|
The patient came to the clinic 08-April-2006 from YAR complaining of
headache for 1 month with blurring vision, loss of concentration
with difficult nominal memory with decreased hearing left side. She
is in enalepril twice daily for one month. Her sister is
pediatrician, and she was giving her mannitol 40 gm i.v 8 hourly,
zantac 50 mg twice and decadron 8 mg 8 hourly. The patient was sent
to MRI investigation and a mass in the left occipital lobe was
diagnosed. On examination, the patient had only right sided paresis
more in the distal muscles. The patient was operated in the
setting position. Considering the localization of the mass, which
was near the calcarine artery and polycystic nature, and severe
surrounding oedema, it was decided to attack the tumor directly
through transcortical approach. This decision was made so as to
avoid any traction injury to the visual structures. Considering the
high upward expansion of the tumor, it was decided that
supratentorial approach will not be the wise one. The tumor was
found 20 mm under the surface and it had clear margins with rubbery
blue-yellowish highly vascular consistency.
Radical removal of the tumor was performed without violating the
posterior horns, preserving during that the calcarine artery, which
was the main feeder of the mass. Intraoperative histologic
verification, confirmed the presence of metastatic carcinoma, which
will be exposed for further investigations for more accurate
diagnosis.
Routine closure with smooth postoperative recovery. For
detailed theoretical references about metastatic brain tumors,
click here!
For detailed theoretical reference about glioblastoma
multiforme,
click here!
17-April-2006: The final
result of permanent and immunostaining studies was glioblastoma
multiforme, since: EMA was negative
Pancytokeratine was negative
Ki-67: 10%
GFAP was positive. |
