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내시경적 생검 및 제 3 뇌실 개창술과 감마나이프 방사선 수술로 치료된 시상부 교종
조원호 ( Won Ho Cho ),이상원 ( Sang Weon Lee ),이동훈 ( Dong Hoon Lee ),차승헌 ( Seung Heon Cha ),송근성 ( Geun Sung Song ),최창화 ( Chang Hwa Choi ) 대한뇌종양학회·대한신경종양학회·대한소아뇌종양학회 2005 대한뇌종양학회지 Vol.4 No.2
We present the case of a thalamic glioma with obstructive hydrocephalus. The patient was successfully treated with neuroendoscopic biopsy, third ventriculostomy and subsequent gamma knife radiosurgery. At 12 months the tumor has decreased in size and the patient has no neurologic deficits. Neuroendoscopic surgery combined with gamma knife radiosurgery may play an important role in the selected intracranial tumors with minimally invasive technique.
김영준 ( Young Zoon Kim ),유헌 ( Heon Yoo ) 대한뇌종양학회·대한신경종양학회·대한소아뇌종양학회 2009 대한뇌종양학회지 Vol.8 No.1
Epileptic seizures are common in patients with brain tumor, even if the tumor is under control. Miltiple factors affect the mechanism of seizure in brain tumors, including changes of morphology, pH, ion level, amino acid, and enzyme in peritumoral brain tissue, role of glutaminergic N-methyl-D-aspartate(NMDA) receptor, damage of peritumoral brain immunology, and change of intercellular communication. Additionally, traditional anti-epileptic drug(AED) can cover only a few mechanisms of epileptogensis in brain tumors. Tumor progression or recurrence may make seizures reappear during AED. Owing to combined treatment modality with chemotherapy or other drugs, insufficient levels of AEDs have been reported in the many patients with brain tumor. Therefore, comprehensive understand about pathophysiology of epileptogensis in the brain tumor and drug interactions between AEDs and other drugs, which are widely used in the field of neurooncology, can give an aids to manage brain tumor related epilepsy.
터어키안 주위 종양으로 오인된 침윤성 아스페르길루스 접형동염
김준학 ( Jun Hak Kim ),최경미 ( Gyeong Mi Choi ),안성기 ( Sung Ki Ahn ),송준호 ( Joon Ho Song ) 대한뇌종양학회·대한신경종양학회·대한소아뇌종양학회 2008 대한뇌종양학회지 Vol.7 No.2
Invasive Aspergillus sphenoidal sinusitis rarely occurs and it is a potentially life threatening disease. It can be divided into an acute fulminant form with rapid disease progression and a chronic non-fulminant form. We report a case of fulminant invasive Aspergillus sphenoidal sinusitis in a 69-year-old diabetic woman who presented with ptosis of left eye and headache. Neuroimaging studies showed osteolytic tumor-like lesion in the sphenoidal sinus. Mass removal was performed using endonasal transsphenoidal approach and surgical biopsy revealed fungal hyphae in the specimen. In spite of using massive antifungal agents, the patient died of brain invasion and septisemia.
Tamoxifen 복용중인 유방암환자에서 발생한 출혈성 뇌전이를 닮은 정맥 색전증
이승준 ( Seung Joon Lee ),허원 ( Won Huh ),김재용 ( Chae Yong Kim ) 대한뇌종양학회·대한신경종양학회·대한소아뇌종양학회 2008 대한뇌종양학회지 Vol.7 No.2
We report a rare clinical case of cortical vein thrombosis diagnosed in a patient with breast cancer treated with tamoxifen. A 70-year-old woman presented with sudden right hemiparesis and motor aphasia. She had been diagnosed with breast cancer four years earlier, and had undergone a modified radical mastectomy. She was taking tamoxifen as an adjuvant hormonal therapy, afterwards. Serial brain computed tomography(CT) revealed growing size of multiple hemorrhage in the left high frontoparietal area and contrast-enhanced brain magnetic resonance image(MRI) revealed a small enhanced lesion around the hematoma. We performed craniotomy and the removal of the lesion to allow a pathological diagnosis of possible brain metastasis and cerebral decompression. During surgery, a bluish area was observed in the left postcentral area and there was a thrombosed cortical vein in the center of this area, previously emptying into the superior sagittal sinus. The pathologic finding demonstrated that the surrounding brain tissue and the hematoma showed no evidence of cancer cells. We concluded that the occlusion of the cortical vein by a thrombosis caused the hemorrhagic infarction. Given the popular use of tamoxifen therapy in breast cancer patients, we should consider a possible cerebral venous thromboses mimicking brain metastasis, especially cortical vein thromboses, in patients presenting with rapid neurological deterioration.
kr뇌정위 생검 후 발생한 종양 파종의 진단과 치료에 있어서 11C-methionine PET의 유용성- 증례보고 -
이정헌 ( Jeong Heon Lee ),최기영 ( Ki Young Choi ),김인영 ( In Young Kim ),정신 ( Shin Jung ) 대한뇌종양학회·대한신경종양학회·대한소아뇌종양학회 2012 대한뇌종양학회지 Vol.11 No.2
This paper reports a useful application of 11C-methionine positron emission tomography (PET) in the detection of iatrogenic secondary tumor seeding in the biopsy track after a stereotactic biopsy in a metastatic brain tumor patient. Considering that gadolinium-enhanced magnetic resonance image (MRI) does not always offer definitive discrimination of tumoral enhancement with biopsy-related contrast enhancement, 11C-methionine PET may be a good diagnostic method for detection of iatrogenic secondary tumor seeding after stereotactic biopsy for a metastatic brain tumor, which usually needs prompt local treatment.
이철현 ( Chul Hyun Lee ),이현승 ( Hyun Seung Lee ),장은덕 ( Eon Duck Chang ),강석구 ( Seok Gu Kang ) 대한뇌종양학회·대한신경종양학회·대한소아뇌종양학회 2009 대한뇌종양학회지 Vol.8 No.2
The atypical choroid plexus papilloma(CPP)is a new category of choroid plexus tumor recently added in the 2007 WHO classification of tumors of the central nervous system. We report the case of a 64-year-old female patient with atypical CPP of fourth ventricle. The patient presented with a 2-month history of dizziness and gait disturbance. Imaging studies showed a large tumor in fourth ventricle. We did suboccipital craniotomy with tumor removal. Pathologic study revealed atypical CPP. Based on our knowledge, up to now, this patient is the first atypical CPP case of fourth ventricle in Korea.
이원석 ( Won Seok Lee ),곽호신 ( Ho Shin Gwak ),홍은경 ( Eun Kyeong Hong ),유헌 ( Heon Yoo ) 대한뇌종양학회·대한신경종양학회·대한소아뇌종양학회 2012 대한뇌종양학회지 Vol.11 No.2
We report a case of 39 year old man with stepwise malignant progression from benign to anaplastic meningioma with a transition of atypical meningioma. He received the 1st time craniotomy 5 years ago for parasagittal meningioma and the histopathological diagnosis was benign meningioma of WHO grade 1. Radiation was given to residual tumor at 54 Gy/27 fractions. Four years after the craniotomy, the tumor recurred. Second craniotomy was done and the biopsy was atypical meningioma of WHO grade 2. Residual tumor in the superior sagittal sinus regrew one year later and the third craniotomy was done with excision of involved superior sagittal sinus. The pathological diagnosis was still atypical meningioma, then. Three months after the 3rd craniotomy, the tumor recurred on both parasagittal area and remote cortical surface. The 4th craniotomy was done and the biopsy was turned out to be anaplastic meningioma of WHO grade 3. Adjuvant chemotherapy was given one month after, and the tumor showed mixed response of partial remission and new lesion. The 5th craniotomy was done for both residual tumor and bone flap infection and adjuvant chemotherapy was given again. Five months later, stereotactic radiosurgery was performed for residual enhancing lesion, which was in stable state. With this case, we’d like to discuss about possible genetic alterations associated with the malignant transformation of meningioma, and what can be effective therapy for such residual or recurrent meningiomas.
뇌하수체졸중 환자에서 나타난 안검하수를 동반한 고립된 제 3 뇌신경 마비 -증례보고-
이현구 ( Hyun Goo Lee ),노재섭 ( Jae Sub Noh ),임종국 ( Jong Kook Rhim ),정봉섭 ( Bong Sub Chung ) 대한뇌종양학회·대한신경종양학회·대한소아뇌종양학회 2011 대한뇌종양학회지 Vol.10 No.1
Pituitary apoplexy is an acute ischemic or hemorrhagic vascular accident of a pituitary adenoma. Clinical features of pituitary apoplexy include sudden onset of headache, nausea, vomiting, visual symptoms, ptosis, altered mental status, and endocrinologic dysfunction. However, isolated third cranial nerve palsy with ptosis as the presenting sign of pituitary apoplexy is very rare. We describe one case of pituitary apoplexy presenting as sudden-onset unilateral ptosis and diplopia. So we suggest that pituitary apoplexy should be included in the differential diagnosis of patients presenting with isolated third cranial nerve palsy with ptosis and recommend that early surgical decompression should be considered for preservation of third cranial nerve.
이수환 ( Su Whan Lee ),김해유 ( Hae Yu Kim ),이선일 ( Sun Il Lee ) 대한뇌종양학회·대한신경종양학회·대한소아뇌종양학회 2011 대한뇌종양학회지 Vol.10 No.1
Introduction:Multicentric glioblastoma is rare disease entity, which is frequently mimicking metastatic brain tumor. We experienced a case of multicentric glioblastoma which was diagnosed finally after multiple craniotomies for the multicentric intracranial lesions having been believed as metastatic brain tumor. We reported this rare case with literature reviews. Case Report:A 48-year-old man had underwent Novalis radiosurgery for multiple malignant tumors in other institute. He had no other malignant lesion in other part of body. He was followed up for 10 months and was taken brain magnetic resonance image (MRI) which showed progressed and newly developed intracranial lesions. He visited our institute with the images for Gamma Knife radiosurgery. During follow up after second radiosurgery, he developed neurological symptoms due to increasing intracranial lesions. We performed multiple craniotomies for large two lesions. He gradually recovered after surgery. Pathological report was glioblastoma. He underwent chemotherapy without radiotherapy due to previous radiosurgeries. Conclusion:This case`s intracranial lesions were considered as metastatic brain tumor undiagnosed primary tumor due to the multicentricity and formation of new lesions for several months. However this was not based on pathological diagnosis which should be necessary to decide precise treatment. This rare case might give us an education about the importance of consideration of invasive procedures for pathological diagnosis in the case of multiple intracranial lesions without evidence of extracranial lesions.
서영준 ( Young Jun Seo ),조원호 ( Won Ho Cho ),최병관 ( Byung Kwan Choi ),이상원 ( Sang Weon Lee ),송근성 ( Geun Sung Song ),최창화 ( Chang Hwa Choi ) 대한뇌종양학회·대한신경종양학회·대한소아뇌종양학회 2006 대한뇌종양학회지 Vol.5 No.1
Hemorrhage from meningioma is rarely reported. We report one patient with intratumoral hemorrhage with meningioma. A 43-year-old women presented with severe headache and right hemiparesis. Brain computed tomography and magnetic resonance images revealed a mass lesion with intratumoral hemorrhage in the left frontal lobe. Total removal of the tumor and hematoma could be achieved. The patient recovered uneventfully after the operation. Histologic findings are considered to be a atypical meningioma. The Ki-67 labelling index was high, which is considered proliferative property of meningioma. We review the relevant literature and discuss the possible mechanism of intratumoral hemorrhage in the meningioma.