Showing posts with label Metastasis. Show all posts
Showing posts with label Metastasis. Show all posts
Tuesday, January 29, 2013
Friday, February 26, 2010
Metastatic Squamous Cell Carcinoma
•53 Years old Gentleman
Chronic smoker with underlying COAD
Developed progressive left sided limbs weakness for 2 months, associated with headache.
No other symptoms on systemic review
GCS full, PEARL
Higher mental function intact
No cranial nerves deficit noted
Left hemiparesis 4/5 with no sensory impairment
No cerebellar sign
Other examinations - Normal
MRI showed homogenous enhancing lesion at right motor cortex, left insular and left cerebellum
Chronic smoker with underlying COAD
Developed progressive left sided limbs weakness for 2 months, associated with headache.
No other symptoms on systemic review
GCS full, PEARL
Higher mental function intact
No cranial nerves deficit noted
Left hemiparesis 4/5 with no sensory impairment
No cerebellar sign
Other examinations - Normal
MRI showed homogenous enhancing lesion at right motor cortex, left insular and left cerebellum
Tumour markers done – within normal value
CXR - NAD
CT thorax and abdomen - NAD
•
Right parietal craniotomy and excision of tumour done under IGS transsulcus approach
Right parietal craniotomy and excision of tumour done under IGS transsulcus approach
Post-operatively, his weakness remain same.
On follow-up 2 weeks after surgery his weakness improved
HPE = Metastatic squamous cell carcinoma
Friday, October 16, 2009
Brain Metastasis of Testicular Yolk Sac Tumour
28 Years old Male
Diagnosed Left testicular tumour with lungs metastasis 1 year ago
Underwent left orchidectomy and HPE diagnosis of Yolk sac Tumour
He had completed radiotherapy and chemotherapy
Presented with 1/12 history of progresive left sided body weakness and numbness
Associated with worsening headache
Admitted with 1 episode of generalised tonic clonic seizure
O/E Pink, alert
GCS full
PEARL
BP 120/71
PR 77
Higher mental function intact
No cranial nerves deficit noted
Left hemiparesis 3/5 with sensory impairment
CT scan brain (plain + contrast) done showing homogenous enchanced tomour over right post central gyrus with marked surrounding edema
MRI was performed and he was planned for surgery
He underwent right parietal craniotomy and tumour excision. The tumour was just below a thin grey matter of post central gyrus (detected using intra-operative ultrasound). Post-central gyrus corticotomy done.
The tumour was pink-greyish in colour, soft to firm in consistency, well-circumscribed with surrounding gliotic brain tissue, highly vascular- completely excised
Post-operatively he was extubated and maintained on dexamethasone.
Clinically he still having left hemiparesis power of 3/5
CT scan (plain) post-operative day 1 showing pneumocranium with edema, no post-operative bleeding.
Diagnosed Left testicular tumour with lungs metastasis 1 year ago
Underwent left orchidectomy and HPE diagnosis of Yolk sac Tumour
He had completed radiotherapy and chemotherapy
Presented with 1/12 history of progresive left sided body weakness and numbness
Associated with worsening headache
Admitted with 1 episode of generalised tonic clonic seizure
O/E Pink, alert
GCS full
PEARL
BP 120/71
PR 77
Higher mental function intact
No cranial nerves deficit noted
Left hemiparesis 3/5 with sensory impairment
CT scan brain (plain + contrast) done showing homogenous enchanced tomour over right post central gyrus with marked surrounding edema
MRI was performed and he was planned for surgery
He underwent right parietal craniotomy and tumour excision. The tumour was just below a thin grey matter of post central gyrus (detected using intra-operative ultrasound). Post-central gyrus corticotomy done.
The tumour was pink-greyish in colour, soft to firm in consistency, well-circumscribed with surrounding gliotic brain tissue, highly vascular- completely excised
Post-operatively he was extubated and maintained on dexamethasone.
Clinically he still having left hemiparesis power of 3/5
CT scan (plain) post-operative day 1 showing pneumocranium with edema, no post-operative bleeding.
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