Sudden death due to subarachnoid bleeding from ecchordosis physaliphora

Fracasso, Tony; Brinkmann, B.; Paulus, Werner

doi:10.1007/s00414-007-0192-4

Cited by 34 publications

(27 citation statements)

References 13 publications

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“…The longer the interval between initial factor and its consequences, the more difficult is the identification of the causal chain. For these reasons if at autopsy a lethal subarachnoid bleeding [30] is associated to multiple aneurysms, the forensic pathologist should consider the type of complication described here, even if there exist no direct hints from the previous history.…”

Section: Discussionmentioning

confidence: 90%

Fatal mycotic aneurysm caused by Pseudallescheria boydii after near drowning

et al. 2009

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Pseudallescheria boydii is a rare cause of mycotic infection. Factors predisposing to systemic infection include traumas, immunosuppression, and near drowning. We report a case of multiple aneurysms caused by this hyalohyphomycete, occurred after near drowning. The car driven by a 53-year-old woman plunged into a canal in The Netherlands. After a 20-min-long submersion, the woman was rescued. At hospital, a severe aspiration of muddy water and a mycotic pneumonia were diagnosed. Despite the immediate prescription of a long-term antimycotic therapy and the initial good response, the patient died 4 months later. The autopsy showed a mycotic aneurysm of the abdominal aorta and multiple ruptured mycotic aneurysms of the circle of Willis with fatal subarachnoid bleeding.

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Section: Discussionmentioning

confidence: 90%

Fatal mycotic aneurysm caused by Pseudallescheria boydii after near drowning

et al. 2009

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“…In 1 patient, a fatal subarachnoid hemorrhage from a ruptured EP was believed to be the direct cause of death. 12 In the second patient, the discovered EP had no relation to the cause of death, which was a fatal heart infarction. 1 Among the remaining 16 cases (not including our case), 10 were reported as incidental.…”

Section: Discussionmentioning

confidence: 93%

“…The increased propensity of chordoma cells to multiply and grow is underscored by the relatively higher proliferation index of their MIB-1 proliferation marker, which is another helpful distinguishing feature. 9,12,13,17,19,22,25 Ecchordosis physaliphora, instead, is usually slow growing and therefore rarely causes direct symptoms. It is often discovered incidentally as part of an evaluation for unrelated symptoms.…”

Section: Discussionmentioning

confidence: 99%

“…Ling et al 17 documented the case of a 45-year-old man who presented with left-sided hearing loss and tinnitus, which led to an MR image of the brain demonstrating an incidental 30 × 30 × 14-mm EP. Finally, Fracasso et al 12 reported an unusual case of a fatal subarachnoid hemorrhage due to a ruptured giant EP measuring 3.2 cm that was discovered at autopsy. To our knowledge, ours is the first instance of a giant symptomatic EP in an adolescent.…”

Section: 25mentioning

confidence: 99%

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Giant ecchordosis physaliphora in an adolescent girl

Krisht

Palmer²,

Osborn

et al. 2013

PED

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The authors describe a rare case of giant ecchordosis physaliphora (EP) in a 16-year-old female patient who presented with diplopia. Magnetic resonance imaging of the brain with Gd contrast revealed a 3.0 × 1.7 × 1.8–cm nonenhancing, extraaxial epidural mass along the dorsal aspect of the clivus that was T2 hyperintense and T1 isointense with intermediate signal on diffusion sequences. Resection via a transnasal transsphenoidal approach to the ventral clival wall resulted in a stable tumor size with no evidence of interval growth after 30 months. Although this case features a strictly extradural EP, this tumor more commonly occurs in the subdural space and requires differentiation from intradural chordoma. Unlike EP, intradural chordoma may enhance with Gd contrast, is more likely to be associated with cranial nerve palsies and brainstem symptoms, and will occasionally have an elevated MIB-1 index. In this paper the authors highlight the different possible midline locations for both EP and chordoma, the difficulty in distinguishing between intradural giant EP and intradural chordoma, and the potential occurrence of these lesions in young people despite their typically slow rate of growth, while also underscoring the need for further investigation into the tumors' cytogenetic behavior.

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“…The histology of chordoma is very similar to that of ecchordosis physaliphora [17][18][19]; both consist of vacuolated cells in a myxoid matrix [20]. Chordoma is characterised by neoplastic cell arrangements in cords and lobules within the myxoid matrix and higher EMA and S-100 positivities of about 50-95% [25,26].…”

Section: Discussionmentioning

confidence: 98%