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Primary Pituitary Abscess Gland Mimicking Adenoma: A Rare Case Report

Open Journal of Modern Neurosurgery 2022年第3期12卷 167-174页

作者： Dimbi Jose Alingar Djimrabeye Mehdi Hakkou adyl melhaoui Abdessamad el Ouahabi Service de neurochirurgie de l’H?pital Des Spécialités Rabat Morocco Faculté de médecine et pharmacie Université Mohamed V Rabat Morocco

Pituitary abscess gland is an uncommon lesion on sellar region. Clinical diagnosis is not easy to make and it is difficult to make difference from other pituitary lesions on clinical and sometimes on Neuroimaging. This pathology is characterized by vague symptoms, headaches, generalized tiredness and hypopituitarism manifestations. A 35-year-old woman was admitted to neurosurgery with complaints of headaches and blurred vision. MRI of the head revealed a suprasellar mass that was centrally hyperintense lesion on T2-weighted images with peripheral hypointensity. Treatment of the lesion of this lesion pituitary area through a transsphenoidal approach and spectrum antibiotic therapy with ceftriaxone metronidazole and vancomycin for 6 weeks. The patient continues to have pituitary insufficiency and is treated with oral hydrocortisone. After the diagnosis, the surgery and antibiotics should be commenced rapidly. Our aim is to report this rare case and to show how sometimes it is difficult to make diagnosis and clinical features vary mimicking other pituitary lesions before pre-operative and how to manage pituitary abscess gland. The outcome is usually good with proper treatment.

关键词： Pituitary Abscess Endoscopy Transsphenoidal Antibiotics

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Spheno-Temporal Langerhans Cell Histiocytosis: A Case Report

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Open Journal of Modern Neurosurgery 2020年第2期10卷 260-266页

作者： Christine Milena Sayore Nda Bankole Loubna Rifi Nadia Cherradi adyl melhaoui Abdessamad Elouahabi Department of Neurosurgery Mohamed V University Rabat Morocco Department of Histopathology Mohamed V University Rabat Morocco

Langerhans cell histiocytosis (LCH) is a proliferation of Langerhans cells with inflammatory cells, characterized by the activation of histiocytic cells or their proliferation that affects structures of the human body, including the temporal bone which localization is rare in children. The objective of this study is to illustrate the clinical presentation, management and prognosis of this disease, and to compare our case with previously reported series. We report the case of a young 4-year-old patient with a history of otorrhea and recurrent otalgia, with left axillary non-blowing exophthalmia progressive since 5 months associated with indurated left temporal swelling and also an indurated swelling of posterior face of the left shoulder on pathological fracture. A cerebro-orbital MRI performed at home showed an extra-conical process with extension at the temporal fossa. The patient, then, underwent an open-air biopsy of the temporal mass and the pathological analysis returned to favor Langerhans cell histiocytosis. The diagnosis was made by immunohistochemical findings of the S-100 protein and/or the CD1 antigen. The child was treated by chemotherapy with a good outcome. Our results concord with literature. The prognosis is different and better in children with unifocal bone disease than those with a multifocal disease with a survival rate of 65% - 100%.

关键词： Langerhans Cell Histocytosis Temporal Sphenoid Exophthalmia

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Extracranial Metastasis of an Anaplastic Ependymoma, RELA Fusion-Positive: A Rare Occurrence

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Open Journal of Modern Neurosurgery 2020年第1期10卷 9-18页

作者： Christine Milena Sayore Nabil Adio Mousse Mohammed Yassaad Oudrhiri Nadia Cherradi adyl melhaoui Abdessamad El Ouahabi Department of Neurosurgery Mohamed V University Rabat Morocco Department of Histopathology Mohamed V University Rabat Morocco

Primary intracranial ependymomas originate from ependymal cells. They may migrate mainly in the spinal cord but rarely metastasize outside the central nervous system. Metastases outside the central nervous system are rare. Metastatic diffusion from the central nervous system is low due to the unique interaction of the brain and the tumor with the blood-brain barrier. Nevertheless, three main hypotheses have been mentioned in the literature, the tumor growth, the surgical manipulation (which may be considered to be the case in our patient), and the aggressiveness of the tumor according to the Ki67 index. We report the case of a 16-year-old female, who underwent complete surgical removal of a left occipital 2007 WHO grade II ependymoma. 3 years later, the patient presented multiple cervical and occipital indurated masses. MRI showed a left hemispheric meningeal infiltration, with multiple nodules located on the neck, occiput and mastoid. Histopathological study of a left temporal surgical biopsy and resection of an occipital subcutaneous nodule turned to be metastases of an anaplastic ependymoma. The ependymoma considered as a benign tumor could very quickly turn into malignancy by its metastatic potential. Early diagnosis and longer follow-up of patients would be recommended for a rapid management.

关键词： Anaplastic Ependymoma Extracranial Metastasis Extraneural RELA Fusion

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