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Multicystic oligodendroglioma with calvarial destruction.

Bajaj A - Asian J Neurosurg (2014)

Bottom Line: There was history of slowly progressive decreased vision in both eyes leading to complete blindness in both eyes for the past one month.There was no recurrence of seizure at nine month of follow-up.However, the final diagnosis is established by means of histopathological examination.

View Article: PubMed Central - PubMed

Affiliation: Department of Neurosurgery, Brijlal Hospital and research Centre, Haldwani, Uttrakhand, India.

ABSTRACT

Context: Calvarial erosion is known to occur with some superficially located tumors. Very few case reports of calvarial erosion associated with oligodendroglioma are reported in the literature, but calvarial destruction with oligodendroglioma is very rare.

Aim: To report an unusual case of multicystic frontoparietal oligodendroglioma with destruction of the calvaria and scalp involvement in the absence of prior surgery or radiation.

Materials and methods: A 30-year-old male presented with the history of left focal seizure with secondary generalization for last three to four years along with left sided weakness for the past one month. There was history of slowly progressive decreased vision in both eyes leading to complete blindness in both eyes for the past one month. On neurological examination, patient had left hemiparesis of grade-2/5 with perception of light absent in both eyes. Fundus examination revealed bilateral optic atrophy. Magnetic resonance imaging (MRI) of the brain showed a large supratentorial heterogenous multicystic ring enhancing mass lesion involving right frontal lobe, right frontotemporal opercular region, and posteriorly abutting the central sulcus and anteriorly destroying the calvaria. Patient underwent right frontoparietal craniotomy and near total excision of tumor. Histopathological examination revealed oligodendroglioma WHO grade-2. Patient received postoperative chemoradiotherapy.

Results: At nine month follow-up patient neurological status was same and his seizure was controlled on single AED. There was no recurrence of seizure at nine month of follow-up.

Conclusions: Calvarial destruction in association with extra and intra axial neoplasm should include oligodendroglioma especially in patients with long history of symptoms, although calvarial destruction is very rare. However, the final diagnosis is established by means of histopathological examination.

No MeSH data available.


Related in: MedlinePlus

Postcontrast T2W saggital image showing vertical extent of tumor
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Figure 2: Postcontrast T2W saggital image showing vertical extent of tumor

Mentions: Magnetic resonance imaging (MRI) of the brain showed a large supratentorial heterogenous multicystic ring enhancing mass lesion involving right frontal lobe, right frontotemporal opercular region, and posteriorly abutting the central sulcus [Figures 1 and 2]. The lesion was hyperintense on T2WI and FLAIR images. The lesion was showing multiple cystic components of various sizes with smaller solid component abutting the dura peripherally; largest cyst showing ring enhancement with enhancing mural nodule in the superior aspect of the lesion. There was mild perilesional oedema and marked mass effect seen causing compression of right lateral ventricle and producing significant midline shift towards left side.


Multicystic oligodendroglioma with calvarial destruction.

Bajaj A - Asian J Neurosurg (2014)

Postcontrast T2W saggital image showing vertical extent of tumor
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4129584&req=5

Figure 2: Postcontrast T2W saggital image showing vertical extent of tumor
Mentions: Magnetic resonance imaging (MRI) of the brain showed a large supratentorial heterogenous multicystic ring enhancing mass lesion involving right frontal lobe, right frontotemporal opercular region, and posteriorly abutting the central sulcus [Figures 1 and 2]. The lesion was hyperintense on T2WI and FLAIR images. The lesion was showing multiple cystic components of various sizes with smaller solid component abutting the dura peripherally; largest cyst showing ring enhancement with enhancing mural nodule in the superior aspect of the lesion. There was mild perilesional oedema and marked mass effect seen causing compression of right lateral ventricle and producing significant midline shift towards left side.

Bottom Line: There was history of slowly progressive decreased vision in both eyes leading to complete blindness in both eyes for the past one month.There was no recurrence of seizure at nine month of follow-up.However, the final diagnosis is established by means of histopathological examination.

View Article: PubMed Central - PubMed

Affiliation: Department of Neurosurgery, Brijlal Hospital and research Centre, Haldwani, Uttrakhand, India.

ABSTRACT

Context: Calvarial erosion is known to occur with some superficially located tumors. Very few case reports of calvarial erosion associated with oligodendroglioma are reported in the literature, but calvarial destruction with oligodendroglioma is very rare.

Aim: To report an unusual case of multicystic frontoparietal oligodendroglioma with destruction of the calvaria and scalp involvement in the absence of prior surgery or radiation.

Materials and methods: A 30-year-old male presented with the history of left focal seizure with secondary generalization for last three to four years along with left sided weakness for the past one month. There was history of slowly progressive decreased vision in both eyes leading to complete blindness in both eyes for the past one month. On neurological examination, patient had left hemiparesis of grade-2/5 with perception of light absent in both eyes. Fundus examination revealed bilateral optic atrophy. Magnetic resonance imaging (MRI) of the brain showed a large supratentorial heterogenous multicystic ring enhancing mass lesion involving right frontal lobe, right frontotemporal opercular region, and posteriorly abutting the central sulcus and anteriorly destroying the calvaria. Patient underwent right frontoparietal craniotomy and near total excision of tumor. Histopathological examination revealed oligodendroglioma WHO grade-2. Patient received postoperative chemoradiotherapy.

Results: At nine month follow-up patient neurological status was same and his seizure was controlled on single AED. There was no recurrence of seizure at nine month of follow-up.

Conclusions: Calvarial destruction in association with extra and intra axial neoplasm should include oligodendroglioma especially in patients with long history of symptoms, although calvarial destruction is very rare. However, the final diagnosis is established by means of histopathological examination.

No MeSH data available.


Related in: MedlinePlus