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  • Author: Yu Ma x
  • Basic Medical Science, other x
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Giant malignant peripheral nerve sheath tumors of the occipital scalp

Abstract

Background: Malignant peripheral nerve sheath tumors (MPNST) are rare neoplasms, usually arising from peripheral nerves or showing a nerve sheath differentiation. Primary MPNSTs of the scalp is exceptionally rare, and only sporadic cases have been reported recently.

Objectives: Report a rare case of giant malignant peripheral nerve sheath tumor (MPNST) beneath occipital scalp, and discuss how to treat with this kind of tumor.

Methods: Descriptive study of a rare case of giant peripheral nerve sheath tumors of occipital scalp without adjuvant treatment with nine months follow up.

Results: In a 52-year-old man with MPNSTs beneath occipital scalp, the tumor was treated with complete surgical resection. Histological examination proved that the lesion was a scalp MPNST. The patient was followed up asymptomatic for the following nine months after surgical resection without adjuvant radiotherapy.

Conclusion: MPNSTs beneath the occipital scalp should be treated individually, for those well-circumscribed MPNSTs without bone destruction or brain invasion (low-grade tumors), complete surgical resection with clear margins (if possible) is recommended. Otherwise, adjuvant postoperative radiotherapy is necessary.

Open access
Dumbbell-shaped primary CNS lymphoma involving the hypothalamus and pituitary gland

Abstract

Background: Primary central nervous system lymphoma (PCNSL) involving the hypothalamus and pituitary gland is extremely rare. Therefore, no case to our knowledge has been reported to date.

Objective: We described our findings in a 48-year-old immunocompetent man, who presented with four months progressive diabetes insipidus (DI) and two months subsequent headache.

Methods and Results: A radiological study and magnetic resonance imaging (MRI) suggested a homogeneous enhancing dumbbell-shaped lesion, 2.4⃞1.2 cm in size, involving both the hypothalamus and pituitary gland. A brain biopsy was conducted through a transnasal transsphenoidal approach, and a final histopathological diagnosis of the tumor was confirmed as diffuse large B-cell malignant lymphoma. After extensive tumor surveys, including computed tomography, MRI, ultrasound, bone marrow biopsy, lumbar puncture, and positron emission tomography (PET), no evidence of other lesions found. Subsequently, he received six cycles of intravenous highdose methotrexate-based chemotherapy followed by one cycle of whole-brain radiotherapy. The progressive DI and headache completely resolved and he was in good health 11 months later.

Conclusion: Clinicians should consider the possibility of PCNSL in non specific clinical presentations.

Open access