Background:Paraganglioma of the filum terminale is an uncommon tumor of cauda equina region. Lumbar radiculopathies are revelations that can get complicated from cauda equina syndrome. Magnetic resonance imaging (MRI) allows the diagnosis without distinguishing it from a neurofibroma. Only histopathological study can bring certainty in the diagnosis. The treatment of choice is a complete removal.Case Description:We report a case of paraganglioma of the filum terminale in a 74-year-old female patient, admitted for cauda equina syndrome, which has been progressing for 2 years. MRI of medulla objectified an extramedullary lesion at L3–L4, diagnosed as neurinoma. A complete resection of the tumor was performed with a section of the filum terminale, which she was taking since birth. Histology confirmed the diagnosis of paraganglioma. The clinical course was characterized by a complete recovery of the deficit.Conclusion:Through this case report, the authors discuss clinical and radiological aspects of this tumor, as well as the management in the light of published data.
Glioblastoma is the most frequent and most aggressive primary brain tumor. Primary and secondary glioblastomas develop through different genetic pathways. The aim of this study was to determinate the genetic and clinical features of primary glioblastoma in Moroccan patients. The blood and tumor samples were obtained from a group of 34 Moroccan patients affected with primary glioblastoma. The tumors were investigated for TP53, IDH1, and IDH2 mutations using PCR sequencing analysis. Clinicopathological data showed that the mean age at diagnosis of patients was 50.06 years, the sex ratio was 11 F/23 M, and the median of Karnofsky performance score was 60. About 18 % of patients were initially treated by total tumor resection, 41 % by subtotal, and 38 % by partial resection, but biopsy was performed for a single patient (3 %). Twenty-five patients (74 %) received radiotherapy. In addition, the median survival of the all patients was 13 months following diagnosis. There was a significant impact of higher Karnofsky performance score (KPS) (≥80) on overall survival, p-log-rank test = 0.0002, whereas other parameters did not show any significant differences. The molecular analysis revealed TP53 mutations in 3/34 (8.82 %) cases; R273H, R306X, and Q136X. However, none of the analyzed samples contained the R132-IDH1 or R172-IDH2 mutations. These results showed the absence of IDH1 mutation in primary glioblastoma, confirming that this mutation is a hallmark of secondary glioblastoma. It can be used to distinguish primary from secondary glioblastomas. We found also that higher KPS was a significantly favorable factor in patients with primary glioblastoma.
Brain echinococcosis is the most common brain parasitic infection in the world. It happens in a very rare location, representing 1% to 2% all cases with hydatid disease. It is more common by approximately 50-70% in pediatric population and young adultswith a male predominance. The definite hosts of echinococcus are various carnivores; man is an accidental host. The growth of hydatid cysts is usually slow and asymptomatic, and clinical manifestations are caused by compression of the involved organ. CT provides definitive results of diagnosis. It shows hydatid cyst as a spherical, well defined, thin walled, homogeneous and non-enhancing cystic lesion without peripheral oedema. Dowling technic is the most commonly done procedure designed to give birth to the intact cyst by irrigating saline between cyst wall-brain interfaces. Medical treatment can be indicated in multiple locations and in cases with peroperative rupture. Prognosis is often good, but same complications can occur after surgery and depend on the location, the size, the number of cysts and the technique used.
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