Afonso Antoniuk

Carcinoma de plexo coróide: relato de quinze casos

Choroid plexus carcinoma (CPC) are rare central nervous system tumours derived from choroid plexus epithelium, affecting mainly children under 3 years of age. We present a clinical, epidemiological and histopathological study of 15 cases of CPC. Ten patients were male. Age ranged from 4 months to 21 years (mean=3,4). The lateral ventricles were affected in 73,3% of cases. Main symptom were: hydrocephalus (62.5%), intracranial hypertension (25%) and convulsion (12.5%). The patients were treated by surgery with partial resection in 75% of cases and total resection in 25%. There was one death due to surgical complication, 85.7% of patients had recurrence of tumours with mean survival rate of 13.6% months after diagnosis. Only one patient remain alive 5 years after initial treatment. These results support the poor prognosis and high mortality rate of CPC.Choroid plexus carcinoma (CPC) are rare central nervous system tumours derived from choroid plexus epithelium, affecting mainly children under 3 years of age. We present a clinical, epidemiological and histopathological study of 15 cases of CPC. Ten patients were male. Age ranged from 4 months to 21 years (mean=3,4). The lateral ventricles were affected in 73,3% of cases. Main symptom were: hydrocephalus (62.5%), intracranial hypertension (25%) and convulsion (12.5%). The patients were treated by surgery with partial resection in 75% of cases and total resection in 25%. There was one death due to surgical complication, 85.7% of patients had recurrence of tumours with mean survival rate of 13.6% months after diagnosis. Only one patient remain alive 5 years after initial treatment. These results support the poor prognosis and high mortality rate of CPC.

Craniofaringiomas: achados clínicos, epidemiológicos e anatomopatológicos de 25 casos

We report the clinical and pathological findings of 25 cases of craniopharyngiomas. Fourteen patients were males and 11 were females. The ages ranged between 3 and 64 years, with a mean of 30.52 years. The symptoms reflected the growth and topography of the tumours; visual disorders (72%), headache (68%), vomits (40%) and papilledema (24%) were the most frequent symptoms. Twelve cases were suprasellar; 10 tumours arose from sellar region, from which 8 presented suprasellar extension; frontal lobe (n = 2) and ponto cererebellar angle (n = 1) were also affected. Eleven patients undergone total resection of the tumor and 14 were submitted to partial resection, from which 1 received adjuvant chemotherapy. The overall recurrence rate was 48%. Eight recurrences were observed in the patients submitted to partial resection and 4 in which total resection were performed. These results are similar with the literature, corroborating to the extension of residual tumour after the surgical resection as the main prognostic factor for this neoplasm.

Oligodendrogliomas: estudo anatomopatológico e clínico de 15 casos

Oligodendrogliomas account for 4-5% of primary central nervous system tumours with a slow and infiltrative growth. We report the clinical and pathological findings of 15 cases of oligodendrogliomas. Eight patients were males and 7 were females. The ages ranged between 17 and 66 years, with a mean of 39.73 years. The symptoms reflected the growth and topography of the tumours; migraine (60%) and seizures (60%) were the most frequent symptoms. Frontal (n=6), parietal (n=2), temporal (n=1) and occipital (n=1) lobes were affected. Five patients undergone total resection of the tumor and 10 were submitted to partial resection, from which 3 received adjuvant radiotherapy, 1 adjuvant chemotherapy and 1 chemotherapy and radiotherapy. The overall recurrence rate was 60% for a 32 month follow up. Five recurrences were observed in patients submitted only to the surgical treatment and 4 in which adjuvant radio or chemotherapy were performed. These results are similar with the literature and may contribute to further understanding the biological behavior of these rare tumours.

Ependimomas: achados clínicos, epidemiológicos e anatomopatológicos de 22 casos

Ependymomas are composed of neoplastic ependymal cells, affecting mainly children and young adults. We report the clinical and pathological findings of 22 cases of ependymomas. Fourteen patients were males and 8 were females. The ages ranged between 1 and 58 years, with a mean of 24.63 years. The symptoms reflected the growth and topography of the tumours; muscle weakness (59.1%), gait disorders (36.3%), sensitive disorders (36.3%), hyperreflexia and intracranial hypertension syndrome were the most frequent symptoms. Ten tumours affected the medulla, 7 the cerebral hemispheres, 2 the cerebral ventricles and 1 brain stem. Seven patients were submitted total resection of the tumor, from which one received adjuvant radiotherapy. 15 other patients were submitted to partial resection; from which 4 received adjuvant radiotherapy, 3 adjuvant chemotherapy and 1 chemotherapy and radiotherapy. The recurrence rate was 18.2%. These results are similar with the literature and may contribute to further understanding the biological behavior of these tumours.Ependimomas sao neoplasias compostas por celulas ependimarias neoplasicas, manifestando-se predominantemente em criancas e adultos jovens. Relatamos os achados clinicos, epidemiologicos e anatomopatologicos de 22 casos de ependimomas. Dos 22 casos analisados, 14 ocorreram em pacientes do sexo masculino e 8 em pacientes femininos. As idades variaram de 1 a 58 anos, com media de 24,63 anos. Quanto a localizacao, 10 casos acometeram medula, 7 ocorreram em hemisferios cerebrais, 2 intraventriculares e 1 no tronco cerebral. Os sinais e sintomas observados incluiram reducao da forca muscular (59,1% dos pacientes), alteracoes da marcha (36,3%), alteracoes da sensibilidade(36,3%), hiperreflexia e sindrome de hipertensao endocraniana, com periodo de evolucao variando de 15 dias a 8 anos, com media de 17,58 meses. Sete pacientes foram submetidos a resseccao cirurgica total , 7 a exerese parcial, 4 a exerese parcial associada a radioterapia adjuvante, 3 a resseccao parcial seguida de quimioterapia e 1 a tumorectomia total associada a radioterapia. Evidenciou-se taxa de recidiva tumoral total de 18,2%. Estes achados aproximam-se dos encontrados na literatura internacional, corroborando para a compreensao do comportamento biologico deste tumor.