopontine angle, as demonstrated by CT scans. Histologic examinations showed the lesions to be a meningioma and a neurinoma. The rarity and the possible pathogenesis of this association are discussed.
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Affiliation(s)
- A Dario
- Neurosurgical Division, Varese Regional Hospital, Italy
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9
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Torun N, Sharpe JA, Nag S. Compressive optic neuropathy from pituitary adenoma and intracranial meningioma. Neuroophthalmology 1996. [DOI: 10.3109/01658109609009681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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10
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Cannavò S, Curtò L, Fazio R, Paterniti S, Blandino A, Marafioti T, Trimarchi F. Coexistence of growth hormone-secreting pituitary adenoma and intracranial meningioma: a case report and review of the literature. J Endocrinol Invest 1993; 16:703-8. [PMID: 8282967 DOI: 10.1007/bf03348915] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
The simultaneous occurrence of a pituitary adenoma and an intracranial meningioma is a rare event. We report the coexistence of an eosinophilic pituitary adenoma and a endotheliomatous meningioma, in the sellar region, and evaluate their endocrine, neuro-radiological and immunohistochemical pattern. A 47-year-old woman affected by acromegaly was referred to us. Serum GH level was 82 ng/ml and remained unresponsive to both OGTT (75 g per os) and iv. GHRH 1-29 (100 micrograms); IGF-1 was 807 ng/ml. Eight hours after acute sc administration of octreotide (100 micrograms) GH returned to normal levels (2.3 ng/ml). CT scan showed a large intra- and suprasellar mass involving the right cavernous sinus, with a retrosellar extension along the tentorium. A slight and inhomogeneous enhancement, with a periferal rim of bright signal was apparent at MRI. Conversely, the retrosellar component showed a bright homogeneous enhancement. The patient, therefore, underwent neurosurgery. Histological examination revealed the coexistence of 2 types of tissue: areas of endotheliomatous meningioma were interspersed among sheets of acidophilic adenoma tissue. Immunohistochemical analysis was performed in order to determine the relationship between the two masses: a positive staining for GH was shown in the areas of adenoma, as against for GHRH, neither in the adenomatous tissue nor in the slices of meningioma. Although MRI showed a latero-sellar post-surgical residual of meningioma, serum GH value was < 1 ng/ml. In conclusion, the relationship between the GH-secreting adenoma and the meningioma is unclear; however the GH-hypersecretion is not induced by a hypothetic GHRH-activity from the meningioma.
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Affiliation(s)
- S Cannavò
- Cattedra di Endocrinologia, Università di Messina, Italy
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11
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Affiliation(s)
- A Jones
- Department of Radiotherapy, St. Bartholomew's Hospital, London, UK
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12
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Spallone A, Santoro A, Palatinsky E, Giunta F. Intracranial meningiomas associated with glial tumours: a review based on 54 selected literature cases from the literature and 3 additional personal cases. Acta Neurochir (Wien) 1991; 110:133-9. [PMID: 1927605 DOI: 10.1007/bf01400681] [Citation(s) in RCA: 31] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
The simultaneous occurrence of meningioma and glioma is extremely rare. Three new cases and 54 adequately described in the literature are analyzed. Clinical diagnosis may be difficult due to discrepancy between clinical and radiological findings. Unexpected clinical deterioration following removal of a tumour and relapse simulating recurrence may occur. The introduction of CT technology does not seem to have offered the expected contribution to the early diagnosis of these coincidental lesions, at least before the introduction of the newer generation scanners or MRI. While removal of both tumours in one session yielded the best results, surgery for the sole glioma appeared to be associated with an unacceptably high mortality. Although several aetiopathogenetic hypotheses have been suggested for explaining this curious association, coincidental meningioma and glioma are most likely to be different primary brain tumours occurring randomly in the same individual.
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Affiliation(s)
- A Spallone
- Section of Neurosurgery, 2nd University of Rome Tor Vergata, Italy
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13
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Zentner J, Gilsbach J. Pituitary adenoma and meningioma in the same patient. Report of three cases. EUROPEAN ARCHIVES OF PSYCHIATRY AND NEUROLOGICAL SCIENCES 1989; 238:144-8. [PMID: 2721531 DOI: 10.1007/bf00451002] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Three patients are presented in whom both pituitary adenoma and meningioma were found. The pituitary tumour was a prolactinoma in one case and non-secreting adenoma in the other two. In one case the meningioma originated from the planum sphenoidale and was seperate from the pituitary adenoma. Another patient had a parasellar meningioma, which was suspected preoperatively by different enhancement on the CT scan. In the third case, both tumours were mainly infradiaphragmatic and could not be differentiated preoperatively or intraoperatively. This appears to be the first case with both tumours below the diaphragm. The clinical, radiological and histopathological findings are presented.
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Affiliation(s)
- J Zentner
- Department of Neurosurgery, Medical School, University of Freiburg, Federal Republic of Germany
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14
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Honegger J, Buchfelder M, Schrell U, Adams EF, Fahlbusch R. The coexistence of pituitary adenomas and meningiomas: three case reports and a review of the literature. Br J Neurosurg 1989; 3:59-69. [PMID: 2675917 DOI: 10.3109/02688698909001027] [Citation(s) in RCA: 29] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
A coexistence of pituitary adenomas and meningiomas is very rare. We have reported on three of our own cases and reviewed the 17 cases reported in the literature. One has to differenciate between the coexistence of a pituitary adenoma and a meningioma without previous irradiation, and the occurrence of a meningioma following the irradiation of a pituitary adenoma. In the cases without irradiation, the adenoma and the meningioma are diagnosed simultaneously. On the other hand meningiomas arising after irradiation of a pituitary tumour are usually diagnosed only after a long latent period. The coexistence of pituitary tumours and meningiomas resulting from hormone dependent growth as well as the induction of growth of meningiomas by irradiation are discussed.
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Affiliation(s)
- J Honegger
- Department of Neurosurgery, University of Erlangen-Nürnberg, Federal Republic of Germany
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15
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Mashiyama S, Mori T, Seki H, Suzuki J. Multiple brain tumours with von Recklinghausen's disease. Acta Neurochir (Wien) 1987; 84:29-35. [PMID: 3103377 DOI: 10.1007/bf01456347] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Over the past 10 years we have experienced 33 cases of von Recklinghausen's disease, among whom 5 were cases of multiple (3 or more) brain tumours. In the past we have extirpated multiple tumours in a one-stage operation, but the results were poor. Recently, we have done multi-stage operation in two cases thought to require surgical treatment and have obtained satisfactory results. We have discussed the autopsy results of our own case of multiple neurinomas and meningiomas and have reviewed the 44 reported cases of von Recklinghausen's disease in whom the presence of three or more brain tumours had been confirmed at surgery or autopsy.
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16
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Antunes ACM, Coutinho MF, Coutinho LMB. Meningeoma e glioblastoma concomitantes: registro de um caso. ARQUIVOS DE NEURO-PSIQUIATRIA 1978. [DOI: 10.1590/s0004-282x1978000300012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
É relatado um caso com associação de glioblastoma heteromorfo e de meningioma meningotelial, cuja manifestação inicial foi crise convulsiva focal. Por ser infrequente a associação de neoplasias intracranianas, discute-se a forma de expressão clínica, as teorias referentes à presença concomitante de tais associações tumorais e, ainda, o valor do diagnóstico pré-operatório no estabelecimento da conduta cirúrgica e do prognóstico em tais ocasiões.
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17
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Wilson PJ, Ashley DJ. Meningioma after contralateral hemispherectomy for malignant glioma: case report. J Neurol Neurosurg Psychiatry 1975; 38:493-9. [PMID: 1151416 PMCID: PMC492002 DOI: 10.1136/jnnp.38.5.493] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
A patient is described who successfully underwent cerebral hemispherectomy for malignant glioma and whose death nine months later, wrongly ascribed to recurrent malignancy, was in fact due to a subsequently-developing benign meningioma in the remaining hemisphere. The possible advantages of a modification of standard hemispherectomy technique are also discussed.
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18
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Nicola GC, Nizzoli V. Multiple intracranial tumours of diverse origin in the same patient. Report of a case. J Neurol Sci 1967; 4:595-9. [PMID: 6051759 DOI: 10.1016/0022-510x(67)90038-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
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