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Biomedical subjects

M C Sharma

Publications and source records attributed to M C Sharma.

At least 91 records · Page 5Linked to original sources
PubMed2000

Intrasellar tuberculoma--an enigmatic pituitary infection: a series of 18 cases.

OBJECTIVE: Intrasellar tuberculomas are rare and only few case reports have been described in the literature. We report a series of 18 cases of histologically proven intrasellar tuberculomas, which, to the best of our knowledge, is the largest series in the English literature. METHODS: A total of 1143 pituitary lesions, between 1984 and June 1999, were operated for various reasons in our institute. Of these, 18 cases were histopathologically proven intrasellar tuberculomas. The clinical profile was reviewed in detail. Radiological data and histopathological slides were also reviewed. RESULTS: The age ranged from 8 to 43 years (average 23.6 years) with a female preponderance. The duration of symptoms varied from 15 days to 2 years (average 4 months), the most common symptoms being headache followed by decrease or loss of vision. Five patients had features of pan-hypopituitarism whereas three had raised prolactin (PRL) levels. In six patients, both sella as well as sphenoid sinus were involved. In one patient the lesion was extending from the sella over the clivus. Clinically as well as radiologically, these lesions were mistaken for pituitary adenomas except for one case where tuberculoma was suspected on imaging. In three patients, there was past history of pulmonary tuberculosis, in one patient of tuberculous meningitis, and in one patient, of spondilytis of the spine. In one patient there was cervical lymphadenopathy along with features of acromegaly (also proved by high levels of serum growth hormone) and radiology revealed a pituitary pathology. Microscopic examination of the excised lesion revealed a composite lesion consisting of a pituitary adenoma and tuberculoma, which has not been documented in literature to date. One patient died during the hospital stay. All the other patients were put on antitubercular chemotherapy following surgery and had good outcomes. CONCLUSION: Intrasellar tuberculomas are rare. These may be suspected in female patients especially if radiological imaging shows involvement of paranasal sinuses and pituitary fossa along with thickening of pituitary stalk. Simultaneous involvement of clivus may also be an additional feature. The incidence of pituitary tuberculosis is likely to increase with a rise in the incidence of AIDS.

Adolescent↗
PubMed2000

Intracranial adenoid cystic carcinoma--a case report.

Adenoid cystic carcinoma (ACC) is a relatively common malignant neoplasm which occurs in the head and neck region, particularly in the salivary glands. It is a slow growing, locally aggressive neoplasm with a unique feature of perineural spread. Intracranial extension can occur by direct extension, hematogenous metastases or by perineural spread. However, the occurrence of primary intracranial ACC with no evidence of a primary, is rare, with only ten cases reported in reviewed English literature until now. One such case is presented here with brief review of literature. This patient showed a good response to treatment with surgery followed by post-operative radiotherapy and has remained disease free, 32 months after the completion of treatment.

Adult↗
PubMed2000

Orbital drainage from cerebral arteriovenous malformations.

OBJECTIVE: To describe the neuro-ophthalmic findings in patients with orbital drainage from cerebral arteriovenous malformations (AVMs). METHODS: We reviewed the records of 100 consecutive adult patients with cerebral AVMs who presented to our institution during a 4-year period. All patients with orbital drainage were identified, and their neuro-ophthalmic evaluations were reviewed. RESULTS: Three patients (3%) were identified with orbital drainage from a cerebral AVM. The first patient presented with typical chiasmal syndrome (reduced visual acuity, bitemporal hemianopia, and optic atrophy). Magnetic resonance imaging demonstrated a large left temporal and parietal lobe AVM with compression of the chiasm between a large pituitary gland and a markedly enlarged carotid artery. The second patient presented with headaches and postural monocular transient visual obscurations. Examination revealed normal visual function with minimal orbital congestion and asymmetrical disc edema, which was worse in the left eye. Magnetic resonance imaging revealed a large right parietal and occipital lobe AVM without mass effect or hemorrhage and an enlarged left superior ophthalmic vein. The third patient had no visual symptoms and a normal neuro-ophthalmic examination; a right parietal lobe AVM was discovered during an examination for the cause of headaches. CONCLUSION: Orbital drainage from cerebral AVMs is rare. Manifestations may include anterior visual pathway compression, dilated conjunctival veins, orbital congestion, and asymmetrical disc swelling.

Adult↗
PubMed2000

Cerebellar medulloblastoma in a 65 year old Indian male.

A case of cerebellar medulloblastoma in a 65 year old male is reported. Cerebellar medulloblastoma is classically seen during childhood, and less than 25% of these tumours are found in adults below 40 years of age. Rarely, cases are reported above the age of 40 years. So far only three cases have been reported in patients aged above 64 years and none of these case reports are from India.

Adult↗
PubMed2000

An unusual case of primary lymphoma of the skull base extending from cerebellopontine angle to cavernous sinus and orbit. A case report.

The authors describe a rare case of a primary central nervous system lymphoma of the cerebellopontine angle, extending into the right cavernous sinus and orbit. The patient presented with multiple right sided cranial nerve palsies and rapidly progressive proptosis and ophthalmoplegia of the right eye. Imaging revealed a cerebellopontine angle mass extending into cavernous sinus. Surgical decompression of the tumor was undertaken through a right sided retromastoid craniectomy. Histopathology revealed Non Hodgkin's lymphoma of diffuse large cell type. There was no evidence of systemic lymphoma. Primary lymphoma of cerebellopontine angle with direct extension into cavernous sinus and orbit is rare and to our knowledge this is the only case reported.

Adult↗
PubMed2000

Relevance of direct agglutination test in seroepidemiological survey of Kala-azar in epidemic foci of Bihar.

The performance of direct agglutination test (DAT) was evaluated under field conditions in three endemic districts of Bihar. In three villages of these districts, 197 households were surveyed with a population of 1167 individuals. Out of 1167 individuals, 603 were clinically examined for VL and blood samples of each examined individual were collected for DAT. The proportion of DAT positivity in both males (32.33%) and females (32.94%) was statistically not significant (p > 0.05). The proportion of DAT positivity in all age groups was observed to be similar (p > 0.05). The GMRT was observed highest in active VL cases. Out of 20 DAT positive individuals having fever, 5 were examined parasitologically (bone marrow aspiration) and in three cases positivity was observed. This showed the relevance of DAT in early diagnosis of visceral leishmaniasis and usefulness of DAT in field conditions.

Adolescent↗
PubMed2000

Primary intracranial chondrosarcoma--a case report.

Intracranial malignant cartilaginous tumors, not arising from the skull bones are a rare phenomenon, and few cases have been reported till date in literature. We hereby describe one such case treated by us.

Adult↗
PubMed1999

Macular fibrosis associated with talc retinopathy.

PURPOSE: To investigate a patient with talc retinopathy who developed macular fibrosis with resultant visual loss. METHODS: A 64-year-old intravenous drug abuser was evaluated for bilateral peripheral retinal neovascularization. He admitted to abusing oral methylphenidate intravenously. Funduscopy showed numerous intravascular talc particles in the macular area of both eyes. Over a period of next 4 years, visually significant macular fibrosis gradually developed in both eyes, the left eye more than the right eye. RESULTS: Fluorescein angiography confirmed the presence of bilateral peripheral retinal neovascularization with adjacent areas of ischemic retina. The patient was treated with peripheral laser treatment to the ischemic retina with resultant regression of peripheral retinal neovascularization. Bilateral macular fibrosis accounted for the reduced vision in our patient. CONCLUSION: Talc retinopathy can be associated with macular fibrosis with resultant visual loss.

Fibrosis↗
PubMed1999

Choroid plexus papilloma: a clinicopathological study of 23 cases.

BACKGROUND: Choroid plexus papillomas (CPPs) are rare, accounting for less than 1% of all intracranial tumors in adults. However, they are relatively more common in childhood and constitute 1.5 to 4% of intracranial tumors. DESCRIPTION: They are most often located in the lateral ventricle, followed by the fourth and third ventricles and, rarely, in the cerebellopontine angle. The radiological appearance of a CPP as a cyst with a mural nodule is a curiosity. Bone formation is rare in CPPs and only 6 cases have been described in the literature. Neuromelanin production is also extremely rare and only 2 cases have been reported to date. CONCLUSION: In the present communication, 23 cases of CPP are analyzed and rare clinical, pathological, and radiological features are described.

Adolescent↗
PubMed1999

Pituitary adenoma with neuronal choristoma: a report of two rare cases.

Two rare cases of pituitary adenoma with neuronal choristoma are described. Both patients were female and presented with features of acromegaly with elevated growth hormone and prolactin levels. Radiologically, both lesions were predominantly intrasellar in location with extension into suprasellar region, but hypothalamus was not involved. Histopathological examination revealed a mixture of chromophobe pituitary adenoma cells and neuronal cells. In both cases, the adenoma component was positive for growth hormone and prolactin. Interestingly, immunopositivity for alpha-subunit, cytokeratin and prolactin was seen in the adenoma and neuronal cells in one case. Our findings support the hypothesis that the neuronal cells possibly arise from adenoma cells as a result of metaplasia.

Acromegaly↗
PubMed1999

Prepubertal testicular teratomas.

Testicular teratomas in prepubertal children are distinct from adult testicular teratomas as well as from teratomas located elsewhere in the body, both with respect to their pathologic features and biologic behavior. Over a period of 12 years, testicular teratomas comprised 25% (5 of 20) of all testicular tumors in prepubertal children, treated at our institution. Their clinical presentation and pathologic profile was analysed. Their mean age at presentation was 6.7 m (range 1 m to 18 m) with the mass having been noted at birth in 3 infants. The right testis was involved in all except one patient. Serum AFP was elevated preoperatively in only one case with an immature (grade II) teratoma containing fetal liver tissue. Immunohistochemical staining for AFP and alfa-1-antitrypsin were positive in these fetal liver cells. Serum AFP levels returned to normal after orchiectomy in this patient. While a high inguinal orchiectomy was the standard operative procedure, testicular-sparing surgery was planned in the last two patients. However the tumor had replaced the entire testis in one of these patients, while in the other, the mass was homogeneous, with no visible cystic areas or dermal elements on cut section. Hence both of these patients also underwent orchiectomy. Histologic examination and immunohistochemical staining for AFP were performed on the specimen. Peri-tumor testicular parenchyma was found to be unremarkable and did not stain for placental alkaline phosphatase, a marker for carcinoma in situ. All these children are doing well with no evidence of residual or recurrent disease at a mean follow-up of 4.7 years (range 4 m to 11 yrs).

Adolescent↗
PubMed1999

Trends in vitreoretinal surgery at a tertiary referral centre: 1987 to 1996.

AIM: To identify trends in vitreoretinal surgery at a tertiary referral centre from 1987 to 1996. METHODS: A retrospective study of patients who had undergone vitreoretinal surgery at St Paul's Eye Unit over two 6 month periods in 1987 and 1996. Preoperative ocular status, surgery details, and outcome were collected. chi 2 and Mann-Whitney U tests were used to analyse the data. RESULTS: The two periods under study were July to December 1987 and January to June 1996. 110 operations performed during 1987 (96 patients) and 330 operations during 1996 (289 patients) were analysed. There was a fourfold rise in the number of tertiary referrals and a seven-fold rise in the number of operations performed for conditions other than rhegmatogenous retinal detachment (RRD). Increasing indications for surgery included diabetic eye disease, macular hole, dropped nucleus, endophthalmitis, and subretinal neovascular membrane. There was a rise in the proportion of patients with RRD following cataract surgery (from 19.5% to 29.5%). For both primary repair and reoperation, vitrectomy with internal tamponade was more commonly used in 1996. The anatomical success rate for primary repair changed from 76.6% to 84.7% after one operation and from 89.1% to 94.3% following additional surgery. CONCLUSIONS: This study points to a trend towards subspecialisation and tertiary referral in vitreoretinal surgery. Vitrectomy techniques are more commonly used for the primary repair of RRD and are applied to a wider spectrum of diseases.

Humans↗
PubMed1999

Spectrum of cystic variants of Wilm's tumour: cystic nephroma (multilocular cyst) and cystic partially differentiated nephroma--a report of four cases.

Two cases of cystic nephroma (multilocular cyst of the kidney), and one case each of cystic partially differentiated nephroblastoma (CPDN) and rhabdomyomatous Wilms' tumour are described. All were male and in the pediatric age group. Grossly tumours were unilateral, unicentric and multiloculated. The need for proper designation of these lesions is highlighted because of difference in the treatment and prognosis of these tumours.

Child, Preschool↗