Endometriosis is a common disease, which affects 5-10% of women in fertile age 1 . It can affect multiple organs, such as ovaries, lungs, colon, nasal mucosa and brain 2 . Endometriosis of the sciatic nerve is a rare presentation 3 , manifesting as cyclic sciatica, parestesis and paresis with loss of deep tendon reflex. We cite a case of sciatica endometriosis and make a review of the literature. CASEA 26-year-old Caucasian woman exhibits intense pain and weakness in the lower left limb, which had progressed over the past nine years. She had no previous pregnancy and symptoms were worse during the menstrual period.During examination, a dorsiflexion paresis of the left foot was notable. Magnetic resonance imagining (MRI) revealed an expansive process in the left sciatic nerve topography at gluteal topography.The patient was referred for microsurgery, proceeding exeresis of a cystic lesion in the left sciatic nerve. Neuropathology analysis showed an endometrioma ( Figure). The patient had no complications during the post-operative period.During initial follow-up, dorsiflexion paresis in the left foot persisted. Post-operative MRI showed a cicatricial process, with no residual tumor. The eletroneuromiography (ENMG) displayed signs of a subacute denervatory process.
Spontaneous intra-aneurysmal thrombosis occurs in approximately 50% of giant intracranial aneurysms. The incidence of this process is associated to location, size, and origin, and the natural history of spontaneous thrombosis occurrence in non-giant aneurysms is rare and still unclear. We describe two non-giant middle cerebral artery (MCA) aneurysms that spontaneously thrombosed and comment the aspects of the literature.
ResumoO osteoblastoma é uma doença benigna geralmente tratada com ressecção completa com intenção curativa e é responsável por 14% dos tumores ósseos benignos. Uma apresentação mais incomum refere-se a uma rápida apresentação em massa conhecida como osteoblastoma agressivo. Relatamos o caso de um jovem com inchaço cervical devido a uma massa progressiva no lado direito do pescoço com 3 meses de evolução. A biópsia incisional demonstrou osteoblastoma grau 3. Tentou-se uma ressecção cirúrgica radical, mas a ressecção completa não foi viável por causa da invasão cervical de C3 sem envolvimento espinal. Apesar da falta de dados robustos, a radioterapia modulada de intensidade foi realizada na região cervical ipsilateral em uma dose de 50 Gy em 25 frações até novembro de 2013. O paciente está sendo seguido regularmente sem evidências de recorrência desde então. O tratamento até agora bem-sucedido destaca a importância de uma abordagem multidisciplinar para o tratamento de pacientes com osteoblastoma agressivo.
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