Intrasellar cavernous hemangiomas: A case report with a comprehensive review of the literature

Background: Extra-axial cerebral cavernous hemangiomas particularly those found in the sellar region, are extremely rare. Their clinical manifestations and imaging characteristics can mimic those of a pituitary adenoma thus making preoperative diagnosis difficult. Few cases are reported in the literature. We present a case, along with a comprehensive review of the literature regarding specific aspects of diagnosis and management of all similarly reported rare cases. Case Description: We present the clinical, radiological, and operative data of a rare case of a large intrasellar cavernous hemangioma in a 49-year-old female patient presented with headache and diminution of vision, which was diagnosed intraoperatively during an endonasal endoscopic transsphenoidal approach. Subtotal debulking was performed with immediate postoperative clinical improvement. The patient was then referred for radiotherapy and maintained her clinical improvement since then. Conclusion: Neurosurgeons should consider this rare pathology in the preoperative differential diagnosis of sellar tumors. Bright hyperintense T2 signal with or without signal voids associated with centripetal delayed contrast enhancement in magnetic resonance imaging images might raise the suspicion which can be further confirmed intraoperatively with frozen sections. Due the reported high vascularity and intraoperative profuse bleeding leading to high operative morbidities, piecemeal subtotal resection followed by radiosurgery may be considered today as the safest and most effective strategy.

Delayed Contrast Enhancement On Cardiac MRI In a CASE of Steinert Disease: A Case Report

Type 1 myotonic dystrophy (Steinert’s disease) is a genetic syndrome characterized by progressive muscular weakness and multisystemic repercussions. Cardiac conduction abnormalities are frequently seen, but the incidence of dilated cardiomyopathy and heart failure seems to be less common. Current evidence suggests that subclinical cardiomyopathy can be demonstrated by means of cardiac magnetic resonance imaging (CMRI). We present a 31-year-old man with genetically established muscular dystrophy 1 and no signs of cardiac involvement. CMRI revealed intramyocardial and pericardial contrast uptake in some regions. The meaning of these findings should be investigated in order to understand and prevent future complications.

Extra-pleural solitary fibrous tumors: a review

Solitary fibrous tumor (SFT) is a rare mesenchymal ubiquitous tumor reported in the pleura and a wide variety of extrapleural locations, most frequently in the orbits and extremities. Approximately 78–88% of SFTs are benign and 12–22% are malignant. Although tumor characteristics are highly dependent on the location there are unifying features in MR imaging suggesting SFT: well-circumscribed, often lobulated nodular lesion, delayed contrast enhancement and the presence of fibrous contents which are hypointense on T1 and T2-weighted MRI imaging. There are many SFT differential diagnosis, highly dependent to the tumor location. Due to its rarity the diagnosis of extrapleural SFTs may be challenging. Histopathologic analysis is always required to confirm the diagnosis and to allow the distinction between the benign and malignant forms. We review pleural and extrapleural SFTs, presenting diagnostic clues, differential diagnosis and prognostic factors.