Among adult patients with supratentorial GBM, female sex and histopathological characteristics consistent with giant cell GBM may be predictive of a better survival rate, as may traditional factors (that is, younger age, good KPS score, more aggressive resection, and a long progression-free interval).
We report an unusual pedunculated polyp in the stomach in a 41-year-old woman. She was hospitalized because of epigastric discomfort. Endoscopy revealed a polyp with a long stalk in the fundus of the stomach. The polypectomyzed polyp measured 23 x 18 x 9 mm and was characterized by submucosal proliferation of glands and cystic dilatation. The surface of the polyp was covered with gastric mucosa of fundic or pyloric gland type. The glandular structures consisted of various types of lining cells, including pyloric or mucous-neck cell type, surface mucous (foveolar) cell type, parietal-like cells, and somatostatin-positive cells. The submucosal glandular or cystic elements were connected with the overlying gastric mucosa through a defect of the muscularis mucosa, suggesting that this polyp may have been formed by the heterotopic inverted downgrowth of mucous glands into the submucosa. We discuss the histogenesis of this rare polyp and present a review of the literature.
Myofibroblastoma is a rare type of benign mesenchymal tumor; only two cases of intracranial myofibroblastoma have been reported in the literature. The authors report on the case of a 34-year-old woman with a myofibroblastoma in the suprasellar region who presented with the complaint of sudden onset of headache followed within 2 weeks by progressively worsening visual disturbance. Computerized tomography scanning demonstrated a mixed low- and high-density mass in the suprasellar region and contrast-enhanced magnetic resonance imaging revealed the mass to be of mixed intensity with heterogeneous enhancement. The tumor was subtotally removed via a right frontobasal translamina-terminalis approach and her vision improved immediately. Histologically, the tumor was characterized by alternating areas of spindle-shaped and round cells that were separated by collagen fibers. The diagnosis of myofibroblastoma was based on the tumor's intense immunoreactivity for alpha-smooth-muscle actin and the ultrastructural identification of myofibroblasts. The tumor was thought to have originated from the meninges in the suprasellar region.
Intracranial intraparenchymal schwannomas are rare. We report three patients with an intracranial intraparenchymal schwannoma and discuss the clinical and neuroradiological aspects of this particular tumour. The patients were a 21-year-old male, a 64-year-old female and a 17-year-old male. The tumours were located in cerebrum in two patients and the cerebellum in one patient. Computerized tomography (CT) scans demonstrated a slightly high density area with homogeneous enhancement by contrast medium. Magnetic resonance imaging (MRI) showed slightly low signal intensity on the T1-weighted image, high or mixed signal intensity on the T2-weighted image and homogeneous enhancement by gadolinium diethylene triamine penta-acetic acid (Gd-DTPA). Radiological studies revealed cystic components in 2 of the 3 patients. All tumours were firm, well-demarcated, and completely removed. The diagnosis of schwannoma was derived from histological and immunohistochemical studies in all 3 cases; 2 cases were also examined by electron microscopy.
Although the degree of permanence of this embolization material is yet unknown, the mixture was easy to handle, and appeared safe and effective for AVM embolization. Its nonadhesive characteristic and its ability to be infused by repeated injections make it an attractive alternative to currently available materials. The good results obtained in this study led us to undertake a clinical trial, the results of which are contained in a companion article in this issue of the Journal of Neurosurgery.
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