Limits...
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

Histopathology shows oligodendroglioma WHO grade 2
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC4129584&req=5

Figure 3: Histopathology shows oligodendroglioma WHO grade 2

Mentions: Patient underwent right frontoparietal craniotomy and near total excision of tumor. He received standard preoperative medication, including phenytoin, dexamethasone antibiotic, and mannitol on the morning of surgery. After the scalp was opened, the tumor was visible anteriorly, and there was destruction of galea and bone was present. Craniotomy was performed by using wide margin around the destroyed calavaria with the use of multiple burr holes. After the bone flap was removed, a large tumor mass was found in the extradural space anteriorly. The dura under this mass was completely intact macroscopically. The extradural mass was easily peeled off the dura. The dura was excised widely around the tumor, and attention was focused on intraparenchymal part of the tumor. Tumor was gray, soft, and friable, and at places, it showed cystic components also. It was moderately vascular and there was no clear plane of margin between tumor and normal brain. Near total excision of tumor was done and dura was repaired with bovine pericardium dural substitute. Bone flap was then inspected and the tumor resected with high speed drill and bone flap was replaced and scalp was closed. Postoperatively, patient kept on elective ventilatory support for 24 hours. Histopathological examination of tumor revealed oligodendroglioma WHO grade-2 [Figure 3].


Multicystic oligodendroglioma with calvarial destruction.

Bajaj A - Asian J Neurosurg (2014)

Histopathology shows oligodendroglioma WHO grade 2
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Figure 3: Histopathology shows oligodendroglioma WHO grade 2
Mentions: Patient underwent right frontoparietal craniotomy and near total excision of tumor. He received standard preoperative medication, including phenytoin, dexamethasone antibiotic, and mannitol on the morning of surgery. After the scalp was opened, the tumor was visible anteriorly, and there was destruction of galea and bone was present. Craniotomy was performed by using wide margin around the destroyed calavaria with the use of multiple burr holes. After the bone flap was removed, a large tumor mass was found in the extradural space anteriorly. The dura under this mass was completely intact macroscopically. The extradural mass was easily peeled off the dura. The dura was excised widely around the tumor, and attention was focused on intraparenchymal part of the tumor. Tumor was gray, soft, and friable, and at places, it showed cystic components also. It was moderately vascular and there was no clear plane of margin between tumor and normal brain. Near total excision of tumor was done and dura was repaired with bovine pericardium dural substitute. Bone flap was then inspected and the tumor resected with high speed drill and bone flap was replaced and scalp was closed. Postoperatively, patient kept on elective ventilatory support for 24 hours. Histopathological examination of tumor revealed oligodendroglioma WHO grade-2 [Figure 3].

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